SEATTLE - A new survey finds support for the first-of-its-kind long-term care program set up by Washington state.

Under the WA Cares Fund, Washingtonians will have access to $36,500, adjusted for inflation, to pay for care services when they retire. The AARP survey found 51% of Washingtonians support the program, but Cathy MacCaul, advocacy director for AARP Washington, noted that support goes up as people find out more about the fund, such as the fact that they don't keep paying for it once they retire.

"As the voters learned that you're not going to be excluded by pre-existing conditions, you can pay a family caregiver, men and women pay the same," she said, "that significantly increased the favorability of the WA Cares program."

MacCaul said seven in 10 adults age 65 and older will require some type of assistance to live independently as they age. Some opponents of the program have said it doesn't offer enough coverage.

MacCaul said there are likey some details about private long-term policies of which people aren't aware.

"Consumers should be aware of buying a policy and what they are paying into and how much they're paying into the policy," she said, "because the premium payments don't stop when you retire."

MacCaul said people often don't think about long-term care until they need it and have some misconceptions on how they will afford it. She said three-quarters of the people surveyed incorrectly believe Medicare or private insurance would pay for long-term care in a nursing home. She said they have other impressions as well.

"Almost 80% mistakenly thought that they would be able to use Medicare or private health insurance for a paid family caregiver to help them with dressing or bathing, etc.," she said.

Beginning in 2022, workers will pay 58 cents for every $100 they make into the WA Cares Fund. They will have access to the fund in 2025.

What is the quality of Virginia's nursing homes? If you ask one advocate, he says "bad."

Jared Calfee, state advocacy director for AARP Virginia, said nursing home inspectors are "woefully" behind.

A possible legislative fix is a bill that would update what Calfee called the outdated fee structure for medical facilities.

The Virginia Department of Health would use those extra funds to increase recruitment and retention of inspectors. Calfee added understaffing can lead to worsening health for nursing home residents.

"What we know is that understaffing leads to negative outcomes, like pressure sores, falls, and ultimately sickness, and even death in a lot of cases," said Calfee. "And so the best thing that we can do for nursing home residents is ensure that there is adequate staff to provide quality care in our facilities."

The Virginia Joint Legislative Audit and Review Commission finds that nearly 40% of nursing homes are in need of their biennial state licensing inspection.

And the Commonwealth has the sixth highest proportion of nursing homes that have not been inspected within two years.

Another budget proposal would include $3.5 million to train Virginians as certified nurse aides, or CNAs.

CNAs provide the bulk of assistance within nursing facilities. Calfee said this small budget ask could have big impacts for nursing home staff.

"This is a high-demand area where we badly need staff," said Calfee, "so a program like this could take a relatively small amount of money, and hopefully infuse the workforce with badly needed staff - to make sure that our nursing homes can staff adequately."

A Virginia Health Care Association survey in 2022 found that 93% of facilities in the Commonwealth have openings for CNAs.

A number of bills in the Maryland legislature are looking to increase the quality and accountability of the state's nursing homes and assisted living facilities.

Advocates for seniors are supporting a bill that would require facilities to install video surveillance systems in common areas.

That way, there would be video evidence to monitor any neglect, abuse or exploitation of residents.
Another bill would increase the number of inspections of assisted living facilities.

Tammy Bresnahan the senior director of advocacy for AARP Maryland.

She said a lot of her focus this legislative session is on assisted living facilities, because of how many high-care individuals they take in.

"We've been looking at assisted living, because they're systematically taking more chronically health-needed individuals," said Bresnahan. "So they look a lot like what's in a nursing home, but people are privately paid for that."

Bresnahan explained that nursing homes have many layers of accountability, given the state and federal medicare dollars flowing into the facilities.

Assisted living centers, on the other hand, usually only receive funds from private customers - with little oversight.

Data from the Center for Medicare and Medicaid Services found Maryland has some of the longest wait times for nursing home inspections, at nearly three years.

Bresnahan added that it's important to have more inspections for assisted living facilities.

"The regulations really only require initially for the licensure to have the inspection - and if there's a problem, they have to go out," said Bresnahan. "So, they really want their assisted living to be inspected more often. "

Bresnahan said any Maryland senior considering a nursing home or assisted living facility should call the Maryland Office of Healthcare Quality.

That office can let seniors know if a facility has a history of issues.

Increasing housing options for the state's seniors is at the top of AARP Iowa's priority list for the new legislative session and the group is pushing for a tax credit for Iowa's growing number of family caregivers.

A lack of housing reduces options for Iowa seniors who want to age in place. Accessory Dwelling Units can help address the problem, from a small house or cottage on the property of an existing home, or even a garage apartment.

Paige Yontz, state advocacy manager for AARP Iowa, said smaller housing units can be the difference between an older person staying in their home or having to find another place to live.

"Currently, those are not allowed in all communities across the state of Iowa," Yontz pointed out. "We are looking to expand access to this housing option by championing a statewide ADU law that would give all Iowans the right to build an ADU on their property, which would reduce unnecessary regulations and red tape."

AARP Iowa will also push for a tax break for the caregivers in the state who provide billions of dollars in unpaid services, mostly to family members.

The tax credit for family caregivers is designed to help offset the costs of services and care they provide, which is often more than $7,000 out of their own pockets.

"It would be a nonrefundable income tax credit that would allow working caregivers to claim up to 50% of eligible expenses when caring for a relative," Yontz outlined. "This would be capped at $2,000 per year, with an additional $1,000 available for individuals caring for veterans or those with a dementia-related diagnosis."

As the group has done in years past, she added AARP Iowa is working to help reduce fraud among the state's aging population, a target for a growing number of phishing and other information scams.