Long-Term Care - Illinois General Assembly

folks are looking at other kinds of options, particularly when you're able to provide some
residential options.
• There are also community-based service development funds. The legislature provided
$6 million a year to expand community-based services. One of the major areas and
interests of the State was providing much more housing and service options, including
affordable housing and assisted living services. We had very few assisted living
opportunities for individuals that were participating in the waiver programs. More assisted
living services offer the best substitute for nursing home care in terms of providing
assistance for individuals with medication management problems and dementia problems.
Money was provided for nursing homes for capital projects to re-configure wings to provide
assisted living services, daycare services and other home and community-based services --
essentially trying to encourage the industry to get into the home and community-based
marketplace.
• Minnesota also increased funding of the elderly waiver and alternative care programs.
Significant dollars were reinvested into these particular programs based on projections and
forecasts of the number of facilities that would voluntarily come forward to close beds. The
state estimated that about 5,000 beds in Minnesota would close during the 2-year biennium,
and the dollars saved would be used to finance assisted living and diversification projects.
• The task force developed an incentive for voluntary nursing home bed closures. There was
a need to guard against beds leaving the market where there was a need in the system, and
where there were projections based on the “2030” demographer that indicated a need for
beds in the future. There was a need for careful investment in building the nursing home
stock in the system. This is a voluntary system, which helped in getting it passed through
the legislature. Facilities were not told: “You have to come forward.” Incentives were
provided to come forward. The incentive was $2,080 for each closed bed. That amount
would be moved into a home’s base rate. So, some of the savings went back to the
facilities, while other dollars were moved into investments in the long-term care system,
including cost-of-living adjustments for both nursing homes and home and community-based
service providers. That was really important, because we had been more generous with
cost of living adjustments for nursing homes than for home and community-based services.
The incentive program cost approximately $8 million
• There were also proposals and initiatives to further strengthen the long-term care workforce.
Dollars were provided to facilities interested in providing scholarships to their workers to
advance in long-term care. The conditions required the workers to stay in long-term care for
a set amount of time. The State provided participating facilities additional revenues on a per
bed basis to develop scholarship programs to send nurse's aides to LPN, or RN training to
help them advance careers and hopefully keep them in long-term care.
• Initiatives were also added to enhance quality and consumer satisfaction. The idea in this
case is to establish report cards on nursing facilities and also on home and
community-based service providers.
• What would a long-term care reform proposal have without somebody designing a long-term
care payment system? This is a process that actually has been on hold. The goal is
provide reimbursements based on quality of care. That is now on hold. It will be moving
more toward a simplified reimbursement system, for which details are not currently
available.
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