Unveiling the Long-Term Supports and Services (LTSS) Program for Older Adults and People with Disabilities
Delve into the LTSS program's introduction, the homecare affordability issue, and the importance of a new LTSS program in addressing the needs of older adults and individuals with disabilities. Discover how you can be part of the solution and participate in the grassroots movement advocating for fair pay and benefits for caregivers. Explore the essential services provided by LTSS and the coalition's mission to create a just system that ensures dignity for all. Understand the significance of planning for future care needs and the financial aspects associated with long-term care.
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LTSS & CARA C A R A 2 0T HA N N U A L C O N V E N T I O N O A K L A N D , C A L I F O R N I A O C T O B E R 2 5 , 2 0 2 3 C A R A P R E S E N T A T I O N C A R A P R E S E N T A T I O N 1 1 8 / 1 5 / 2 0 2 4
Todays goals Introduce the homecare affordability problem Share what a solution could be a new Long-term Supports and Services (LTSS) Program for the older adults and people with disabilities Invite you to take action and be part of the solution 8 8 / / 1 5 1 5 / / 2 0 2 4 2 0 2 4 C A R A P R E S E N T A T I O N C A R A P R E S E N T A T I O N 2 2
Pair Share Discussion Questions Do you have an experience caring for a loved one? Do you have experience needing care for yourself? What concerns or hopes do you have about your future care needs? 8 8 / / 1 5 1 5 / / 2 0 2 4 2 0 2 4 C A R A P R E S E N T A T I O N C A R A P R E S E N T A T I O N 3 3
Our coalition 4 4
What is LTSS? Long-Term Services and Supports That is day-to-day help needed by older adults and those with disabilities, including: Dressing Bathing & bathroom Housekeeping Transportation & shopping Meal prep Etc., etc. Can be provided at home or in institutional settings (e.g., long-term care facilities, assisted living, etc.) 5 5 8 / 1 5 / 2 0 2 4 C A R A P R E S E N T A T I O N
Introducing the LTSS4All Grassroots Coalition We are older adults, people with disabilities and chronic health conditions, and home care providers, paid and unpaid. We are families, neighbors and friends who support one another. We are a growing grassroots movement who believe we all deserve to live and age and work with dignity We work to unite the many frontline communities who have a direct stake in creating a just Long-term Services and Supports System We organize to win campaigns that: Fully fund existing LTSS safety net programs, like IHSS, Create new public LTSS programs that achieve a universal LTSS safety net in California, and Achieve fair pay, benefits, and citizenship for caregivers and homecare workers C A R A P R E S E N T A T I O N C A R A P R E S E N T A T I O N 6 6 8 / 1 5 / 2 0 2 4
It could happen to you and your family About 56% of those turning 65 will need it, about one in five will need it for over 5 years Nationally, median costs for: Long-term care range from around $1,600 per month for adult day healthcare services to around $8,800 per month for a private room in a nursing home. Home health aide services in the US is $27 per hour. Based on that rate, 24-hour care would come to $4,536 per week, or $18,144 per month C A R A P R E S E N T A T I O N C A R A P R E S E N T A T I O N 7 7 8 / 1 5 / 2 0 2 4
Who picks up the tab? Private long-term care insurance 1% The super rich have reserves or private insurance MedicAid (MediCal) Other (insurance, VA, etc. Most of us use MediCal 16% But that leaves a gap that happens to include the middle class that is met out-of-pocket 23% 57% 57% Out-of-pocket C A R A P R E S E N T A T I O N C A R A P R E S E N T A T I O N 8 8 8 / 1 5 / 2 0 2 4
Family members often bear the burden The median age for a family caregiver is about 50. In a survey study of caregivers, 40% reported that their health had suffered from caregiving and 65% reported that their social life suffered Caregivers may also be forced to quit their jobs. Nationwide, family caregivers spend 20% of their income or about $7000 out of pocket (in 2016(!)) 8 / 1 5 / 2 0 2 4 C A R A P R E S E N T A T I O N 9
California IS trying to address this problem Under AB 567 of 2019, the California Department of Insurance created a Long-term Care Insurance Task Force They are developing a set of five program designs that will be presented to the Legislature for enacting Long Term Care service The designs range between: Expanding existing benefits for seniors & disabled people (e.g., caregiver support, meal delivery, limited home improvements), As above + home care support for seniors including residential care, As above + skilled nursing facility care C A R A P R E S E N T A T I O N C A R A P R E S E N T A T I O N 1 0 1 0 8 / 1 5 / 2 0 2 4
Issues to be resolved Variable Opt in Options Who s allowed to opt out Benefits availability outside of California and USA Portability 5 or 10 years; 18+ years old eligible Vesting* Maximum benefit $1500 to $6000 monthly benefit for one- or two-years Payroll tax employer contribution 0, 25, or 50% (self-employed pay a tax) Contribution rate structure Will there be one and what will it be Contribution limit Benefit response to inflation Benefit increases based on Consumer Price Index ( CPI ) with benefit increases evaluated annually but not automatically applied (except for Design 5) *Currently, it doesn t cover people who are out of the work force C A R A P R E S E N T A T I O N C A R A P R E S E N T A T I O N 1 1 1 1 8 / 1 5 / 2 0 2 4
Our positions Everybody in! Currently retired people must also be covered Highest level of support Full portability in USA and world Have the rich pay their fair share C A R A P R E S E N T A T I O N C A R A P R E S E N T A T I O N 1 2 1 2 8 / 1 5 / 2 0 2 4
A single payer healthcare effort (CalCare) is underway LTSS could be incorporated into CalCare This offers the prospect of being more efficient and user-friendly C A R A P R E S E N T A T I O N C A R A P R E S E N T A T I O N 1 3 1 3 8 / 1 5 / 2 0 2 4
Your help is needed! Rich people own the political system so Citizen oversight and participation will be critical Taxes could rise but: These services are not coercive like police at home or the military abroad These services actually help us C A R A P R E S E N T A T I O N C A R A P R E S E N T A T I O N 1 4 1 4 8 / 1 5 / 2 0 2 4
What can I do? First: Tell the Long-term Care Task Force What You Think. Join us in observing and making comment at their next meeting. The next (and 2nd to last meeting) is November 2nd at 9:30am. We ll prep together Second: Join us in the Care Agenda Committee and the LTSS4All Grassroots Coalition to build our power to influence the state. (We meet first Wed of each month, 12-2pm via ZOOM) Third: Call your local state representatives and tell them to make affordable homecare and LTSS a top priority next year C A R A P R E S E N T A T I O N C A R A P R E S E N T A T I O N 1 5 1 5 8 / 1 5 / 2 0 2 4
Get in Touch! The Care Agenda Committee of the LTSS for All Grassroots Coalition: Committee Chair, Juan Carlos Guerrero juan@caringacross.org (562) 240-3499 8 8 / / 1 5 1 5 / / 2 0 2 4 2 0 2 4 C A R A P R E S E N T A T I O N C A R A P R E S E N T A T I O N 1 6 1 6