AARP Report: Lack of adequate and affordable support system threatens long-term independence for older adults

Texas House Passes Budget Containing Significant Cuts to Programs

AUSTIN, Texas -- Americans with disabilities want independence in their daily lives, but they and the families who assist them are often frustrated by the lack of an adequate and affordable system to help them meet their needs, according to a new report released today by AARP.

The report, "Beyond 50 2003: A Report to the Nation on Independent Living and Disability," includes results of the first ever national survey of Americans age 50+ with disabilities. The report documents the gap between what older adults say they need and what is actually available. It also raises concerns that the U.S. is ill-prepared to meet the demand for independence among people over the age of 50 who will experience disabilities in the coming decades.

The reported unmet needs are basic, including everyday tasks that most people take for granted. For example, one quarter of survey respondents say they need more help with daily activities such as cooking, bathing and shopping.

"For tens of thousands of older Texans, this kind of help makes all the difference," says AARP Texas State President, Gus Cardenas. "With a little assistance they are able to remain in their own homes, avoiding more expensive nursing home care and the loss of personal independence and dignity."

To help fill a nearly $10 billion state budget gap, the Texas House of Representatives, in its state budget bill (HB 1), passed last week, proposed significant cuts to programs for Medicaid Community Services geared to frail and elderly Texans, as well as qualified low-income seniors. These programs are Medicaid programs that pay for personal care and other services for people and allow them to remain independent in their own homes. Under HB 1 as it is currently written, approximately 56,000 Texans face having these essential services eliminated.

"We understand that the state legislature has some very difficult choices to make in these difficult times. However, with the increasing number of older Texans needing assistance with meeting their long-term care needs, it certainly does not seem like the time to reduce our state's health and human services programs and not even be able to meet existing needs," says Cardenas.

The report found that on average, Americans 50 and older with disabilities give their community a grade of B-/C+ as a place that makes it possible for them to live independently. While some community features receive good marks, others -- most notably, public transportation -- are rated poorly. More than half of respondents currently give their communities a "C" or lower rating for having dependable and accessible public transportation.

The report also found that most of those with disabilities are trying to manage by themselves, with less than half receiving any regular help with daily activities. More than half of those with disabilities also say they were unable to do something they needed or wanted to do in the past month -- quite often basic tasks such as household chores, exercise, or simply getting out of the house.

According to the AARP report, broader long-term improvements are also needed, and will require fundamental policy changes.

AARP Public Policy Director John Rother explains that while many relatively inexpensive immediate fixes would make important qualitative differences, other improvements will require longer-term, more fundamental change. "Planning for these changes must start now," he said.

Inadequate health insurance coverage is at the top of a list of problems experienced by persons 50 and older with disabilities. This is even true for those with Medicare coverage, which does not pay for prescription drugs. In addition, one out of three respondents reported specific needs, such as for assistive equipment, not covered by health insurance.

Based on the 'Beyond 50" findings, AARP outlined a number of sweeping proposals for long-term improvements:
 

  --  Public funding for long-term supportive services should be reoriented

      toward increasing options for home and community-based care.  The

      nation must also provide more options for "consumer-direction" in

      publicly funded programs.

  --  Individuals must be insured against the high costs of long-term

      supportive services and people with disabilities and their families

      must be protected from some of the heavy burden of the costs of long-

      term services.

  --  Communities should be made more physically accessible for people with

      disabilities.

  --  Information should be more easily accessible for those who are trying

      to learn more about available long-term services and whether or not

      they are eligible.

  --  America's health care system must focus on enhancing functioning and

      health-related quality of life, not just providing acute and curative

      care.

The AARP report is based on commissioned original research, including a telephone survey of 1,102 persons with disabilities age 50 and older conducted by Harris Interactive last September. It also includes an AARP-conducted review of a wide array of previously published data and literature, as well as newly commissioned analyses of the National Long-Term Care Survey and the Medical Expenditure Panel Survey.