Wednesday, September 12, 2007

A tale of two agings. . .and another warning about the budget

Two aging-related articles telling very different stories of the lives of aging people appeared in the Milwaukee Journal Sentinel September 12.

Front page (though below the fold) was Retiring an old notion. It’s about people staying employed into their 60s and 70s. And it confesses to an “idealized glimpse of the American way of working into the golden years. . .” The article featured Pat Benway, who works for Consortium member Stowell Associates SelectStaff, and who is at the top of her game at an age when many are retired.

It’s a story we all love to hear. People who are vital doing vital work as long as they feel like it, and shaping the job to suit their own changing desires.

Then there’s the other article, buried a little on page 3 of the Metro section: Study finds disparities in area nursing homes. Milwaukee holds the dubious claim to the largest gap in quality care between blacks and whites in nursing homes, according to a study in the journal Health Affairs.

According to the study, which was based on data from the year 2000, race, poverty, and segregation are intermingled in this sorry state of affairs. It's not that individuals of different races receive different care in the same nursing home.

Nursing homes in Milwaukee are largely segregated--by race and income. Mainly white nursing homes—not in the central city; mainly black nursing homes with high percentages of residents receiving Medicaid—in the central city.

The disparities include more significant inspection difficulties, staffing shortages, and financial problems in the inner city nursing homes.

In fact, the environment has changed greatly since 2000, if only because many nursing homes in the central city that served predominantly African-American clients have been closed down.

As Stephanie Sue Stein, director of the Milwaukee County Department on Aging, pointed out, in the few that still exist, “It is very difficult for a nursing home with 100% Medicaid recipients to provide a quality of care that we would expect to provide to older people.”

* * *

Another article appearing a day earlier suggested that the state may have to cut Medicaid payments to hospitals and doctors by 35% starting in January—if the legislators haven’t passed a budget.

Cuts for nursing homes and other home and community based waiver services would be at the rate of 15%, according to Secretary Kevin Hayden of the Wisconsin Department of Health and Family Services. That's because these long-term care providers "provide vital supports to highly vulnerable frail elders and individuals with disabilities.

Of course, if the legislature adopts a state budget, the whole thing becomes moot.

Maybe some of those Elder Boomers we talked about the other day and other vital working adults—including our elected officials--can put their heads together to improve an unacceptable situation.

Thoughts? Ideas? Stories?

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