As published as an OpEd in The Hartford Courant, November 7, 2006.

Focus on Long-Term Care as Millions Reach 60

By Julia Evans Starr

About 20,000 Connecticut residents are participating in a groundbreaking - and long overdue - study that will serve as a roadmap for improving a long-term care system that serves thousands of older adults and people with disabilities.

"Long-term care" is often incorrectly associated exclusively with nursing home care or insurance.

In reality, it encompasses a wide range of assistance, services or devices provided over an extended period of time to meet medical, personal or social needs in a variety of settings and locations.

The care is designed to help people live as independently as possible and may be provided in a person's home, at other sites in the community or in managed residential or institutional settings.

Under this broad definition, virtually every person in Connecticut, regardless of age, health or financial status, will need long-term care at some point during their lives.

Clearly, the need is great and the stakes are high.

Though the Connecticut Medicaid program alone spends about $2 billion annually on long-term care services for people of all ages, the state has not conducted a comprehensive needs assessment in more than 20 years. Despite the best intentions of everyone involved, no one knows for certain if the long-term care system is working as efficiently as it should to deliver quality services.

To remedy this situation, the Connecticut General Assembly this year authorized and funded a new assessment in consultation with the state's Long-Term Care Advisory Council, Connecticut Commission on Aging and Long-Term Care Planning Committee. Additional funding has been provided by the Connecticut Long-Term Care Ombudsman Program.

The assessment, now underway, is being conducted by the Center on Aging of the UConn Health Center in Farmington. Preliminary results are due in January.

The center is reaching out statewide via mail, telephone, the Internet and in-person interviews to the public and to private and public providers of long-term care services. It is contacting approximately 20,000 Connecticut residents and providers.

In addition to the surveys, the center is conducting a comprehensive review of both Connecticut-specific and national data on long-term care.

The assessment will document the needs, desires and expectations of Connecticut's residents, analyze the current system, highlight its strengths and weaknesses and make recommendations for the future. Providing quality care in the least restrictive setting - whenever possible in a person's home - is the ultimate goal.

Among its major objectives the assessment will:

Document the current public and private inventory of long-term care services.

Assess which segments of the population receive services.

Project the number of people who will require long-term care services over the next 30 years.

Document the future needs, desires and expectations of those surveyed.

Recommend changes to existing services and suggest new programs and services.

In addition to sharing Connecticut's public policy spotlight, long-term care is finally receiving more attention nationally. Delegates attending the 2005 White House Conference on Aging ranked the need to develop a "coordinated, comprehensive long-term care strategy" as the second most important resolution in its list of top 10 recommendations for the president and Congress.

Ensuring that the long-term care system is ready for the future becomes an even more pressing issue as Connecticut's one million baby boomers age. This year the oldest of the nation's 78 million boomers turn 60 - about 7,920 each day, in fact, or 330 per hour. More than 600,000 Connecticut residents are 60 or older and it is estimated that when the baby boomers begin turning 65, one in five Americans will be 65 or older. The size of the older population is expected to double over the next 30 years, growing to 70 million by 2030.

Based on these staggering numbers alone, it's clear that the General Assembly's recent action was both timely and wise.

While much work remains in the months and years ahead, Connecticut is on the right track to ensure that quality long-term care is available for all who need it and that the state's funds are spent where they will do the most good.

Julia Evans Starr is executive director of the Connecticut Commission on Aging, the state's independent advocacy organization for present and future generations of older adults.

People wishing to participate in the survey may contact Irene Reed at the UConn Health Center at 860-679-2089 or via e-mail at ireed@uchc.edu.