OHCA Spring/Summer 2019

www.ohca.com SPRING/SUMMER 2019 The Oregon Caregiver 17 Economic Impact of Long Term Care Sector in Oregon, Annually Source: NCA/AHCA Research Division (2018). Nursing and Residential Care, Personal Care Aides, & Home Health Care Impact for Oregon. Washington, DC: American Health Care Association DIRECT IMPACT $3.68 billion TOTAL IMPACT $8.07 billion FEDERAL TAX REVENUE GENERATED $777.4 million STATE TAX REVENUE GENERATED $390.8 million COMBINED TAX REVENUE GENERATED $1.168 billion TOTAL EMPLOYMENT 95,843 DATA & RESEARCH As the number of Oregonians who need long term services and supports increases, the economic footprint of this sector will also continue to grow. Impor- tantly, the economic impact is shared across the entire state. While Mult- nomah County sees the highest rate of employment in this sector with 19,596 workers and a $1.6 billion economic footprint, non-urban counties are also greatly impacted. For example, Josephine County employs over 2,000 long term care workers and saw an economic impact from the long term care sector of $175,092,328 in 2015. The role of Ore- gon’s long term care services and supports sector in local economies is significant. The 2018 report highlights the sizable number of Oregon’s workers who are employed within the long term care services and supports sector. The data shows 91,000 Oregonians are directly or indirectly employed in this sector, including 51,000 Oregonians who are employed in direct caregiving. This includes over 19,333 personal care aides and 2,690 registered nurses. As the population in need of long term care services and supports increases in future years, the demand for workers will also increase. Estimates show that by the year 2024, the number of personal care aides needed in Oregon will increase by 29%. The demand for registered nurses will grow by as much as 50% by the year 2025. The total estimated economic impact of the long term care sector in Oregon is $8.07 billion, while the combined federal and state tax revenue it produces is $1.1 billion. This significant amount of tax revenue generates nearly $390.8 million for Oregon’s general fund and $777.4 million in federal tax dollars. Medicaid continues to be the primary funder of long term care services in outpaced other regions. For instance, 33% of Curry County residents are 65 years of age or older, while Wheeler and Grant counties have populations of adults 65 years of age and older of 32.6% and 32.2%, respectively. Oregon. The state has a long history of using Medicaid funded home and community-based services. The data shows that 39% of all assisted living residents are Medicaid beneficiaries, while 48% of Oregonians living in residential care receive Medicaid funded services. Further, 60% of all Oregon skilled nursing stays are paid for by Med- icaid, although Medicare also continues to be an important payer of skilled nursing care at 25% of all stays in 2016 according to data compiled by Oregon State University. Unfortunately, a significant shortfall exists between what Medicaid reim- bursements are able to cover and the average costs of care in Oregon’s assisted living and memory care communities. At a Level 4 need in assisted living, the level where the majority of all Medicaid residents are at, the shortfall is 40% of average costs. In memory care, the Medicaid shortfall is approximately 28% of average care costs. These shortfalls highlight the need for continued invest- ment in Medicaid to ensure that all Oregonians are able to receive the care they need. These are just some of the key data points found within the 2018 Long Term Care State Report. Additional data on the characteristics of the population served within Oregon’s long term care commu- nities and trends in care are also included and much more. This data can help inform state policymakers of the needs of the people served within Oregon’s long term care sector and point to solutions to better Oregon’s existing system. Walt Dawson is a consultant for OHCA and an Atlantic fellow at the Global Brain Health Institute UCSF Memory and Aging Center. A significant shortfall exists between what Medicaid reimbursements are able to cover and the average costs of care in Oregon’s assisted living andmemory care communities.