If a society is judged by how it cares for its most vulnerable, Indiana’s lawmakers need to be looking hard at what their legacy will be.

While the clock is ticking on the 2022 General Assembly session, the majority of lawmakers seem incapable of moving beyond playing games of partisan politics.

Meanwhile, as trends in population change become clearer, the financial challenges for aging Hoosier residents and their families are real.

CNHI STATEHOUSE REPORTER WHITNEY DOWNARD explained in a recent story the struggle of a Hoosier family trying to take care of an aging and disabled relative. The family first turned to a nursing home.

“They would just line him up outside of the nurse’s station in the hall with 8 or 10 other people. When you walked by the nurse’s station, there would be people crying out for help and nobody, nobody, paying attention. Every time I went there and he was in his room, he was wet (in his diaper),” said Valerie DeBusk, who took on the care of her cousin James “Dougie” Upchurch.

Indiana has more than 500 nursing homes and sits at the bottom of all 50 states in the amount of Medicaid funds it spends on services at home or in the community for long-term care — just 35% in 2019. The nationwide average is 59%.

And, if lawmakers think this problem is going to fix itself, they need to think again. The population of Hoosiers 65 and older was 966,124 in 2015. That number will grow to 1,412,196 by 2030, according to a report by the Bureau of Business Research at Indiana University’s Kelley School of Business.

THE U.S. CENSUS BUREAU QUICK FACTS in July 2021 reported 11.6% of Indiana residents at the poverty level, a median household income in 2019 dollars at $4,692 per month and a per capita monthly income of $2,482. In 2020, Social Security benefits for retired workers nationwide averaged just $1,555 monthly.

The cost of Indiana nursing facilities on average begins in the $7,500-a-month range and can go much higher. Income is already painfully shy of the costs associated with long-term care. What hope do families have if current trends continue?

The president of the Indiana Health Care Association, which represents hundreds of for-profit nursing homes in the state, estimated that the care of 65% to 85% of residents is paid by Medicaid.

So far during this session of the General Assembly, three bills with significant effect on aging Hoosiers have been filed.

One deals with relaxing existing rules on the number of admissions that can be accepted annually at schools of nursing. The COVID-19 pandemic hit hard at the state’s number of nurses and certified nursing assistants in all health care facilities. Of the 21,667 COVID-related deaths reported in Indiana from March 16, 2020, to last Friday, 7,357 were in long-term care facilities. That bill has been returned to the House with amendments.

Another bill, filed Jan. 12, was focused on public disclosure of how the money the state receives is spent in nursing care facilities. That bill was sidelined to the Senate committee on Health and Provider Services and remains there.

A third bill, which set forth new rules governing operations of managed care, was introduced Jan. 12. It made its way to the House Ways and Means Committee after many amendments to the original Senate bill. But, Ways and Means has declined to hear the bill, meaning that bill is now dead.

CENSUS NUMBERS are showing a significant change ahead. The population of the state is growing older, and the birth rate is declining. Where there is population growth, much of that growth could be in historically disenfranchised populations that may never earn the income levels of earlier generations.

If Indiana does not lay the groundwork to ensure the care of its most vulnerable populations, history will judge us harshly. More importantly, many of our fellow Hoosiers will suffer.
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