Long-Term Care - Illinois General Assembly

• The legislature provided funding to counties and area agencies for planning and
development. This was critical. The counties and aging agencies will enable the state to
take stock of what is being invested and what kind of services were being provided, so the
state could have an accurate (road) map – showing which areas were rich in services and
which were not. This will enable us to use funds to focus on areas in greatest need of
development – where people have few choices and greater service needs.
What has happened with long-term care reform over the past couple of years? First, the state
has come close to its mark. 4,000 beds have been taken out of the institutional system. That's
really important. There are another one-thousand beds that facilities have applied to close.
This has been an advantage for facilities that have low occupancy rates. It can be a very good
deal for them by pulling those beds out of system and get a bump rates..
There has been an increase in the use of waivers. In 2000, 34% of the older persons served in
the long-term care state and federal systems in Minnesota were served in home and
community-based services. In 2003, 47% are served in the community. That has increased the
average monthly cost for community care. This increase is primarily due to people requiring
more intensive care in home and community-based care settings. This is also due to the
provision of more affordable housing options, more assisted living options for individuals
and more in-home personal care options. In 2000, the monthly average cost was about $550.
The monthly average cost in 2003 is $850, again primarily because of higher assisted living
costs.
The information assistance and access system is moving forward. The goal by the middle of
2005 is to have a fully integrated, single-entry-point for people to access all services, including a
process by which a person can, either on-line or by telephone, as well as on a face-to-face
basis, access the system and make application and become eligible for state programs.
The task force set some benchmarks for the state to judge how it was doing under the reforms.
One benchmark is the ratio of nursing home beds per thousand elderly over the age of 65.
Minnesota is quite a bit above the national average – about 54. The current rate is 64.6. It's
going down gently, but it's going in the right direction.
Minnesota is serving more and more people and spending more for home and communitybased
care, about 22% in 2003 (estimated). That's more than in 2000, which was about 14.4%.
The expectation in 2004 is around 27%.
With regard to supportive housing: In 1999, there were about 99 units per thousand people
over 65, and now that is about 115.
In terms of case mix, performance is below expectation. Minnesota has a classification system
“A” through “K”. “A” is the lowest level of care in nursing facilities. There is still a fairly
significant number in that classification; close to 15%. That number has not gone down an
awful lot. Maybe it's the cold winters.
The percentage of non-case mix “A” elderly in waiver programs is very promising. These are
cases involving heavier levels of care, and that's a really important piece. This demonstrates
that these individuals can be served in home and community-based settings.
The nursing home industry in Minnesota has adopted what it calls its “long-term care
imperative,” under which it is also embracing the need to further balance the system by
providing more home and community-based services.
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