Amid a wave of new COVID-19 cases, the primary group that advocates for Florida’s older residents will be back in the halls of the state Capitol as fights resume over nursing homes and care for senior citizens in the 2022 Legislative Session.
“It seems to be we are at a pretty significant fork in the road,” said Jeff Johnson, who is the state director for Florida AARP. “And I think that COVID didn’t cause the issues that we are seeing in nursing homes, but it exacerbated some of them, and it shone a spotlight on all of them.”
Already on AARP’s radar this year is SB 804 filed by Sen. Ben Albritton. Nursing homes currently are required to provide patients with 3.6 hours of licensed nursing care per day, of which certified nursing assistants can provide 2.5 hours. The proposed bill reduces the mandated hours of licensed nursing care to one hour.
And in place of the 2.5 hours of care provided by a CNA, the bill would allow nursing home facilities to provide instead what is called 2.5 hours of “direct care.”
“Our hope is, one, that we turn away from the idea of lightening staff requirements for staffing quality and instead focus on making sure that every facility has the staff that it takes in order to provide good quality care,” Johnson told Florida Politics. “And at the same time, do we use this as an inflection point to (look at whether) putting frail, predominantly elders all together in large institutional settings (is) really the best way to provide that care, or can we think differently about long-term care?”
Johnson stressed that AARP isn’t opposed to nursing homes and said there always will be a need for them. Florida currently has 690 nursing homes that together have more than 199,000 beds.
But Johnson maintains the state would be better off if it devised a plan that guaranteed the frail and elderly access to home- and community-based services that keep elderly residents out of nursing homes.
Currently, those services aren’t considered “entitlements” or care that Medicaid must provide. But more costly nursing home care is an entitlement.
Johnson said the state could ask the federal government to flip the entitlement, so home- and community-based services are required and not nursing home beds.
“I think that would set Florida up to be even more not only the destination for people who want to retire someplace sunny but also a destination for people to live the rest of their lives well,” he said.
Florida does operate a Medicaid-managed long-term care program waiver program where it allows people who are at risk of nursing home placement access to tap into home- and community-based services. But there is a lengthy waitlist for services. According to Florida Department of Elder Affairs data, 55,263 people in November qualified for nursing home care but were on the waiting list.
Johnson said the state should focus some of its resources at nursing homes to lower the number of people on the waiting list.
“We are clear that this is a long-term shift. But if the state committed to whittling down the waitlist, taking 10% of the people off a year, we would get there,” he said.
Aging in place, though, requires more than funding. It involves planning and building environments.
To that end, AARP has been working with local municipalities on infrastructure plans that support various mobility options so people can live, work, play and age in place in their communities. AARP supports Complete Streets, a design plan that encourages a variety of mobility options from walking to cycling to driving to hopping on public transportation. Complete Streets are designed for all users, from the sprite to the slow, from young to old.
While AARP focuses its efforts on the 50-plus population and issues that impact them, not everything the association does is aimed at just more mature residents.
AARP will be sponsoring the upcoming gubernatorial debates, as residents go to the polls in November to vote for congressional members, Governor, three cabinet members, 120 state House members, and 40 state Senators.
AARP also will be launching voter education efforts highlighting the many changes that go into effect for the 2022 election. Lawmakers last year approved changes that limit where and when ballot drop-off boxes can be used and altered rules on who is allowed to collect mail-in ballots.