The numbers are scary, according to policy experts and legislators at a Senate Subcommittee on Aging and Long-Term Care meeting yesterday:
• The cost of care in a nursing home in California is approximately $6,000 a month, and the cost of part-time, in-home care is roughly $1,700 a month, according to state officials.
• Both those numbers are expected to double in less than 20 years to $12,000 a month for nursing home care and $3,400 a month for in-home help, according to committee Chair Elaine Alquist (D-Santa Clara).
• California has more than four million seniors right now. That figure is expected to more than double to 8.8 million by 2030, according to Steven Wallace of the UCLA Center for Health Policy Research.
• About one-third of the respondents in a UCLA survey say they couldn't afford one month of nursing home care, Wallace said.
"Californians are financially unprepared for their later years," Alquist said. "Medicare doesn’t cover long-term care services. And long-term care insurance is expensive and few people in California have it."
A growing senior population in California will need a substantial amount of care over a long time and won't have the money or insurance to pay for it, most experts predict. That leaves Medi-Cal as the resource of last resort, Wallace said.
Given the current financial pressures individuals and the state are under, not much is likely to change and we are looking at a looming health crisis in California, Wallace said.
"When you're under the worst recession since the 1930s, that makes it hard to even think about long-term care," he said. "And in state policy, there has been a series of reductions already, such as SSI/SSP (Supplemental Security Income/State Supplementary Payment) reductions. And ADHC (Adult Day Health Care) centers are threatened with being closed Dec. 1."
Some Californians are turning to long-term care insurance, but that's weak porridge to Bonnie Burns of California Health Advocates.
"Long-term care insurance is often proposed as the solution to all of this, and that could not be farther from the truth," Burns said.
"You're talking about a private, profit-making industry. That won't take care of the people who need it most. You have to be young enough [so you're less of a risk], you have to be wealthy enough to pay for it, and you need to qualify," Burns said. "So if you have medical conditions, you're not likely to get it."
At the federal level, an insurance program called the CLASS Act (Community Living Assistance Services and Supports Act) was proposed and then shelved.
Most of the policy experts at yesterday's hearing lamented the loss of that program as a possible solution for the long-term care conundrum.
"I don’t think anyone has talked about an equivalent of the CLASS Act on the state level," Wallace said, "but I don't see why that couldn't happen."
"A CLASS Act for California, that would be a class act," Carroll Estes of UCSF said.
"That's good," Alquist said. "That's what I'm looking for here, some kind of actionable ideas."
John Shen of the Department of Health Care Services said the state has worked with the commercial health insurance industry to develop long-term care plans that are affordable and high-quality. "We have about 115,000 active policies now," Shen said. "And those policy sign-ups are growing at a pace of 10,000 a year.
Shen also noted that the state has a consumer education website to help Californians deal with long-term care issues.