Almost one in four Kentuckians will be 60 or older by 2030, making them the state's fastest-growing demographic.
We should be doing all we can to provide the services they need to age at home rather than in institutions, not only because that's what people say they want but also because it costs less.
The General Assembly took a big stride in that direction by enacting a Medicaid hospital-to-home transition program.
House Bill 144, signed last week by Gov. Steve Beshear, will guarantee the services and care needed at home by eligible Medicaid recipients immediately after leaving the hospital, at less cost than a nursing home.
The newly streamlined eligibility process should eliminate a wait for services that now can be up to six weeks and often produces expensive emergency room visits and hospital readmissions.
By streamlining the eligibility process for such things as care attendants and in-home meals, seniors can also be spared from "being admitted prematurely to nursing homes, losing their homes, and experiencing increased impairment with longer recovery times," according to a memorandum by the Legislative Research Commission entitled "Supports For Family Caregivers Of Elders." (www.lrc.ky.gov/lrcpubs/rm517.pdf)
Commissioned by the legislature, the LRC memo also reports:
■ About 735,000 Kentuckians are caregivers to family members. There will be fewer children to care for more aging parents in the future, so the pool of caregivers is likely to expand within families and to non-relatives.
■ Kentucky's Medicaid program pays about $48,000 a year for a nursing home bed compared to $15,000 for in-home supports. But Kentucky lags other states in supports for caregivers such as respite care, family and medical leave and home health and personal care services.
■ About 81 percent of Medicaid spending on long-term care in Kentucky goes to nursing homes and institutional care, compared to the median for all states of 69 percent. The growth of the senior population may outpace available Medicaid funds without a redistribution of spending.
The Beshear administration is in the process of enacting more in-home options that should begin to offset the pro-institution bias in Medicaid spending for long-term care in Kentucky. The new hospital-to-home law will dovetail nicely with the larger changes.
Kudos to the legislature's health committee chairs — Rep. Tom Burch, D-Louisville, and Sen. Julie Raque Adams, R-Louisville — for shepherding bipartisan support for this much-needed change.
The new law takes effect in 2016. The next governor and the legislature should be sure to support it in the state's next budget.