SACRAMENTO – A panel of experts on Wednesday told state legislators that California’s health care policies steer older adults into expensive institutional care following a hospital visit, even when the patients might qualify for less expensive and less restrictive care at home.

The result, say researchers and care providers, is a system that wastes money while restricting the choices of older adults and people with disabilities.

At issue during a joint hearing of the Aging and Long-Term Care Committee and the Health Committee was the “discharge plans” that hospitals provide to patients before releasing them.

“Hospitalization is a turning point for seniors,” said Assemblywoman Patty Berg, D-Eureka, who chairs the Aging and Long-Term Care Committee. “Better discharge planning can mean the difference between a patient getting better, getting to stay home, or getting hospitalized again.”

Research has shown that as hospital stays have shortened and health care costs have risen, patients are increasingly likely to leave the hospital with inadequate care plans, or with little understanding of what those plans entail. Patients and caregivers – especially non-English speakers – have difficulty finding information about health conditions and home care, where or how to get help, eligibility for services, and other social support.

Oftentimes, hospital discharge planners have large caseloads and not enough information to help patients decide on an alternative to a nursing home. Moreover, Medi-Cal and Medicare rules make it less complicated to opt for an institutional setting, while erecting a confusing maze for those seeking to return to their homes.

The Centers for Disease Control and Prevention say that California hospitals now discharge someone over the age of 65 more than one million times each year. According to the American Journal of Nursing, about 40 percent of patients in hospitals are over the age of 65.

Discharge planning will become an even larger issue as the baby boomers enter retirement. According to Health Research for Action at University of California Berkeley, one in five Californians will be 65 or older in California by mid-century. The American Journal of Nursing states that hospital admissions of older adults are expected to increase by 78 percent in the next 20 years.

As co-author of the three-part Master Plan on Aging, Berg has focused on policies that give seniors more flexibility in choosing to stay in their homes, rather than nursing homes. She has been an advocate of more home-based services.

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