Pennsylvania lawmakers know that a crisis in dementia care is looming. Will they agree to an answer? Featured sound system


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HARRISBURG – Democratic Gov. Tom Wolf said this week he was backing large investments to address a growing dementia care crisis in one of the country’s most aging states, including millions to support contested reforms of the struggling elderly care industry in Pennsylvania.

But the governor offered no concrete figures for the total investment needed and no insight into the political path forward through the GOP-led General Assembly. For their part, legislative leaders declined to comment on what, if anything, needs to be done.

Wolf’s comments come in response to a recent Spotlight PA and PublicSource survey which found that the state is sadly unprepared to meet the growing need for dementia services and the toll it will take on providers and family caregivers. .

Among other things, the survey found that few state-approved long-term care facilities have dementia-specific accommodation, nursing homes are understaffed, and care costs are unusually low. students.

Key action items of a state-commissioned preparedness plan remain incomplete or have yet to begin seven years later, while a working group formed by Wolf in 2018 to lead the work has failed. no money at their disposal, slowing progress as the emergency increases.

Task Force chair Jennifer Holcomb said action was desperately needed.

“The problem is now,” said Holcomb. “It’s today. It’s not coming, it’s here.

The Pennsylvania Department of Aging – which oversees the task force – attributes the slow progress to a lack of resources, even as its demands for funding from the legislature for dementia-related initiatives have remained steady.

Wolf’s office told Spotlight PA the governor welcomed funding to support the task force’s “critical work”, but noted that it should be cleared by the General Assembly as part of the budget process. .

Although older voters are a much sought after constituency by both parties, legislative support has not been guaranteed. In 2012, a bill that would have kicked off the state’s preparedness plan failed to gain majority support, in part because it included independent regulations on the tanning industry. in the room that aroused opposition. Then-Gov. Tom Corbett single-handedly started the planning process months later by executive order.

Overall, advocates say meaningful dementia-related legislation remains a rarity in Pennsylvania, with offerings traditionally focused more on raising public awareness than solving public policy failures.

A bill to create a public awareness and education campaign for the early diagnosis of Alzheimer’s disease and dementia disorders was passed by State House in June with a single vote against and is in awaiting review in the Senate.

But experts said that while awareness is important, the problem requires tangible resources.

This includes more investment in frontline work done outside of nursing homes and collective care facilities, places generally considered to be of last resort.

“The only reason I have a job and the other social workers we just hired have jobs is because of philanthropy,” said Alison Lynn of the Penn Memory Center in Philadelphia, noting that the The economics of care often discourages more proactive services and interventions.

“Our jobs are fully funded by donations because we cannot charge [insurers] for the types of services we provide, overall.

President Joe Biden wants to inject $ 400 billion into home care programs, which help dementia patients and others nationwide, but the effort remains in limbo.

In Pennsylvania, Democratic lawmakers have said efforts to address the impending dementia care crisis in the state could also be funded by a rare state budget surplus backed by a windfall of federal relief money. COVID-19 which has been mainly hijacked by Republican leaders.

“To ignore the lack of support for people with dementia and the facilities that provide their treatment and care while we are making these allowances is unreasonable,” said Senator Maria Collett (D., Montgomery), former healthcare nurse. long-term and minority chair of the State Senate Committee on Aging and Youth.

Other leaders of the Aging and Youth Committee and the State House Elderly and Elderly Services Committee did not respond to requests for comment.

About $ 315 million was allocated to nursing homes, assisted living communities and personal care homes in this year’s budget – $ 282 million of the state’s $ 7.29 billion share into the federal bailout money.

Collett and Wolf – who signed the budget into law – said the amount was nowhere near enough.

Across the aisle, House GOP spokesman Jason Gottesman said the Republicans’ “cautious” approach to spending Pennsylvania’s stimulus funds was a bulwark against future economic turmoil.

While dementia patients with severe symptoms in nursing homes are more likely to require specialist care in secure memory care units, many more will have milder symptoms and live in traditional units with less. guarantees – at least until their symptoms progress.

Wolf’s office said the regulations proposed in June would have a dramatic impact on the quality of care that state-approved homes receive.

The regulations would increase the time workers in these facilities spend with patients to the federally recommended minimum of 4.1 hours per day. Pennsylvania currently requires nursing homes to provide residents with 2.7 hours of “direct care” per day.

Achieving the higher quota would force senior care homes to spend significantly more on staff, resulting in reluctance from some in the industry.

Zach Shamberg, CEO of the Pennsylvania Health Care Association, which represents for-profit elderly care facilities, called the proposed benchmark “unattainable.”

LeadingAge PA, an advocacy group for nonprofit providers, questioned the timeline, citing advancements in technology and other innovations that it says allow nursing homes to do more with less.

Wolf spokeswoman Lyndsay Kensinger defended the plan, telling Spotlight PA in an email that the administration would offset hundreds of millions of dollars in compliance costs by increasing reimbursements from Medicaid, a major donor. funds dementia services in nursing homes across the state.

“If this regulation is approved through the regulatory process, it will be funded,” Kensinger said, adding that the administration would use both state and federal funds. “The estimated cost of the increase is $ 385.7 million in total funds, including $ 182.5 million in public funds.”

Shamberg at the PHCA isn’t sold, saying Medicaid reimbursements to nursing homes are already less than about $ 50 per resident per day, adding, “This underfunding needs to be corrected first.”

Jason Thompson, spokesperson for Pro Tempore Senate Speaker Jake Corman (R., Center), echoed the criticism. He said facilities need “the flexibility to deal with these difficult and unique financial circumstances – no unfunded mandates from the state.”

Kim Jackson, a Service Employees International Union-affiliated nurse at a Pennsylvania retirement home, supports the Wolf administration’s proposal, but doubts it will work without a raise – something Wolf also advocates.

“It’s not doable because they don’t pay wages high enough that people live and live in poverty,” Jackson said.

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