Rhode Island Long-Term Care: An AARP Survey Data Collected by Woelfel Research, Inc. Report Prepared by Katherine Bridges Copyright 2002 AARP Knowledge Management 601 E Street NW Washington, D.C., 20049 http://research.aarp.org Reprinting with Permission Only
AARP is a nonprofit, nonpartisan membership organization for people 50 and over. We provide information and resources; advocate on legislative, consumer, and legal issues; assist members to serve their communities; and offer a wide range of unique benefits, special products, and services for our members. These benefits include AARP Webplace at www.aarp.org, AARP Modern Maturity, and My Generation magazines, the monthly AARP Bulletin, and a Spanish-language newspaper, Segunda Juventud. Active in every state, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands, AARP celebrates the attitude that age is just a number and life is what you make it. Acknowledgements This project was a collaborative effort among numerous AARP staff. Special thanks go to John Luehrs, State Affairs; Kathleen Connell, AARP Rhode Island; Lois Smith, Grassroots and Elections; Scott Melton, Independent Living/Long-Term Care/ End of Life; Gretchen Straw, Knowledge Management, for their valuable guidance and timely assistance, and to Woelfel Research, Inc. for conducting a high-quality survey. Katherine Bridges, Knowledge Management, managed all aspects of this project and prepared the report. For more information, contact Katherine Bridges at (202) 434-6329.
Background Rhode Island s long-term care system consists of many types of services and programs, ranging from nursing home care to transportation services and home-delivered meals. In addition, the system relies on funding from a variety of sources, from consumer payments to private insurance and government subsidies. In an attempt to make the system easier for consumers to negotiate and to ensure that adequate services are available to meet residents current and future long-term care needs, the Rhode Island legislature requested that a plan for the future of the state s long-term care system be developed. In 1996, a group of stakeholders consisting of service providers, interest groups, and government agencies took on this task and in early May 2002 emerged with a draft plan. AARP Rhode Island has been an integral voice in this taskforce and plans to continue working on this issue to ensure that its members opinions are represented as the process of long-term care reform unfolds. As such, AARP Rhode Island commissioned this telephone survey of 800 randomly selected Rhode Island members, which took place between May 17 and June 1, 2002. 1 The goal for the survey was to assess member support for the broad outline of the proposed plan, which includes developing a long-term care system that supports consumer independence and choice while delivering coordinated, high-quality services. Findings Long-term care was defined in this survey as care provided over an extended period of time in a nursing home, at home, or in a community setting. People of all ages who are frail, ill or disabled who need assistance with regular daily activities, such as getting dressed, bathing, preparing meals or eating, may receive long-term care services. Respondents were also given a brief description of the long-term care system in Rhode Island which stated: Currently, a wide variety of long-term care services are available in Rhode Island, ranging from home-delivered meals to adult day services, home health care, assisted living, and nursing home care. However, Rhode Island residents have to contact each of these separately to find the programs or services they need. Some of these services have waiting lists or are available only in certain communities. These descriptions were used to ensure that members who were responding to the survey could have baseline familiarity with long-term care, in general, as well as in the state. 1 The survey has a sampling error of +/-3.5%. See page 5 for additional information on methodology.
Members Support Funding A New Long-Term Care System Respondents were briefed on the new long-term care plan that has been drafted by the taskforce and presented to the legislature, which includes Expanding the types and quality of services available Having resources that help consumers find the care they need Expanding financial assistance to help consumers pay for services Upon hearing about the plan, the majority of Rhode Island members say they support the state funding this new long-term care system. Moreover, seven in ten supporters (69%) said they would still support the state funding this plan, even if it meant an increase in state taxes. This translates into 57 percent of all respondents who would support funding the plan, even if it involved a tax increase. Strongly support 49% Support for State Funding New Long-Term Care System (n=800) Don't Know/ Refused 9% Oppose 8% Somewhat support 34% Fewer supporters (51%) said they would still support the plan if it meant reallocating funds from other undefined state programs. Thus, 42 percent of respondents would continue to support the plan if it meant reallocation of state funds from other programs. However, it is significant that supporters were more unsure of their support for the state funding this plan if it meant the reallocation of funds from other programs, as opposed to raising taxes (26% vs. 10% "don't know"). In-Home Services Are Most Important to Members In addition to assessing general support for the state funding a reformed long-term care system, the survey also tested four separate features of the proposed plan. In rating the importance of these four aspects of long-term care, having the ability to choose and receive services at home has the greatest number of members rating it as very important. However, each major component of the plan is nonetheless very important to at least seven in ten AARP members in the state. Rhode Island Long-Term Care: An AARP Survey, June 2002 2
If you or a family member needed long-term care services, how important would it be to you to (n=800) Be able to choose and receive services at home Have high-quality nursing home care if needed Have a central place for information and referrals Have a central place to apply for benefits 83% 81% 73% 72% 12% 12% 21% 20% 0% 20% 40% 60% 80% 100% Very important Somewhat important Members Anticipate Needing Long-Term Care Services Twice as many members anticipate needing long-term care services in the next five years compared to those who report having used long-term care for themselves or a family member in the last five years. One in seven (14%) members say they or a family member have used long-term care services within the last five years, while almost one in three (28%) say it is likely they or a family member will need such services in the next several years. Members Believe in Cost Sharing Most Rhode Island respondents believe that the costs of long-term care should be shared between the individual and the government. Only one in eight think the individual receiving care should pay for their long-term care services on their own. Respondents Views on How Long-Term Care Services Should Be Paid For (n=800) Shared between the individual and gov't 58% Paid primarily though gov't programs 30% Paid mostly by the individual 12% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Not surprising, those who think long-term care should be paid for primarily through government programs or through cost-sharing between the individual and government are more likely to strongly support the state funding the proposed plan compared to those who think individuals should bear the costs on their own (58% of those who support paying for long-term care through government programs, 49% of those who support cost-sharing, and 30% of those who support individuals paying strongly support the state funding the plan). Rhode Island Long-Term Care: An AARP Survey, June 2002 3
Long-Term Care Reform Should Be A Priority Three-quarters of members say that it should be at least a high priority for Rhode Island to work to implement this new plan for the delivery of long-term care services in the state. Priority for Reforming Rhode Island s Long-Term Care System (n=800) Top priority 31% High priority 46% Don't know 3% Low/not a priority 4% Medium priority 16% Beyond this directive for the state, nine in ten members feel that it should be a top or high priority for AARP to work to ensure that older persons and persons with disabilities have an easy-to-access, high-quality long-term care system that allows consumers to choose from a variety of services. Priority for AARP to Work on Long-Term Care System (n=800) Top priority 49% Don't know 2% High priority 40% Low/not a priority 2% Medium priority 8% Rhode Island Long-Term Care: An AARP Survey, June 2002 4
Summary It appears that Rhode Island members recognize the impending demand for long-term care services in the state. With greater numbers of members anticipating a need for long-term care services for themselves or family member than have used them in the past, it is not surprising that the majority support the state funding a new long-term care plan that will expand and strengthen up what currently exists in Rhode Island. The high proportion that would continue to support this plan even if it meant an increase in state taxes further demonstrates this support. Considering that members place the highest level of importance on being able to receive longterm care services at home, ensuring that the new long-term care plan has a strong element of home and community-based services will likely result in continued support for the plan. Having a plan that guarantees high-quality nursing home care is also essential, as is one that allows consumers to get information and apply for benefits in a central place. With more than three-quarters of members rating it as a top or high priority, AARP members clearly want the state to work on implementing a new plan for the delivery of long-term care services in Rhode Island. Members also provide a directive for AARP to work to ensure that older persons and persons with disabilities in Rhode Island will have a system that allows consumers to choose from a variety of high-quality long-term care services. Methods AARP commissioned Woelfel Research, Inc. to conduct this opinion survey of Rhode Island AARP members. From a random list of 3,514 member telephone numbers, 800 interviews were completed between May 17 and June 1, 2002, yielding a 25 percent response rate and a 93 percent cooperation rate. The survey has a sampling error of plus or minus 3.5 percent at the 95 percent confidence interval. Survey responses were weighted by age to reflect the AARP Rhode Island membership. Rhode Island Long-Term Care: An AARP Survey, June 2002 5
Demographic Characteristics of Rhode Island Respondents (n=800) AGE INCOME 50-59 27% $50,000 + 29% 60-74 42% $35K-$50K 15% 75+ 28% $25K-$35K 16% WORK STATUS Employed fulltime 34% <$25K GENDER Female 20% 55% Retired 55% Male 45% Unemployed/Other 11% EDUCATION College grad or more 38% RACE/ETHNICITY Post HS/some college 27% White 95% High School or less 34% Black 2% ELECTIONS VOTED Other 2% Nearly all 77% Most 11% HISPANIC ORIGIN 2% Some/few 8% 0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100% Rhode Island Long-Term Care: An AARP Survey, June 2002 6
Rhode Island Long-Term Care: An AARP Survey Annotated Questionnaire Rhode Island Long-Term Care: An AARP Survey, June 2002 7
Rhode Island Long-Term Care: An AARP Survey n = 800 AARP members, Response Rate = 25%, Sampling Error = +3.5% (Percentages may not add to 100 percent due to rounding or multiple responses.) Introduction Hello, this is calling from Woelfel Research, a national opinion research firm. We are conducting a survey in Rhode Island on behalf of AARP to find out your opinion on an important issue facing the state. Your views are important and we would greatly appreciate your participation. Let me assure you, this is not a sales call and you will not be asked to buy anything either now or later. All of your responses are kept entirely confidential. The survey should take only about 7 minutes of your time. Long-term care refers to care provided over an extended period of time in a nursing home, at home, or in a community setting. People of all ages who are frail, ill or disabled who need assistance with regular daily activities, such as getting dressed, bathing, preparing meals or eating may receive long-term care services. 1) Have you or a family member used long-term care services within the last five years? 14% Yes 86% No 0% Don t know (DO NOT READ) 0% Refused (DO NOT READ) 2) What is the likelihood that you or a family member will need long-term care services in the next five years? 9% Very likely 19% Somewhat likely 35% Not very likely 25% Not at all likely 12% Don t know (DO NOT READ) 0% Refused (DO NOT READ) Rhode Island Long-Term Care: An AARP Survey, June 2002 8
Currently, a wide variety of long-term care services are available in Rhode Island, ranging from home-delivered meals to adult day services, home health care, assisted living and nursing home care. However, Rhode Island residents have to contact each of these separately to find the programs or services they need. Some of these services have waiting lists or are available only in certain communities. 3) If you or a family member needed long-term care services, how important would it be to you to: (ROTATE A-D AND READ RESPONSE CATEGORIES FOR EACH) a) Choose and receive services that allow you to stay at home for as long as possible 83% Very important 12% Somewhat important 2% Not very important 1% Not at all important 1% Don t know (DO NOT READ) 0% Refused b) have a central place where you could get information or referrals for all types of long-term care services, both government and private 73% Very important 21% Somewhat important 4% Not very important 2% Not at all important 1% Don t know (DO NOT READ) 0% Refused c) have a central place where you could apply for services and benefits you are eligible for 72% Very important 20% Somewhat important 3% Not very important 3% Not at all important 2% Don t know (DO NOT READ) 1% Refused (DO NOT READ) Rhode Island Long-Term Care: An AARP Survey, June 2002 9
d) have high-quality nursing home care available if it was needed 81% Very important 12% Somewhat important 3% Not very important 3% Not at all important 1% Don t know (Do Not Read) 0% Refused (Do Not Read) 4) Which comes closer to your view of how long-term care services should be paid for? (ROTATE ORDER) 12% the costs of long-term care should be paid mostly by the individual receiving care either through insurance or savings 30% the costs of long-term care should be paid primarily through government programs 58% the costs of long-term care should be shared between the individual and the government 5) Rhode Island is reviewing the long-term care system and has drafted a plan that would change the way long-term care services are delivered in the state. The plan calls for a more consumerdriven system that includes expanding the types and quality of services available having resources that help consumers find the care they need and expanding financial assistance to help consumers pay for services Do you support or oppose the state funding this plan? (Rotate 5a and 5b) 50% Strongly support 34% Somewhat support 5% Somewhat oppose (SKIP TO Q6) 3% Strongly oppose (SKIP TO Q6) 8% Don t Know (Do Not Read) 1% Refused (Do Not Read) 5a) Would you still support the state funding this plan even if it meant an increase in state taxes? (n=666) 69% Yes 20% No 10% Don t Know (Do Not Read) <1% Refused (Do Not Read) Rhode Island Long-Term Care: An AARP Survey, June 2002 10
5b) Would you still support the state funding this plan even if meant reallocating funds from other state programs and services? (n=666) 51% Yes 23% No 26% Don t Know (Do Not Read) <1% Refused (Do Not Read) 6) How much of a priority should it be for Rhode Island to work to implement this new plan for the delivery of long-term care in the state? Remember that the plan calls for expanding the types and quality of services available, having resources that help consumers find the care they need, and expanding financial assistance to help consumers pay for services. Would you say it should be a. 31% Top priority 46% High priority 16% Medium priority 2% Low priority 1% Not a priority 3% Don t Know (Do Not Read) 0% Refused (Do Not Read) 7) How much of a priority should it be for AARP to work to ensure that older persons and persons with disabilities have an easy to access, high-quality long-term care system that allows consumers to choose from a variety of services that best meets their needs? Should it be a? 49% Top priority 40% High priority 8% Medium priority 1% Low priority 1% Not a priority 2% Don t Know (Do Not Read) 0% Refused (Do Not Read) Thank you, now I just need some statistical information. D1) How old were you on your last birthday? 27% 50-59 42% 60-74 28% 75 or older 2% Refused Rhode Island Long-Term Care: An AARP Survey, June 2002 11
D2) Which of the following best describes your highest level of education? 5% Less than high school graduate 30% High school graduate] 27% Some college or technical school 38% College graduate or more 1% Refused (Do not read) D3) Which of the following best describes your marital status? 64% Married 8% Single, never married 27% Divorced/widowed/separated 1% Not married, living together <1% Not sure/refuse (Do not read) <1% No Answer D4) Are you currently (Read List. Record One RESPONSE) 23% Employed full time 11% Employed part-time 55% Retired, not working 4% Homemaker 2% Unemployed and looking for work 5% Something else <1% Don t know (Do not read) <1% Refused (Do not read) D5) What is your race? 95% White/Caucasian 2% Black/African American <1% Asian 1% Native American or Alaskan Native 1% Other <1% Don't know (Do not read) 2% Refused (Do not read) Rhode Island Long-Term Care: An AARP Survey, June 2002 12
D6) Are you Hispanic, Spanish, or Latino? 2% Yes 97% No <1% Don't know (Do not read) 2% Refused (Do not read) D7) Which of the following best describes your voting behavior in state elections, that is elections for Rhode Island Governor and State Legislators, held in the past ten years? Would you say you have voted in Nearly all, Most, Some or A few of the state elections? 77% Nearly all 11% Most 4% Some 4% A few 3% None (Do not read) 1% Don t know (Do not read) D8) Which of the following best represents your household income in 2001? 7% Less than $15,000 13% $15,000 but less than $25,000 16% $25,000 - but less than $35,000 15% $35,000 - but less than $50,000 13% $50,000 - but less than $75,000 16% $75,000 or more 4% Don t know 17% Refused (Do not read) D9) Gender (Do not ask, simply record.) 45% Male 55% Female Thank you for your time and responses to this survey. Rhode Island Long-Term Care: An AARP Survey, June 2002 13
AARP Knowledge Management For more information contact Katherine Bridges (202) 434-6329