Choice of Setting & Provider (home and community-based service services; assisted living and residential care units; adult day services; subsidized housing and home health and personal care aides for people with activities of daily living disabilities): Florida was next to last in this category, just ahead of Alabama.
It scored especially low for the number of home health and personal care aides and subsidized housing opportunities. Fewer than 5% of all housing units in Florida are subsidized housing; in New York, by contrast, about 10% are.
“People coming to Florida from up North may not have a social system here,” said Johnson. “So, when they need help, they don’t have that social infrastructure.”
And, he added, Florida is a state built around cars, with little public transportation to help older residents age in place.
Support for Family Caregivers (this category includes things like state supports for working caregivers; assessing family caregiver needs and the ability to delegate nursing tasks): 10 states offer residents more than the federal minimum Family and Medical Leave Act rules and Florida isn’t one of them.
But, Reinhard said, the Florida state legislature recently gave nurse practitioners more autonomy, which could help some older adults living at home and needing long-term care.
Effective Transitions : Florida was a mixed bag here but ranked last among states for the percentage of nursing home residents with “one or more potentially burdensome transitions at end of life.”
Quality of Life & Qualify of Care (this includes things like the percentage of high-risk nursing home residents with pressure sores and the percentage of long-stay nursing home residents who inappropriately receive antipsychotic medication). Florida showed a substantial improvement from the last Scorecard in 2017 in the use of antipsychotics for nursing home residents.
But the state ranked just 35 for pressure sores in nursing homes. “I started working at AARP in 2000, working on nursing home staffing standards, and it has always been a battle,” Johnson said. “Our standards of care are good, but not the best.”
Johnson and Reinhard are somewhat hopeful about long-term care improvements in Florida, though.
The state legislature has passed a law “drastically reducing the number of poor, disabled and elderly residents on the waiting list for placement in Florida’s Medicaid managed long-term care program,” Johnson said. Before that, roughly 60,000 were on that list.
And, Johnson noted, “one glimmer of hope that doesn’t show up in the Scorecard is just beginning.”
He’s talking about the group of leaders from AARP, the Florida Health Care Association, LeadingAge Florida and a health care union group (its grating name: The Coalition for Silver Solutions) who’ve been meeting to come up with better short-term and long-term strategies to meet the long-term care needs of Florida’s aging population in 2020 and beyond.
“I think the state government is very much aligned with this work,” Johnson said.
The next Scorecard will show whether these efforts pay off.
In the meantime, Johnson said, if you or your parent plan to move to Florida for retirement, “think of the whole span of your life.” In other words: consider the possibility of needing long-term care and do some research.
Added Reinhard: “Don’t expect someone swooping in to take care of you for free.” Instead, she said, “look for a residence that is accessible, try to make friends, get connected to the community and take care of your health. Do as much prevention as you can.”
Florida’s Scorecard ranking “doesn’t mean there aren’t older people who have had good experiences aging in place and in facilities here; there is quality care,” Johnson said.
But “it means you may have to look harder for it and know what you can afford and assess options in your price range,” he added. “Think of Florida not as an extended vacation but as a true move where you’re prepared to spend the rest of your life.”
Richard Eisenberg is the Senior Web Editor of the Money & Security and Work & Purpose channels of Next Avenue and Managing Editor for the site. He is the author of How to Avoid a Mid-Life Financial Crisis and has been a personal finance editor at Money, Yahoo, Good Housekeeping, and CBS Moneywatch.
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