California Partnership for LTC: A consumer education program of the California Department of Health Care Services

Tim Gieseke MD, CMD

As an internist with a long standing interest in Gerontology, I have seen the necessity for SNF, Custodial Care, RCFE, and Home Care. However, most of my patients have not seriously considered the possibility that they might become dependent. Neither have they prepared for its potential financial impact.

SCAN Health recently conducted a focus group survey in which they asked "Baby Boomers" about their parents' health in the last years of life. They acknowledged that most of their parents had a prolonged period of declining health and function that required a great deal of support from the family. However, when these "Boomers" were asked how they thought their last years would go, most thought they would be healthy and functional up until a very short time prior to their death.

My mother-in-law experienced this phenomena several years ago when she said, "I never thought this would happen to us" (my father-in-law had become dependent and lived with chronic pain). Though not mentally prepared for these changes, they fortunately did have good LTC insurance that covered the RCFE care he required the last year of his life.

How well have you prepared your patients, loved ones, and self for the possibility of temporarily or permanently losing ADLs? My wife and I are now old enough to realize this is a real possibility so I was particularly interested in the AGS announcement that California Health Services has developed a web site dedicated to helping us prepare prior to a crisis. California is the first state to create this partnership with the insurance industry. The website: www.rureadyca.org has tool bar sections on: Facing Reality, First Steps, Know Your Options, and Resources.

As a consumer, I found the website to be well designed and understandable. Two out of three of us will spend some time in LTC. The website discloses the public/private partnership behind the web site. I didn't detect bias. I have been skeptical of the insurance industry, since I have seldom seen more than SNF Part A "Medi-Gap" coverage, when my patients had thought they had purchased custodial care. However, in recent times, this has changed. The consumer can now purchase custodial care with premium determined by age, co-morbidities, and extent of coverage.

From a personal perspective, this is a very timely development. My wife and I were recently advised by our financial planner to take action in this area. This website has helped me understand our options. I strongly encourage you to make this website known in your practices and communities. With the current LTC funding crisis and the reduced availability of families, Californians need to better prepare for the possibility of becoming dependent.