Long-Term Care - Illinois General Assembly

didn't matter if he or she had a lot of money, or not. The services simply didn't exist on the
home and community-based service side.
The task force established six broad policy directions for long-term care reform in Minnesota.
• Maximize the ability of people to meet their own long-term care needs. The largest
purchasers of long-term care, or the decision-makers who determined where services were
obtained, were individual consumers, their family members or spouses. Too many of these
folks don't understand all of the different options. They see the bricks and mortars of the
nursing home, and they believe that is “long-term care.” In Minnesota that has essentially
been the only option for years.
The task force really wanted to focus on giving consumers more power -- better information,
more resources to make better choices and to understand the various kinds of options that
were available in the community, and also to inform consumers about more ways of paying
for long-term care privately – i.e., long-term care insurance, home equity loans, etc.
There was an emphasis on “choice” -- trying to reform the system, so that there are more
choices that were meeting people's needs and preferences, and looking at a more
consumer- driven system, rather than the provider-driven system that was already in place.
• Simply expand the capacity and availability of community options in Minnesota. A little over
half of the population -- about 5.5 million – lives in the Metro-area. The rest, about
45 percent, is rural. It's largely a rural state. One of the problems in rural Minnesota is that
there are very few options. In many areas of the state the only option for home and
community-based services might be the services that were provided by the county for
(Medicaid) waiver programs, aside from some home-delivered meal programs and services
through the Older Americans Act and area agencies on aging. This was particularly
disturbing to the task force, which then focused on expansion of home and
community-based service models, and on the development of more options for consumers
which more directly related to consumer needs and preferences.
• Reduce the reliance on the institutional model. The task force looked at the numbers in
terms of the state and federal costs of institutional and home and community-based
services. Nursing homes cost about $48,000 a year. State costs on a monthly basis,
subtracting an individual's share, are about $3,200 a month. Home and community-based
services paid under the (Medicaid) waiver, or the waiver-like-programs in 2003 are about
$850 a month.
The task force also looked at the demographics to try and determine how more individuals
can be served in a more cost efficient way, and still meet the choices and preferences with
the same kinds of dollars and mix.
• Achieve quality and good outcomes in our system. One of the real concerns of the task
force was building a decent quality system and providing some basic measures for
consumers to do comparisons between providers and try to identify quality measures.
• Support informal networks of family, friends and neighbors. In a 1995 survey of older
Minnesotans, or individuals that were living at home, 95 percent of the long-term care
supports were coming from family, friends and informal networks. The task force was very
concerned that any expansion of the system not substitute government paid services for
those being provided by family, friends and neighbors. That is a big challenge. Family
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