From 2001 to 2006, three times more was spent on nursing homes in Hawaii than developing home- and community-based services despite the desire of residents to age in their own homes, says AARP President Jennie Chin Hansen.

“;This calls for an important policy review of what people want and the cost effectiveness of doing this in the long run,”; she said in an interview. “;It's quite well acknowledged right now that Hawaii has an unbalanced Medicaid long-term care system.”;

Hansen is a keynote speaker at a Hawaii Caregiver's Conference, “;Caring for Family, Caring for Yourself,”; from 8 a.m. to 3:30 p.m. today at the Sheraton-Waikiki Hotel. Also speaking is Bill Thomas, founder of the Eden Alternative, a concept of deinstitutionalizing long-term care.

Hansen said “;there is huge urgency”; to move ahead with long-term care planning in Hawaii because of the state's rapidly aging population.

She pointed to Washington as an example of a state that has developed plans with a range of services to meet long-term care needs.

“;What's amazing, they were able to hold down building of nursing homes”; with community-based services to help people carry out their wish to age in place, she said. “;They were able to serve more people for less dollars per person.”;

Hansen is six months into a two-year term that will be marked by the nation's economic problems.

“;But it is also consistent with what AARP has been focusing on all along—both economic long-term security for people as well as health security,”; she said.

The “;quiet crisis of long-term care”; is a significant part of health care reform and costs, she said, pointing out informal caregivers provide 80 percent of caregiving in the United States. They are contributing an estimated $350 billion in caregiving, she said.

Lost productivity is estimated at $33.5 billion because 60 percent of caregivers are employed, resulting in what is called “;presenteeism,”; she said. “;Even though they're there in body, they are mentally and emotionally so worried about it.

“;It's one of those things we all get involved with,”; she said. “;I also took care of both my parents and brother. It's a story that's quite universal.”;

Hansen said Hawaii is a leader in providing caregivers with tools and assistance, such as those offered at today's conference, sponsored by AARP Hawaii and the city Elderly Affairs Division. “;They know they're not alone.”;

AARP Hawaii supported legislation passed to establish a long-term care commission to look into the issues, develop an infrastructure for long-term care and form a policy “;that will make sense for Hawaii,”; Hansen said.

AARP supports the concept of universal health coverage, she said, noting Hawaii is ahead of other places because of mandated employer health coverage for employees.

“;But we still have people losing coverage when they lose jobs,”; Hansen said.

AARP has an initiative called “;Divided We Fail”; that brings together employers, unions, labor and others to discuss health care access, quality and coverage in a nonpartisan way, Hansen said.

“;They're not, oftentimes, likely colleagues but we're saying together we have to take a look at core principles of affordable quality coverage for people. That is one thing we're unified in.”;