As someone who lives with and takes care of my grandmother, I understand the challenges and difficulties she faces as a senior-citizen. She has found it increasingly difficult to live an independent, comforting and safe life as she ages, and finds it challenging to navigate state resources due to the fact that English is not her first language.
Unfortunately, not every senior resident has the type of family support my grandmother has. Furthermore, many seniors are frequently unaware of state resources/programs or do not know how to navigate and benefit from these services.
As such, I believe we need to work towards eliminating restrictions that impede our residents from full participation in the mainstream of our community life. This is how we can help them “Age In Place” (the idea that we need to help our seniors live comfortably, safely & independently in the communities they helped build, including physical, social, mental, emotional and financial assistance).
Here is what my Relief, Recovery, and Reform platform will accomplish:
Medicaid Eligibility Expansion
- Nearly 350,000 Marylanders do not have health insurance, and over 100,000 of these people are not even eligible to receive Medicaid, a federally and state-funded healthcare subsidies program designed to help cover those with financial hardships.
- This significant gap in eligibility is primarily created by state-specific income limits that place extreme caps on how much money a household can make before being rendered ineligible for Medicaid. In Maryland, that income limit is just 138% of the Federal Poverty Level (FPL), which amounts to approximately $17,800 for a one-person household. This income limit is a policy disaster, as hardly any full-time workers in Maryland who earn the state minimum wage of $11.75/hour would be able to qualify for Medicaid, despite making less than $25,000 a year.
- To make matters even worse, undocumented immigrants are technically barred from Medicaid eligibility entirely, because they fail to meet federal immigration status requirements. These flaws in our healthcare system will inevitably continue to lead to needless suffering and increased medical debt.
- Raise Maryland’s Medicaid income limit to 200% of the FPL, which would correspond with approximately $25,800 for a one-person household.
- This would help ensure that nobody slips through the cracks and misses an opportunity for meaningful health coverage, because it would more comprehensively bridge the gap between those who can and cannot afford health insurance.
- Another crucial solution to this problem would be to expand the Emergency Medicaid ‘loophole’ that already enables periodic, selective coverage for undocumented immigrants.
Unlike other policy proposals, this one does not inherently entail additional costs:
- This policy purely expands Medicaid eligibility for those who desire it — instead of automatically enrolling people and increasing spending;
- It will not only help us reduce healthcare costs in the long-term, but the lion’s share of this financial burden will still belong to the federal government.
Improve In-Home Care
Home based services provide opportunities for Medicaid participants to receive services at home. It’s an issue I actually currently work on in my day job at the National Kidney Foundation. This especially helps those who are immunocompromised, seniors and those with disabilities who physically can’t leave their homes, and those in rural communities who can’t get to a more formal setting. We must protect and expand funding for these programs.
Improve Long-Term Care
Nursing homes and assisted living facilities have suffered staffing shortages and confusing and ever-changing protocols. For some of these reasons, more than half of Maryland’s COVID deaths have occurred in these long-term care facilities. As such, we need to ensure we have enough PPE for these residents and that infection control procedures are consistently followed (and remain consistent throughout the state).
Create a Caregivers Program
While we help our seniors age-in-place, it’s also important to assist their caregivers and reduce the burden of family care.
I believe we should model a program in Maryland that is similar to the Kupuna Caregivers Program in Hawaii, in which the state helps offset some of the various costs associated with long-term caregivers (many of whom are women who are forced to leave the workforce to care for their seniors).
In Maryland, I would ensure residents who work 40 hours or more a week outside the home — and who serve as the primary caregivers — are eligible to enroll and eligible to receive $50-$100 per day to help cover some of the costs associated with hiring at-home direct care staff.
In doing so, we will not only help reduce the burdens of family care, but we will also help increase the number of in-home caregivers and help our seniors better — and more successfully — age in place.
Invest in more multilingual specialists
The need for multilingual specialists across state agencies is both urgent and growing. These language proficient professionals make a difference when those who are not native-born English speakers seek support from government resources.
Many of our senior residents have difficulty using some aspect of their home. These residents are more likely to live in or near poverty, and live in a rented housing unit. As our aging population grows, the importance of considering how the functional layout and design of homes will affect our senior residents’ ability to live safely, comfortably and independently.
As such, we must ensure a greater percentage of new homes and housing units (especially those near metro-hubs) have aging-accessible features, such as handrails or grab bars in bathrooms, a wheelchair-accessible kitchen, a bathroom and bedroom on the first floor, and a step-free entryway into the home.
We must do more to make sure retirees have more disposable income, greater access to affordable housing and the ability to age in place. My “Maryland Now Plan”, and my plans that address Transportation Infrastructure and Housing are tangible solutions.
The other part of the solution is making sure we support “defined benefit” plans (where employers contribute the entire amount, payouts are based on years of service and retirees don’t have to track or worry about their pensions) instead of “defined contribution” plans (where both parties assume the risk and expenses with no guarantees that the pension will remain the same).
Support for Nursing Homes and Assisted Living Facilities
Currently, there are no requirements for direct care staff in these facilities to be appropriately licensed and trained as Nursing Assistants; and the resident-to-staff ratios are unreasonably high.
Not only have these issues proven to decrease the quality of care provided to the residents of these facilities, but they have also provided extra stress and strain on the staff. We need to do better and reform the system in which we take care of our nursing home community.
The most effective and tangible solution to resolving some of these issues is by reforming the “Oversight Committee on Quality of Care in Nursing Home and Assisted Living Facilities”.
This committee was established in 2018, but needs better oversight. It only meets once every three months and has typically had issues drawing a quorum. This is why I would amend the Committee’s mandate to establish transparency requirements, regular meeting requirements, and annual progress reporting to the Governor’s Office.
We have an increasing number of older residents who are retiring. These residents are a key element to our state’s success, and we need to keep them in our communities and neighborhoods. As such, I believe in mixed-use development (i.e. smart growth) where residents have greater access to live, work, shop and play (along with increased access to transit).
Furthermore, I would encourage zoning that would include and/or allow a variety of affordable multi-unit, multi-income developments such as apartments, accessory-dwelling, and cohousing. This would allow our older residents who wish to move out of single family homes to continue to live in the communities they have spent the majority of their life.
Increase savings and disposable income
By making public transit free and more accessible — and eliminating the state income tax for 95% of Marylanders (via the “Maryland Now Plan” found here — https://jainforgov.medium.com/the-maryland-now-plan-eliminating-the-state-income-tax-and-a-guaranteed-jobs-program-8ed25788ec47 ) — we can help residents save more for their retirement, as well as reduce the overall costs of living for both the short and long-terms.