PROVIDENCE, R.I. – In a new report to the National Commission for Quality Long-Term Care, two Brown University professors describe the state of long-term care in the United States and outline six key “areas of concern.”
“Out of the Shadows: Envisioning a Brighter Future for Long-Term Care in America,” was authored by Brown’s Vincent Mor, chair of the department of community health, and Edward Alan Miller, assistant professor of public policy, political science and community health. Both are also investigators at the Center for Gerontology and Health Care Research at Brown. They began the report in August 2005, when Mor was the national commission’s executive director.
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“Although the United States is aging rapidly, we still have some time before the real tidal wave of the aged population is felt,” Mor said. “But if we do not begin the process of change now for this increased demand for services, it is not clear how we will manage. It will take time to plan and then implement financing and delivery systems that meet the needs of the coming elder revolution. Reform is necessary not only for the sake of future generations of long-term care recipients, but also for the sake of those thousands of individuals receiving inadequate care in the current environment.”
Out of the Shadows is the product of an in-depth examination of the literature, statistical analysis of data, and testimony to the national commission by outside parties. It is also informed by interviews with commissioners, academics, government officials, and industry experts. The document’s declared purpose is to “inform the work of the National Commission for Quality Long-Term Care as it heightens awareness and formulates policy solutions to the long term care conundrum facing the nation.”
“Long-term care consists of many different services and service locations. There is also a broad range of interested stakeholders, not least of which include providers, government, advocates, families, and, of course, service recipients themselves,” Miller said. “But despite widespread concern about the quality of long-term care, we have yet to reach a national consensus about the way in which long-term care should be delivered and financed.”
In the report, Miller and Mor examine six “areas of concern” they say must be addressed to create a better system: Prioritizing the financing of long-term care; empowering individuals and families; promoting physical and organizational change; investing in the long-term care workforce; modernizing regulatory controls and incentives; and leveraging health information technology.
“To create a fair, comprehensive, affordable, and efficient long-term care system, requires a multi-dimensional strategy that addresses different aspects of the problem,” Miller said. “Unless we engage in a national debate about the six areas of concern … we will continue to find it difficult to develop a strategy to address both current and future need.”
One commission member, Monsignor Charles J. Fahey, called the report “remarkable.” “I am unaware of anything comparable,” he said. “It is comprehensive, factual, and well-written with appropriate commentary. I hope it will inform Phase II of the Commission’s work since it offers a great starting point. … It will be widely read and serve as a basis for many better-informed conversations.”
The report has been submitted to all the commissioners, including former Sen. Bob Kerrey, former U.S. House Speaker Newt Gingrich, Gov. Haley Barbour of Mississippi, Gov. Phil Bredesen of Tennessee, Sen. Gordon Smith of Oregon, Rep. Earl Pomeroy of North Dakota and Rep. Nancy Johnson of Connecticut.
The full, 100-page report is available for download at www.chcr.brown.edu.
