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Maryland ranks 23rd among states for long-term care services

Long-term care is slowly improving across the nation, but a new report says Maryland isn’t acting quickly enough to assist its graying population.

Maryland ranked 23rd overall in an AARP report measuring how states are meeting the long-term care needs of elderly or physically disabled residents and their family caregivers. The State Long-Term Services and Support Scorecard, released Thursday, said Maryland has been slow to transition to support for home- and community-based services, which most residents prefer.

The report ranks state long-term care systems based on five main areas: affordability and access; setting and provider; quality and choice; family caregiver support; and effectiveness of care transitions. Nationally, the quality of care is up. But the Baby Boomer generation is growing older — 8,000 are turning 65 every day — and demand for services is increasing more quickly than some states can accommodate.

“We have to increase the pace of change in this country,” said Bruce Chernof, president and CEO of The SCAN Foundation, at an AARP news conference Thursday. “If we’re committed to a sustainable, high-quality system of care for all — not just the medical side, but the full range of services — we’re really going to need to pick up the pace, particularly as the boomers head into their retirement years.”

Maryland’s long-term care system saw mixed results in the report. It ranked 49th for participant direction, which means giving residents the ability to hire their own care givers and set their work hours. The state also ranked 33rd in support for and protection of family care givers, which would include policies such as paid sick leave. The state has about 770,000 caregivers.

But Maryland has improved since the last long-term services report came out in 2011, said Enid Kassner, vice president of livable communities/long-term services and supports at the AARP Public Policy Institute.

Maryland ranked 16th overall for quality of life and care. It ranked sixth in the country for affordability and access to resources, thanks to the number of aging and disability resource centers.

And the report said the state has improved its nurse delegation of health tasks, or allowing paid home caregivers to perform some medical tasks such as administering eye drops or giving pills. Of 16 medical tasks that researchers looked at, Maryland home caregivers can do 14.

“That’s a positive for the state,” Kassner said. “But the state could do a better job of monitoring the quality of nursing homes.” Pressure sores, which can lead to life-threatening infections, were prevalent in the state’s nursing homes, she said.

Minnesota, Washington state and Oregon top the list for their long-term care services and performance. These states have created laws or policies that build Medicaid programs and support care givers, Melinda Abrams, vice president of delivery system reform at the Commonwealth Fund, said at the news conference.

Maryland’s implementation of the Community First Choice Medicaid program is helping the state to move in the direction of better long-term care, Kassner said.

“Good policy-making at the state level sets the stage for better performance, and that’s so important since so many of these services are funded with public dollars and largely Medicaid,” Abrams said.

Nationally, affordability of long-term care remains a prime concern, Abrams said. But Maryland fared slightly better than average.

Annual nursing home fees cost about 246 percent the median income of older adults, Kassner said. In Maryland, nursing home fees are about 223 percent.

In 12 years, the first of the Baby Boomers will turn 80, and so far the process toward improving long-term care services has been “slow but steady,” Kassner said.

“But we really need to ramp it up for what is going to be a surge of people who need care,” she said. “Really, this is the time when states need to get serious about it.”