Medicare Cutbacks + Delaware's Aging Population: They Are Coming but We're Not Building It (Except Sometimes Below the Canal)Last year colleague James Landon and I offered up a note of caution in the Urban Lawyer regarding Delaware's "perfect storm" of NIMBY-ism, suburban sprawl, inflexible zoning codes, and Medicare reimbursement rates resulting in zoning policy that excludes the elderly, very sick, and their families from residential communities, nursing care, and social support. We discussed the role of the Fair Housing Act and offered a curative prescription of six features zoning codes should have to ensure meeting Delaware's seniors' needs. We regret to report that while our zoning agenda is going nowhere in any Delaware county or municipality, Delaware’s potential Medicare cost increase due to its aging population will be 457 percent by 2030, according to the May 19, 2013 News Journal. The state did initiate plans to staunch the spending increase: "a system was set up to move people from institutional care back to the community."
As reported this morning the private sector has attempted to respond with facilities and services to help seniors age in place and provide desirable alternatives when that is no longer possible. However, without the zoning reforms needed expand such support within residential communities as Mr. Landon and I discussed back in 2012, the question is whether these cost savings programs and new private initiatives can deliver on their promises when New Castle and Sussex County expect to double their 65 and older population by 2040. As we pointed out in Urban Lawyer, inadequate home care systems result in patients frequenting the uber-expensive emergency room setting. With all the tuition payments and weddings ahead I'll likely be here to give the 2040 report on whether Delaware's local zoning laws have become universally friendly to the kind of community based care the state and private companies try to put in place today.
Doug Denison, "State anticipates fiscal impact: While huge projected increases in costs are still years away, many leaders are aware," News Journal, A25, May 19, 2013; Molly Murray, “Leading the Way in Lewes, News Journal, A1, May 20, 2013