Senate Aging Committee Ranking Member Scott Proposes Reforms to Long-Term Caregiving

In conjunction with yesterday’s U.S. Senate Special Committee on Aging hearing on “21st Century Caregiving: Supporting Workers, Family Caregivers, Seniors and People with Disabilities”, Ranking Member Tim Scott (R-S.C.) released a report titled “Expanding Opportunities for Older Americans: Self-Directed Home & Community Based Services.”

The report highlights the inadequate and disastrous policies proposed by the Biden administration and offers a better path forward where caregivers and recipients are empowered to make informed decisions about the services they want and need.

“Caregiving is a deeply personal issue, and policymakers have an obligation to get it right. Bold reform can boost seniors’ quality of life, support caregivers, and tackle new challenges.” said Ranking Member Tim Scott. “However, pushing $400 billion into an inflated and unaccountable program misses the mark for productive reform.”

The Expanding Opportunities for Older Americans report finds that:

The federal government has increased spending on caregiving in recent decades. In 1981, Medicaid spending on Home & Community Based Services (HCBS) accounted for only 1% of Medicaid spending on Long-Term Services & Supports (LTSS). By 2016, it reached 57%. The American Rescue Plan strongly incentivized states to increase Medicaid spending overall and to spend more of that money on HCBS. Yet sharp rises in HCBS spending have not reduced care costs over time. Medicaid still spends slightly more on institutional care than on HCBS for older Americans and people with physical disabilities.

The Biden administration and its partners in Congress should instead adopt a sustainable funding mechanism that supports alternative models, including the National Family Caregiver Support Program. Federal resources should empower patients and families as informed consumers making their own choices, and financial assistance should improve conditions for caregivers while enhancing service quality.

An effective alternative to the administration's proposal would bolster this initiative and similar programs, empowering older Americans and their caregivers to manage their budgets while building on the success of self-direction in innovative state responses to caregiving challenges.

For example, in South Carolina, the Department on Aging has instituted a robust system of caregiver assessment, which looks at a family caregiver's needs, strengths, resources, and ability to care for a loved one. This approach has sparked the growth of care providers with deep roots in S.C. communities. The state’s approach has resulted in a successful environment for care services. By doing so, South Carolina ranks 7th in the country in an AARP scorecard for the fewest number of people in nursing homes whose needs could be met with HCBS. It is 8th in the country for successfully discharging Medicare beneficiaries into the community from post-acute care.

Click HERE to view full report.