Update: The Long-Term Services and Supports Trust Act Washington State Senior Citizen’s Foundation 2019 Fall Conference October 24, 2019
Why this Program is Important Washington’s Aging Population Projected Growth of Older Population in Washington as a Percent of the 2012 Population Source: Washington State Department of Social and Health Services, Research and Data Analysis Division
Why This Program is Important Washington’s Strengths • LTSS system ranked #1 nationally by AARP • 34th in the nation for LTSS costs to the state • 86 percent of clients relying on Medicaid receive LTSS in their own homes or local community residential settings • Professionalized LTSS workforce • Paid Family Medical Leave Act • Integrated payment system 3
Why This Program is Important Problem to be Solved 7 in 10 Washingtonians over the age of 65 will need long-term services and supports within their lifetimes. More than 90 percent of Americans are uninsured for LTSS. Medicare does not cover most long-term care. To pay for LTSS, many people must spend down their savings to qualify for financial support through Medicaid. 4
The Legislature’s Solution • Broad-based • Passage of Actuarial feasibility coalition completed SHB 1087 formed to • Legislators introduce tackle LTC 2017 Long Term Care financing crisis Trust Act 2019 2013-2014 2015-2016 2017 2018 • • Coalition continues LTC Trust Act gets bi-partisan education & outreach support and passed through • Legislature mandates two committees • feasibility study National media • Updated feasibility study • Interim stakeholder policy workgroup
The Legislature’s Solution • HB 1087 and SB 5331 received bipartisan sponsorship and support. • Gov. Jay Inslee signed the bill into law on May 13, 2019. 6
What the Law will Do Trust Contributions • Washington workers will pay up to $0.58 per $100 of income • Every W-2 worker contributes – employers do not • If you are self-employed, you can opt Someone who into the Trust to get benefits makes $750 per • If you have long-term care insurance, week will pay $4.35 into the Trust. you can opt out of the Trust
What the Law will Do The Benefit • Each person who is eligible to receive the benefit can access services and supports costing up to $36,500 . Someone who makes $750 per • The value of this week will pay $4.35 benefit will increase into the Trust. over time. 8
What the Law will Do The Benefit The benefit can be used for a range of services and supports, including: Professional care in your Training, pay and support for home, a licensed residential family members who provide facility or a nursing facility care Adaptive equipment and technology like wheelchair ramps Home-delivered meals and medication reminder devices Rides to the doctor Home safety evaluations
What the Law will Do Vesting in the Trust & Eligibility • To receive the benefit, you must have worked: – At least three of the last six years or 10 years without a break of five or more years, and – At least 500 hours per year during those years • Eligible if you need assistance with at least three activities of daily living
What the Law will Do Established Bodies Trust Legislators Council 12 Trust members Commission Administrating 21 members Agencies Investment Strategy Subcommittee 14 members Stakeholders Non-partisan Investment Experts
Agency Roles • Process payments • Collect • Track benefit Premiums & usage Wage Reports • Coordination of • Determine benefits ESD HCA qualified individuals State DSHS • Administer Actuary benefits • Audit and valuate • Manage providers trust to ensure solvency • Apply for demo waiver from CMS 12
Path Forward Key Milestones Commission must report to the legislature in 2021 on: • Criteria for beneficiaries, providers • Actuarial reports • Recommendations to maintain solvency • Recommendation on whether to amend the law to include individuals with developmental disabilities (following stakeholder consultation)
Questions? Contact: Jeremy Arp, LTC Trust Project Director Jeremy.Arp@dshs.wa.gov 14
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