Long-Term Care - Illinois General Assembly

Trying to get just workers and accounting systems, the care systems, and the hospital systems
to start talking and focusing more on keeping people in their homes is really an important
change in thinking. Helping to transform counties and also the voluntary and community
resources are other measures of success.
Public financing will continue to be a major factor in long-term care. Private options are
growing, but are never going to close the gap because of the high cost and the lack of insurance
and other methods for protecting against the cost of long-term care. There is more shifting to
community and consumer-directed care. The state needs to maintain its long-term care reform
principles, measure progress and take opportunities that arise. There is also a need to promote
more non-government financing and financing options. There may not be tremendous promise
in that area, but there should be as many tools for people as possible to provide some
protection and financing of their long-term care needs. Information systems need to be
expanded to support of family caregivers, which is a real key and critical part of any long-term
reform package.
Christine Gianopoulos
Director, Bureau of Elder & Adult Services, Department of Human Services, Maine
(See Attachment D for power point presentation that guided this testimony.)
Every state has to come up with a strategy or a solution that really best fits its mix of
circumstances.
Maine started its long-term care reform efforts on January 1, 1994, so it is just about the 10 th
anniversary.
Illinois has a lot of the structure and the elements already in place to be moving its long-term
care system forward.
Maine started this process to reduce reliance on nursing home care. In the 1980s and early
1990s Maine had greatly expanded its nursing home capacity. It was a fabulous economic
development strategy in a rural state like Maine, and it was done in spades. So when it found
itself in the early 1990s with its first budget crisis, in a situation where the state was extremely
reliant on nursing facility care, and that spending was increasing geometrically, the first goal
was to reduce reliance on this type of care.
There have been 20 years of task forces and study commissions, where older adults told us
they wanted options. They wanted choices. At the same time, there was no money, nor the
political will for reform.
In the early 1990s when the state budget was going into freefall, that crisis presented the
opportunity to do something about long-term care.
Maine wanted to offer older adults more choices in residential and community-based services.
There was also a significant issue of the very disparate, uneven allocation of home care
resources. It really depended on where you lived, as to how much and what kind of services
you received. In a small state like Maine, people were much more sensitive and aware of that
disparity.
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