Feb. 1, 2006

FOR IMMEDIATE RELEASE

Contact: Lauren Shaham, AAHSA, (202) 508-1219


AAHSA Statement: An Open Letter to the President of the United States in Response to the State of the Union

The President
The White House
Washington, DC 20500

Dear Mr. President:

The annual State of the Union event is the centerpiece symbol of how America works. It gives me chills when the Sergeant at Arms announces "The President of the United States." The cheers, people on both sides of the aisle clamoring for the President's handshake. Even in tough times, the ritual is the same. All differences aside, poll numbers notwithstanding, the State of the Union event summarizes our country's hopes, plans and values. It is the symbolic act of leadership and accountability in a free society.

This year's State of the Union event was no different. The context of war always casts a pall over every other issue the country faces. It preoccupies everyone and exhausts us emotionally. From the time you stood up on the rubble in New York after Sept. 11, your arm around that firefighter, all of us united behind you. We were all afraid, yet inspired that no one will get away with threats to the United States of America. Now, we are into the tough part of it. We never like the tough part. None of us can imagine the responsibility you shoulder every day. We pray for wisdom for you—and for safety for those soldiers and their families in the crosshairs of battle—and comfort for those who have faced loss.

I work in a world called long-term care, which might seem relatively unimportant under the circumstances. But I invite you to look at it differently. We are the professionals who take care of America's Greatest Generation and their spouses. These are the people who helped us achieve the security and prosperity we enjoy today. While everyone talks about the spectra of the economic impact of the "Boomers," we almost forget this Greatest Generation era that strengthened America's values and assured its leadership role in the world.

My late parents—born in the Depression, and maturing in World War II—used to say they "had to make do with what we had." Rationing, belt tightening, stretching every dollar—this was a way of life for them. Today, these Greatest Generation people are in their 80's and 90's. They are nursing home residents, federally assisted low income housing residents, older people and their families living at home, some with dementia and Parkinson's. Many are on Medicaid. They have needs today! They can't wait for the health care system to be studied by yet another bipartisan commission charged to examine the needs of a future generation instead of their own.

As they are accustomed to rationing, this generation quietly accepts the consequences of inadequate Medicaid reimbursement in many states. Did you know that many nursing homes in America are expected to deliver quality care with reimbursement at the equivalent of $4-5 per hour? Policy leaders within your own Administration agree that today's Medicaid reimbursement system is inadequate and is subsidized by Medicare, which is, as you noted, at risk of insolvency.

Your policy direction is rightfully investing more funds in programs so people can stay at home and receive services there. In fact, more funds should be channeled into these initiatives to assist the older people on waiting lists for these services. Another form of rationing softly accepted. And there are services such as respite and adult day care that can play a more important part of a long-term care system.

Your policy directive around technology is on target. The electronic health record is essential to quality of care and cost containment in long-term care. But the plan needs to include technology support for health monitoring in the home, a portable health record card that seniors and their families can take anywhere—like the military and the Veteran's Administration have already implemented. The lack of such a technology plan means that we have Alzheimer's patients evacuated from Hurricane Katrina to other states and no one knows their names.

Those who provide services today need help with technology to document good care, monitor complex health conditions and manage quality improvement plans, an emphasis of your Administration. Many problems facing nursing homes and causing tremendous public concern could be solved through technology applications if reimbursement provided even modest capital for these changes. Ultimately, these technology applications will save precious health care dollars and improve quality of life.

The Greatest Generation — accustomed to rationing — is part of the group of nine older people on a waiting list for every U.S. Department of Housing and Urban Development (HUD) 202 apartment in America. You have rightfully stressed home ownership for younger American families, but I'd also ask you to consider expanding the vision so that enormously successful HUD programs can be retooled to use additional capital for the generation that gave birth to the baby boomers. As you charge a bipartisan commission with examining how Medicare, Medicaid and Social Security will be impacted by baby boomers' impending retirement, I urge you to mandate the group to explore how expanded affordable housing with services can leverage the dollars in all three systems to meet consumer needs, improve choice and reduce costs for care of retirees.

The long-term care vision for the Greatest Generation and baby boom generation is consumer and home-centered care, where families and caregivers can be supported in the place they call home. When this vision becomes reality, elders will have access to people, technology and providers that keep them connected to their physicians, the community networks who serve them, and their loved ones. They will be able to choose where they want to live and receive services. They will be able to expect quality as a given.

That vision can be a short-term reality if we have the will and the imagination. In fact, Louisiana and Mississippi would be great places to create this new vision. Community networks of caring through the reorganization of traditional and new partners could redirect funds to create a better long-term care system in the Gulf States. God only knows that help is needed urgently in that region.

The transition from today's broken long-term care system to a new era of consumer centered care cannot morally be paved with a cutback, make-do, rationing strategy on the backs of the Greatest Generation — whose efforts brought us the freedom and prosperity we enjoy today.

We'd like to help advance a better vision. It is needed now—and for the future. We represent the not-for-profit, mission driven sector — and that's our shared responsibility with you, the Congress, our states and the people we serve.


Respectfully Submitted,

Larry Minnix, AAHSA President & CEO

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About AAHSA
The members of the American Association of Homes and Services for the Aging (www.aahsa.org) help millions of individuals and their families every day through mission-driven, not-for-profit organizations dedicated to providing the services that people need, when they need them, in the place they call home. Our 5,800 member organizations, many of which have served their communities for generations, offer the continuum of aging services: adult day services, home health, community services, senior housing, assisted living residences, continuing care retirement communities and nursing homes. AAHSA’s commitment is to create the future of aging services through quality people can trust.