PROFILES OF LONG-TERM CARE AND INDEPENDENT LIVING RHODE ISLAND. by Ari Houser Wendy Fox-Grage Mary Jo Gibson 2006 AARP

Transcription

1 ACROSS THE STATES PROFILES OF LONG-TERM CE A IEPEENT LIVING RHO IS by Ari Houser Wendy Fox-Grage Mary Jo Gibson 06 AP 06

2 Introduction This short state-specific report has been created from the full book, Across the States 06: Profiles of Long-Term Care and Independent Living, to facilitate access to and distribution of a single state s information on key long-term care issues. To put this information in a broader context, readers also will want to refer to the Overview section of the full book, which highlights national trends and differences between states, and features key indicators for some of the most important current policy debates. Across the States 06 is a compilation of data on many facets of long-term care and independent living in each state and the District of Columbia. Published biennially since 1992 by the AP Public Policy Institute, the Across the States series was developed to help inform policy discussions among public and private sector leaders in long-term care throughout the United States. This 7 th edition of Across the States presents the most up-to-date data available at the time of production. The information is displayed in easy-to-use maps, tables, and graphics. The state-specific reports excerpt the six-page profile of each state from the heart of the full book. This profile provides state- and national-level data and state rankings for 150 indicators in six topic areas. The topic areas are Demographics, Livable Communities & Need for Long-Term Care, Home & Community-Based Services (HCBS), Nursing Facilities, Long-Term Care Financing, and Trends. In addition, the Long-Term Care and Independent Living Maps section, which shows regional patterns for fourteen indicators, is included in this report. Each state s ranking relative to other states for all indicators is included in each state report. In addition, the State Data and Rankings section in this edition of Across the States contains ranking tables for select indicators, and readers may download the complete set of ranking tables from the AP website (the address is at the bottom of this page). For each indicator, the highest data value is given a rank of 1. It is important to recognize that ranking highest does not necessarily imply doing the best (e.g. the highest poverty rate). Some of the indicators in Across the States 06 may be found in prior editions. Please exercise caution when making comparisons with information in earlier editions because of possible changes in the source or definition of a particular indicator. While a list of sources is included in this statespecific report, readers should refer to the Data Documentation section of the full book for complete information specific to each indicator. This section identifies the sources of data, provides a detailed explanation for each indicator, presents any caveats or limitations that apply to the data, and describes how the source or indicator definition may differ from previous years. Questions about the state-specific version of Across the States 06, the full book, or the state data and rankings supplement can be addressed to the AP Public Policy Institute, Independent Living/Long- Term Care Team, at Please visit for electronic versions of these publications.

3 Rhode Island Population & Projections Age Groups Year State Rank U.S. Total population (thousands) ,076 1, ,410 3, Age (% of all ages) Age 65+ (% of all ages) Age (% of all ages) Age (% of all ages) Age 85+ (% of all ages) Race & Ethnicity State Rank U.S. Minority age 65+ (%), Asian age 65+ (%), Black age 65+ (%), Hispanic age 65+ (%), Population Characteristics Men per 100 women age 85+, 05 Persons age 75+ living alone (%), 05 Non-metropolitan population age 65+ (%), 06 Bachelor level education or higher age 65+ (%), 05 Grandparents age 60+ raising grandchildren (%), 05 Caregivers (% of all adults age 18+), Note: The highest data value within each ranking is indicated by a rank of 1 The percent change calculations on this page are based on the total population in each age group. For example, the U.S. population age 65+ was 36,790,113 in 05 (12.4% of the total population) and was projected to be 54,631,891 in (16.3% of the total population). These numbers represent a 48% increase in the age group population between 05 and. 3

4 Rhode Island 2 Livable Communities & Need for Long-Term Care Housing & Transportation Homeownership rate age 65+ (%), 05 Homeowners age 65+ paying 30% of income or more for housing (%), 05 Renters age 65+ paying 30% of income or more for housing (%), 05 Persons age 65+ in housing built before 1960 (%), 05 Persons age 65+ without a vehicle in household (%), Income & Poverty Median household income age 65+, 05 At/below poverty level age 65+ (%), 05 At/below 0% of poverty level age 65+ (%), 05 At/below 300% of poverty level age 65+ (%), 05 Women age 75+ at/below poverty level (%), 05 $27, $28, Disability Rates Persons age 65+ with disabilities (%), 05 Sensory disability Physical disability Mobility disability Self-care disability Cognitive/mental disability Any disability (one or more of the five listed above) Cognitive/mental disability + any other disability Persons age with disabilities (%), 05 Any disability Cognitive/mental disability + any other disability (one or more of the other four listed above) Projected change in disability rate age 65+ due to economic and demographic factors (%), 05- Persons with Alzheimer s disease, 00 Projected increase in the number of persons with Alzheimer s disease (%), , ,700, +38 4

5 Home & Community-Based Services (HCBS) Rhode Island 3 Use of HCBS Medicare beneficiaries receiving home health services (%), 05 Medicare home health visits per user, 05 Medicaid HCBS participants, 02 Medicaid HCBS participants per 1, population, 02 Home health Personal care* HCBS waiver services Aged/disabled waiver services Medicaid aged/disabled waiver participants per 100 beneficiaries in nursing facilities, 02 Persons in group residential care settings covered by Medicaid and state-funded public financing, , NA NA ,6, ,421 Medicaid HCBS Participants per 1, Population, 02 Rhode Island United States Home Health Personal Care HCBS Waiver Services HCBS Resources Medicare-certified home health agencies per 100, age 65+, 05 Adult day facilities per 100, age 65+, Assisted living and residential care facilities, 04 Assisted living and residential care beds, 04 Assisted living and residential care beds per 1, age 65+, 04 Personal and home care aides per 1, age 65+, 05 Median hourly wage, 05 Home health aides per 1, age 65+, 05 Median hourly wage, 05 HCBS aged/disabled waiver waiting list, , $ $ ,451 9, $ $ ,7 Note: The highest data value within each ranking is indicated by a rank of 1 *Only 30 states offered the optional personal care benefit in 02. The lowest rank for this indicator is 30. 5

6 Rhode Island 4 Nursing Facilities Medicaid Spending on Long-Term Care Services, by Type of Service, 05 Rhode Island United States HCBS 43% $7 Million ICF-MR 1% $7 Million Nursing Facilities 56% $94 Million HCBS % $ Billion ICF-MR 13% $1 Billion Nursing Facilities 50% $47 Billion Nursing Facility Resident Characteristics Total nursing facility residents, 05 Total nursing facility stays, 04 Nursing facility residents per 100 age 65+, 05 Residents with Medicaid as primary payer (%), 05 Residents with Medicare as primary payer (%), 05 Residents with other as primary payer (%), 05 Residents with dementia (%), 05 Residents with other psychological diagnoses (%), 05 Nursing Facility Resources Total nursing facilities, 05 Nursing facility beds per 1, age 65+, 05 Nursing facility occupancy rate (%), 05 Quality & Oversight of Nursing Facilities Direct care nursing hours per patient day, 05 RN hours LPN hours/lvn hours CNA hours Nursing facilities with deficiency for actual harm or jeopardy of residents (%), 05 Residents with physical restraints (%), 05 Formal complaints filed with state per nursing facility, 05 Long-term care facility beds per FTE ombudsman, 04 Nursing facilities visited by ombudsman at least quarterly (%), 04 8,383 16, ,460,185 3,084, , ,

7 Rhode Island 5 Long-Term Care Financing Medicaid & State Expenditures Total Medicaid expenditures (millions), 05 Medicaid long-term care expenditures (% of total Medicaid expenditures), 05 Medicaid long-term care expenditures per person in the state, 05 Nursing facilities Intermediate care facilities-mental retardation (ICF-MR) Home and community-based services (HCBS) Home health Personal care* HCBS waiver services Aged/disabled waiver services Medicaid HCBS expenditures (% of Medicaid long-term care), 05 Medicaid HCBS expenditures for age 65+ (% of Medicaid long-term care for age 65+), 02 Medicaid nursing facility expenditures per person served, 03 Medicaid HCBS expenditures per person served, 02 Home health Personal care* HCBS waiver services Aged/disabled waiver services Federal Medicaid Assistance Percentage (%), 05 Medicaid personal needs allowance for nursing facility residents (per month), 06** State-funded HCBS for older people (millions), FY02 $1, $492 $274 $7 $211 $3 NA $8 $ $42,140 $31,472 $3,033 NA $,122 $7, $50.00 $ NA NA $300, $319 $159 $41 $119 $12 $29 $77 $17 17 $23,882 $10,531 $3,514 $7,859 $18,9 $7, $47.53 $1,412 Public & Private Payment Rates Medicaid payment rate per day for nursing facility care, 02 Medicare payment rate per day for nursing facility care, 04 Private pay rate per day in nursing facility (urban avg.), 05 Private pay rate per day in assisted living facility (urban avg.), 05 Medicare reimbursement per home health visit (avg.), 05 Private pay hourly rate for home health aide (urban avg.), 05 $134 $286 $0 $96 $169 $ $118 $270 $176 $96 $152 $19 Note: The highest data value within each ranking is indicated by a rank of 1 * Only 36 states offered the optional personal care benefit in 05, and 30 states in 02. The lowest ranks are 36 and 30. **8 states used only the minimum personal needs allowance of $30 per month. The lowest rank for this indicator is 44. 7

8 Rhode Island 6 Trends Livable Communities & Need for Long-Term Care Year Persons age 65+ at/below poverty level (%) 1999 Persons age 65+ with any disability (%) Home & Community-Based Services Year Medicaid HCBS participants Medicaid aged/disabled waiver participants Medicare home health visits per user Nursing Facilities Year Nursing facility residents Nursing facility beds Nursing facility occupancy rate (%) Long-Term Care Financing Year Total Medicaid spending (millions) Medicaid long-term care spending (millions) Medicaid nursing facility spending (millions) Medicaid HCBS spending (millions) Medicaid aged/disabled waiver spending (millions) ,422 6, ,362 2, ,836 8, ,882 9,046-8 $1,185 $1, $417 $ $248 $ $163 $ $17 $ ,882,490 2,6, , , ,436,571 1,460, ,671,295 1,714, $194,347 $300, $68,568 $94, $39,583 $47, $19,030 $, $2,966 $5,

9 Percent of Population Age 85+, 05 Maps 1.5% % 2.0%+ Nursing Facility Occupancy Rate, 05 84% 85-89% 90%+ 9

10 Maps 2 Percent of Nursing Facilities that are For-Profit, 05 49% 50-69% 70%+ Percent of Nursing Facilities with Deficiency for Actual Harm or Jeopardy of Residents, 05 14% 15-24% 25%+ 10

11 Maps 3 States with Single Entry Point for Long-Term and Supportive Services for Older Adults and Adults with Disabilities, 03 None Older Adults Only Older Adults and Adults with Disabilities States that Offer Medicaid Personal Care Benefit for Adults, 04 Not Offered Offered 11

12 Maps 4 States Adopting Most Recent NAIC Model Long-Term Care Insurance Regulations, 06 Not Adopted Adopted States Requiring Private Rooms in Assisted Living, 04 NA None Some types of facilities All assisted living and residential care 12

13 Maps 5 Medicaid Home & Community-Based Services Spending (% of Total Medicaid Long-Term Care), 05 34% -49% 50%+ Medicaid Long-Term Care Spending (% of Total Medicaid), 05 NA 29% 30-34% %+ 13

14 Maps 6 Federal Medicaid Assistance Percentage (FP), 05 50% % 66%+ HCBS Aged/Disabled Waiver Waiting List, 04 NA None Less than 6, 6, or more 14

15 Maps 7 Family Caregiver Support Programs Include Uniform Assessment Tool, 03 None Some programs All programs Family Caregiver Support Programs Include Training for Staff Who Work with Caregivers, 03 None Some programs All programs 15

16 Data in this report are drawn from AP Public Policy Institute calculations and the following additional sources. Care should be taken when making comparisons to indicators from other publications or earlier editions of Across the States, as data sources, definitions, and methodology may differ. Many of the following sources are available online. Weblinks and detailed documentation for each indicator are included in the Data Documentation section of the full book, available at Administration on Aging, 04 National Ombudsman Report. Alzheimer s Association, Growth of Alzheimer s disease through 25, 04. Brian Burwell, Kate Sredl, and Steve Eiken, Medicaid Long Term Care Expenditures FY 05, Medstat, 06. Bureau of Labor Statistics, Occupational Employment Statistics, May 05 Estimates. Helen Carrillo and Charlene Harrington, Analysis of On-Line Survey Certification and Reporting System (O) unpublished data from the Centers for Medicare and Medicaid Services, University of California, San Francisco, August 06. Census Bureau, Current Population Survey, 06. Census Bureau, American Community Survey, 05. Census Bureau, 00 Decennial Census. Data Sources Census Bureau, Population Division, Interim State Projections of Population by Single Year of Age and Sex: July 1, 04 to 30 Census Bureau, Population Division, State by Age, Sex, Race, and Hispanic Origin Census Bureau, Population Division, State Single Year of Age and Sex Population Estimates: April 1, 00 to July 1, 05 RESENT Centers for Medicare and Medicaid Services, Medicare Enrollment - All Beneficiaries: as of July 05 Centers for Medicare and Medicaid Services, Medicare Home Health Utilization by State Calendar Year 05 Centers for Medicare and Medicaid Services, Office of Information Systems, Health Care Information System, untitled table on skilled nursing facilities in 04, July 05 (unpublished data). Centers for Medicare and Medicaid Services, Office of Survey and Certification and Reporting, Report No. 10 Facility Counts, Active Providers, July 05 (unpublished data). Centers for Medicare and Medicaid Services, Nursing Home Data Compendium: 05 Edition Centers for Medicare and Medicaid Services, Medicare & Medicaid Statistical Supplement 05. Centers for Medicare and Medicaid Services, Medicare & Medicaid Statistical Supplement 04. Centers for Medicare and Medicaid Services, Medicare & Medicaid Statistical Supplement

17 Nancy J. Cox, National Study of Adult Day Services 01-02, Partners in Caregiving: The Adult Day Services Program, Wake Forest University School of Medicine, Winston-Salem,. Federal Register, December 3, 03, Notices, volume 68, number 232, pp Lynn Friss Feinberg, Sandra L. Newman, Leslie Gray, and Karen N. Kolb, The State of the States in Family Caregiver Support: A 50-State Study, National Center on Caregiving at Family Caregiving Alliance, 04. David C. Grabowski, Zhanlian Feng, Orna Intrator, and Vincent Mor, Project HOPE, Recent Trends in State Nursing Home Policies, Health Affairs, Web Exclusive, 04. Charlene Harrington, Helen Carrillo, and Courtney LaCava, Nursing Facilities, Staffing, Residents and Facility Deficiencies, 1999 Through 05, University of California, San Francisco, 06. The Lewin Group, HCBS Population Tool. Data Sources 2 The Henry J. Kaiser Family Foundation, 02 State and National Medicaid Enrollment and Spending Data (MSIS), March 06. Martin Kitchener, Terrence Ng, and Charlene Harrington, Medicaid 1915(c) Home and Community- Based: Program Data , University of California, San Francisco, 06. Sarah L. McKune, Elena M. Andresen, Jianyi Zhang, and Britta Neugaard, Caregiving: A National Profile and Assessment of Caregiver Services and Needs, Rosalynn Carter Institute. Metlife Mature Market Institute, 05 MetLife Market Survey of Assisted Living Costs Metlife Mature Market Institute, 05 MetLife Market Survey of Nursing Homes and Home Care Costs Robert Mollica and Heather Johnson-Lamarche, State Residential Care and Assisted Living Policy: 04, National Academy for State Health Policy, 05. Robert Mollica and Jennifer Gillespie, Single Entry Point Systems: State Survey Results, National Academy for State Health Policy, 03. National Association of Insurance Commissioners, Long-Term Care Insurance Model Regulation, 06. National Long-Term Care Ombudsman Resource Center, National Citizens Coalition for Nursing Home Reform, update of data from Sandra Hughes, Gail MacInnes, and Tina Geraghty, Personal Needs Allowances For Long Term Care Residents, 04. Laura Summer and Emily S. Ihara, The Medicaid Personal Care Services Benefit: Practices in States that Offer the Optional State Plan Benefit, AP Public Policy Issue Paper, May 05. Laura Summer and Emily S. Ihara, State-Funded Home and Community-Based Service Programs for Older Persons, AP Public Policy Issue Paper, November