Senior care is personal for Rep. Annie Menz (D-Norman). She recalled how her great-grandmother, who made the best sweet potato empanadas, lived with her mother until her death rather than move into a long-term care facility.
He wondered what it would have been like if he had. What kind of care would she have received? Would he have had a community around him?
That’s what Menz wanted to know more about from an interim study on senior care delivered Tuesday before the Oklahoma House Health and Long-Term Care Committee.
The committee heard presentations covering staffing shortages, care complaints and service connection issues to identify ways Oklahoma — Ranked 46th in the nation For its long-term services and support, it can improve the quality of life of its aging population.
The situation of long-term care personnel
In 2019, Governor Kevin Stitt signed Senate Bill 280which increased nursing home staffing ratios, reimbursement rates to pay for additional staff and personal needs allowances from $50 to $75 per month for personal items, such as a new pair of socks.
The subsidy is the amount of monthly income a Soonercare-funded nursing home resident can keep, with the remainder applied to the cost of care. Bill Whited, the state long-term care ombudsman, said 70% of people in long-term nursing homes receive Soonercare.
Whited said the COVID-19 pandemic hit long-term care hard: More than 40% of Oklahoma’s COVID-19 deaths occurred in its long-term care facilities. Visits were also restricted, which he said caused despair and hopelessness in many residents.
HB 2566 sought to address this issue in 2021 by codifying the right of access to family, contracted health care providers, and compassionate caregivers, including people like hospice caregivers. It also allows residents to designate compassionate caregivers who could provide care despite any visitation restrictions that may be in place.
But the emotionally draining responsibilities that have always been part of being a caregiver are more pronounced because of the pandemic, Whited said. They had to manage dying residents and work with frustrated families during a difficult time for people around the world.
And he said they do all this without being paid a living wage. For example, him The average salary for a nursing assistant is $30,210..
“So, a lot of times, a caregiver can change their trajectory and can go to work at Hobby Lobby or McDonald’s or some other environment where they can actually make more money and have less stress and less emotional devastation that comes with watching people you’ve developed. a good relationship and a love for what happens in front of your eyes,” Whited said.
Joy McGill, associate state director of advocacy for AARP Oklahoma, said Oklahoma ranks 48th in the country for highest nursing home staff turnover rates, according to State Long-Term Services and Supports Scorecard. Oklahoma ranked 47th in staffing levels, measured by nursing home direct care staff hours per resident per day.
Whited said staffing challenges have resulted in Several long-term care facilities close, limited entrances and the combination of units and rooms. He also said temporary emergency exemptions are “used very liberally” to cover personnel needs by hiring apprentices.
AARP Oklahoma registered voters surveyed 40 years or older in 2022 and 92% were found to be
extremely or very concerned that nursing homes are not adequately staffed.
“There’s a reason our facilities are called nursing homes,” McGill said. “These vulnerable people – our elderly, our people with disabilities – deserve nursing care and the attention they need so they can be as good as possible for as long as possible.”
What do older people have to say?
He Oklahoma Ombudsman Program serves residents in long-term care facilities to improve their quality of life and care. The program receives complaints from residents, families or concerned citizens.
Whited said the program is not an enforcement mechanism, meaning it does not set fines or deficiencies. Instead, it attempts to resolve complaints through investigations.
Whited shared complaint data from fiscal year 2022 during the study, which included 3,068 complaints. Approximately 59% of complaints were verified and 56% were resolved to the resident’s satisfaction.
Whited said the remaining 44% were withdrawn or no action was necessary, and less than 10% of complaints could not be resolved.
Here are the top five reasons behind those complaints:
- 798 complaints: Care in long-term care facilities
- 672 complaints: Choice or autonomy rights
- 476 complaints: Abuse, neglect and exploitation, with a verification rate of around 45%
- 216 complaints: Financial or property access
- 192 complaints: Atmosphere
Whited added that reports of abuse, neglect and exploitation had verification rates of around 45%. He said not all of them were directly related to a facility or staff member being an alleged perpetrator.
He also said some facilities restrict people’s right to access their financial information or property, which is a violation of Oklahoma law.
The Ombudsman Program provides this data to the federal Community Living Administration and Oklahoma Human Services to make policy decisions.
America is aging
The need for long-term care services is not decreasing. In fact, it is increasing as people in the United States age.
The Census Bureau found that by 2034 there will be more people over 65 than under 18, which it predicts will be a “transformative decade.”
Jeromy Buchanan, CEO of Protective, aging and community living servicesHe said he has seen growing concern about the reduction or disappearance of aging programs.
“(One) of these challenges we’re seeing is shrinking infrastructure when we really need to expand to address these future challenges,” Buchanan said.
Buchanan said people over 65 are also getting poorer as time goes on, and the number of older people is living in poverty. increasing from 8.9% in 2020 to 10.3% in 2021. Affordability is a barrier to accessing necessary long-term care services.
Don Blose, CEO and executive administrator of Spanish Cove Retirement Village in Yukon, said another way to build a better foundation for Oklahoma’s growing number of seniors is to make investments to help people stay independent longer.
“That will be our way to save money,” Blose said.
What can be done to improve care for the elderly?
A major point of discussion revolved around options counseling, which refers to a process in which people receive guidance as they make decisions about long-term support. Senate Bill 888Passed in 2019, it directed Oklahoma Human Services to create an options counseling program subject to funding availability.
So far, Whited said no funds have been allocated to the program.
“Funding a options counseling program would give those consumers access to a trained options counselor who could help them identify services and programs that may meet their needs,” Whited said. “Things like respite, things like PACE (Programs of Comprehensive Care for the Elderly), things like benefit waivers.”
McGill said it can be difficult for families to know their options and it is important for consumers to make informed decisions with Oklahoma seniors.
“A lot of caregivers that you talk to, once they get into a moment where they need to care for someone in a critical situation, they don’t have time to do all the research,” McGill said. “They don’t know what their options are. They’re scared. “They don’t know who to turn to, and things like options advice can really make a difference, at least giving people the opportunity to know what their options are before they have to make decisions.”
Buchanan said Oklahoma Community Living, Aging and Protective Services is working on building infrastructure to implement options counseling services despite not having the funding. She said he is using the grant money to create a training certification program.
He hopes to form a foundation for the service and provide it to people beyond long-term care facilities to help them thrive in their community.
“We have people who are denied Medicaid even for home and community-based services or, perhaps, denied SNAP benefits,” Buchanan said. “Whatever the case, we need to look at what other services and supports are available. …That’s what options advice is really about. Not just saying ‘Well, you’re not eligible,’ but ‘Let’s see what we can get you.’”
Whited said the Long-Term Care Ombudsman believes there should be a requirement for 24-hour registered nursing care in nursing homes. The current requirement is only eight hours.
He also said Oklahoma advocates believe there should be dedicated funds to contract for more direct care.
“It’s very important that if the Legislature invests dollars in long-term care, those dollars go toward the basic needs of providing care to residents,” Whited said.
Buchanan said it is also important to continue developing a Multisector Plan on Aging. This Oklahoma Human Services approach involves all partners involved in aging to meet the needs of older Oklahomans now and in the future.
Oklahoma Human Services hosted ten listening sessions over the summer in Lawton, McAlester, Oklahoma City, Tulsa and Woodward. It also hosted tribal listening sessions and virtual sessions to develop feedback from Oklahomans, which will be used to create the plan.
“We’re trying to prioritize what’s important to Oklahoma and develop that future vision of where we want to be and address that gap from where we are and close it to get to where we want to be,” Buchanan said.
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