Senior Care and Services Study Commission
In June 2007, Pennsylvania Public Law 49, Number 16, Act 16 provided for the establishment of a Senior Care and Services Study Commission to assess the senior population's need for care and services. The Commission, created May 1, 2008, has the following purposes:
- To review current services and resources available to Commonwealth residents age 65 and older;
- To project the future need for services through the year 2025;
- To evaluate the ability of the current systems to meet the projected needs; and
- To project the resources necessary to meet the projected need and to make policy recommendations as to how this need can best be met given current resource limitations.
To meet the first of these requirements, the Commission has drafted a report reviewing current services and resources available to Pennsylvanians age 65 and older. This report focused mainly on health- and long-term living services, resources and programs, but also provides information on other important supports such as transportation and housing. Key findings from this report are:
- Pennsylvania ranks third in the nation for share of the population age 65 and older.
- Pennsylvanians age 65 and older do not tend to differ significantly from the national average for this age group on characteristics such as marital status, poverty status, and prevalence of disability and certain chronic health conditions.
- Medicare is the primary payer for health care services for people age 65 and older, but out-of-pocket spending also represents a significant share of older people's health care spending (15 percent in 2004). The largest share of this age group's health care spending goes toward hospital care.
- More than one-third of Medicare beneficiaries in Pennsylvania are enrolled in Medicare Advantage plans (Medicare managed care). Many of these plans offer reduced Medicare cost-sharing and supplemental benefits.
- Roughly 12 percent of Pennsylvanians age 65 and older have supplemental health coverage through the means-tested Medical Assistance program. Some of these "dual eligibles" receive full Medical Assistance benefits, while others receive more limited assistance such as payment of Medicare cost-sharing and/or premiums. For older people who meet both the financial and clinical criteria, Medical Assistance also pays for institutional and community-based long-term living services that Medicare does not cover (see below).
- Medicare's coverage of long-term care is quite limited in that it only pays for skilled care within certain circumstances and for specified periods of time. Medicare home health covers services only for people with part-time, intermittent needs. And, skilled nursing facility care is limited to 100 days per benefit period after a qualifying hospital stay. In addition, there is significant beneficiary cost-sharing for skilled nursing facility care after the first 20 days.
- Nationally, the majority of long-term living services for people age 65 and older is provided by informal (unpaid) caregivers such as adult children, spouses, friends and neighbors. In Pennsylvania, estimates show there are 1.2 to 1.4 million informal caregivers providing 1.3 billion hours of care at an economic value of $11.6 to $14.5 billion.
- Pennsylvania funds numerous programs providing long-term living services to people age 60 and older, as well as two programs assisting with this group's drug costs.
Senior Care and Services Study Commission Report
Act 16 also required public input on current and proposed programs serving seniors and a series of public meetings was held between October 15, 2008, and November 5, 2008. Transcripts of the meetings can be found at the following links:
Meeting held at Center in the Park, Philadelphia, Pennsylvania on 10-29-08
Meeting held at Luzerne County Community College, Nanticoke, Pennsylvania on 11-05-08
Meeting held at Rutherford House, Harrisburg, Pennsylvania on 10-23-08 Meeting held at the Meadville Community Center, Meadville, Pennsylvania on 10-16-08
Meeting held at The Oaks, Pleasant Gap, Pennsylvania on 10-15-08
Meeting held at the Three Rivers Center for Independent Living, Pittsburgh, Pennsylvania on 10-21-08
Meeting held at Westmoreland County Community College, Youngwood, Pennsylvania on 10-21-08
House Bill 1367