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Americans are living longer and increasingly face long-term care needs and challenges related to chronic illness. In fact, over 90 percent of current Medicare spending is for the treatment of chronic illness. CHA advocates public policies that promote a high quality, accessible and affordable continuum of care to address the needs of those who, because of frailty or chronic conditions, require continuing care, services and supports.
As people in our communities live longer and the need for long-term care services and supports grows, the Catholic health ministry is challenged to make senior services a priority and to advocate for a financing, regulatory and delivery system that supports a safe and compassionate continuum of care. Elderly and chronically ill persons should be able to live at home with community-based services when possible and desirable and their family caregivers should have the support they need. Paid caregivers in homes or facilities should earn a living wage. Successful programs such as home care, adult day care, small houses and the Program for All-inclusive Services for the Elderly (PACE) should be adequately financed and accessible.
More recently the coronavirus has unveiled serious problems in our country's approach to serving aging and chronically ill persons in long term care as we witnessed nursing homes hit hard by the virus. While nursing home residents and staff represent only 8% of covid cases by the summer of 2020, they represented 41% of its deaths.
A government sponsored commission has concluded that frail, chronically ill and vulnerable persons conditions are cared for in facilities never designed for an epidemic. Residents live in close quarters and often share rooms, with little capacity to isolate infected persons. Another issue identified by the commission is long-standing staffing problems: many facilities are understaffed, and salaries so low that many employees work multiple jobs, carrying the virus from place to place. At the heart of all these problems is the inadequacy of long-term care financing. Long term care is paid by multiple, uncoordinated and underfunded finance systems, including cash-strapped Medicaid programs and dwindling personal savings.
Slow and inadequate support from government and other sources have added to the problem. Long- term care facilities did not receive personal protective equipment and testing supplies until well after the virus had taken hold. Advocates for seniors have suggested that bias against older people has been a factor.
The mission of the Catholic health ministry is to serve those in need, with special concern for those who are vulnerable through poverty or disability, and to create a society in which everyone has the necessary resources to achieve physical, mental, spiritual, emotional and social health. Ensuring the availability of continuing care throughout illness and in frailty is at the heart of our commitment.
CHA'S POSITION AND ACTIVITIES
CHA strongly supports efforts to coordinate and integrate person-centered health care and social services along the continuum of care, to ensure the best outcome for everyone. CHA activities have included:
- Monitoring and reporting on the impact of the coronavirus on long term care facilities and elders.
- Working closely with LeadingAge, which represents nonprofit homes and services for the aging, to advocate for adequate funds, equipment and testing for nursing homes and senior housing.
- Sharing information about how CHA members are creatively developing a continuum of services, including more home and community-based services; PACE; the use of tele-health; health homes; and population health management.
- Developing educational resources for health care organizations to work with faith congregations in order to support older persons and their care givers in the community
- Studying how to achieve a high quality and stable work force.
- Promoting Age-Friendly Health System, in partnership with the American Hospital Association, in an initiative sponsored by the John A. Hartford Foundation and led by the Institute for Healthcare Improvement.
CHA supports policies that:
- Provide adequate and sustainable financing to ensure the ability of long-term care facilities and services to provide quality and compassionate care.
- Promote improved coordination of care for those with chronic or serious illness.
- Provide elderly persons and persons with disabilities options to receive long-term care services and supports in the most appropriate care setting, whether at home, in the community (such as PACE) or in a residential facility.
- Ensure an adequate aging services workforce
- Promote access to affordable senior housing with the necessary and appropriate services and supports.
- Improve access to high-quality palliative care across the continuum of care.
- Promote a nursing home survey and certification system that achieves quality care through a fair and insistent inspection system.
CHA will address these issues in collaboration with partners in the long-term care continuum, including the LeadingAge, the American Health Care Association, Catholic Charities USA and other faith-based providers and consumer organizations.