New Jersey's long-term care system needs big-picture reform. We can do it | Opinion

Aging comfortably, safely and affordably in our homes, or in the community where we’ve spent the bulk of our lives — that’s an ideal most of us strive for, but far too many older residents of New Jersey are denied.

In NorthJersey.com, The Record and the USA TODAY Network New Jersey’s “Aging in New Jersey” series, writers Scott Fallon and Lindy Washburn provide a detailed and empathic account of the struggles that older adults in need of care routinely encounter: exorbitant prices; services that are insufficient or can’t be tailored to an individual’s needs; confusing bureaucratic hurdles.

The ongoing series is a much-needed primer on the flaws of our country’s long-term-care system, which when combined with challenges of growing old in a high-priced, car-dependent suburban region, leaves too many residents without the help they need, and forces many others prematurely into nursing homes.

Our Age-Friendly North Jersey alliance is gratified to see such extensive coverage of a subject that hugely impacts our everyday lives, yet rarely gets the debate and scrutiny it merits.

The pandemic trained a spotlight on the lack of affordability, accessibility and flexibility baked into New Jersey’s long-term-care and older-adult services systems, fueling some encouraging momentum for changing the status quo.

Lawmakers in Trenton, for example, are considering proposals to increase reimbursements to assisted living providers who primarily serve people on Medicaid to help ensure these safety-net programs can survive.

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Another hopeful sign is the state’s recent awarding of a contract for Bergen County’s first Program for Inclusive Care for the Elderly, a promising alternative that’s been too slow to take hold in New Jersey. A review is also underway of the policies and rules that have stifled the growth of Assisted Living Programs, a smart and sensible innovation that brings affordable care into subsidized senior housing buildings.

In his recent budget address, Gov. Phil Murphy pledged additional funds for home and community-based care programs and incentives to bolster our depleted direct-care workforce – both needed steps if New Jersey is ever to achieve its goal of creating a long-term-care system less reliant on nursing homes and institutional settings.

The increased attention to reforming long-term-care programs and policies is a positive sign, but, to truly make our communities and state more supportive of “aging-in-place” goals, our alliance urges a bigger-picture lens over piecemeal change.

The inadequacies and inequities of our long-term-care system in large part stem from taking a narrow and often top-down view. Too often, problems are framed as an inevitable result of aging or of an individual’s failure to plan and prepare. The blame truly lies in our resistance to redesigning communities to fit our population’s current needs, and on our reliance on Band-aid fixes to a social-services system developed in a bygone era.

Going broke trying to pay for the care you need late in life should not be the norm, and it is past time for New Jersey to reckon with the high rates of young and old who are just barely getting by throughout their lives.

Researchers at the Gerontology Institute at the University of Massachusetts- Boston just published an update to their pivotal research on economic insecurity in older adults.

The economic measure they calculated, called the Elder Index, shows that 48% of older New Jerseyans lack the resources they need to pay for basic needs like food, housing, transportation and health care. In New Jersey, that ingrained economic insecurity is largely a result of our state’s housing affordability crisis, and of our failure to equip communities with the physical and social infrastructure needed to support residents through all ages and stages of life.

The Gerontology Institute created the Elder Index in part to help the general public better understand the inflationary economics of living for years — and perhaps decades — on fixed incomes. The institute also hoped to fuel the groundswell of advocacy that’s long been missing on what are too often mislabeled “senior citizen” instead of “livability” issues.

Our movement is dubbed “age-friendly” out of the recognition that we can’t break the mold of our ill-fitting aging-services programs and community-support systems until we correctly diagnose the changes needed as opportunities to improve quality of life for all.

We are gratified that the governor last year appointed a statewide Age-Friendly Council that is currently receiving testimony on its mission to create a comprehensive plan for change. Murphy’s budget proposal also pledged some grant funding for age-friendly community projects, an approach our alliance considers the initial brick-and-mortar steps needed to build a statewide age-friendly infrastructure.

From our vantage point as an alliance of community leaders, local-service providers and older-adult advocates, we see the most workable and sensible housing and care solutions emerging at the community level. With its mixed geography of small cities, dense suburbs and tiny bedroom communities, North Jersey is too vast and varied for a one-size-fits-all plan for enhanced livability and increased affordability.

At the same time, however, the state does need to take the lead, especially on the housing and transportation gaps that municipalities lack the authority and means to solve on their own.

A good model for how that leadership could look is the current push for a statewide measure on the building of accessory dwelling units, tiny homes built within or next to single-family homes. A statewide policy could lead to more standardization of construction and financing mechanisms, which in turn could make this option seem less pie-in-the-sky to homeowners, and less threatening to municipal zoning boards.

From community to community, the specifics of the age-friendly solutions we need might vary, but just as the ideal of wanting to grow old in the communities we love is universal, so should be our resolve to find the right strategies and implement them.

Julia Stoumbos is director of aging-in-place programs for The Henry and Marilyn Taub Foundation, which helped found Age-Friendly North Jersey.

This article originally appeared on NorthJersey.com: NJ long-term care reforms NorthJersey.com aging series