Long-Term Care - Illinois General Assembly

Michael Gelder
Deputy Director, Illinois Department on Aging
The Department on Aging is primarily responsible for distributing money from the federal
government under the Older Americans Act. The department distributes this money to 13 area
agencies on aging, which further distributes that money to local communities in support of about
two dozen programs, from “Advanced Directives,” which helps people make end of life
decisions, to volunteer programs, which help (dependent) healthy, very frail, and bed-bound
elderly who choose to remain at home in their communities.
The department also manages the Community Care Program, which provides home-based care
to residents who would (otherwise) be nursing home eligible. Illinois is somewhat of a model in
terms of the breadth and scope of services it supports. There are about 39,000 seniors who
receive care at any given time, probably 50,000 over the course of a year. These seniors are
deemed to be nursing home eligible due to restrictions on their activities of daily living, and who
need the services offered under a Medicaid waiver. The program is limited to homemaker and
adult day services. There are a limited number of counties that have adult daycare services, but
the recent increase in reimbursement rates over the last 18 months intends to stabilize the
number of providers and attract additional providers into the program.
The Community Care Program also provides comprehensive case management services.
There is a universal prescreening program, so that everybody about to enter a nursing home, or
considering entering a nursing home, are seen by a case coordinators contracted through the
department and local area agencies on aging. Case managers do the assessment, and if the
person meets the need threshold, they are then given the choice of whether they want to remain
in the community and receive adult daycare or homemaker services, or enter a nursing home.
The department may also be considered the eyes and ears of the senior community, through its
information and advocacy functions. The agency administers an active senior help-line — an
“800” number. Through hundreds of calls a day the department tries to guide seniors to
appropriate service in the community.
The department also administers the Elder Abuse program. There are often cases where
seniors are not protected and sometimes abused. They can be weak, alone, trusting and
vulnerable. The program helps them, along with the ombudsman program, which represents
seniors in nursing homes. Families and seniors can call to report potential abuses.
Seniors can't always advocate for themselves. The department can perform that function.
Resources must be harnessed in a way that helps seniors meet needs in the most direct and
cost effective way.
The department is committed to re-balancing the long-term care system. It's the number one
priority. In the strategic planning process that the Governor has undertaken for all departments,
there is agreement that the status quo is not tenable. The shifting demographics, the high level
of dissatisfaction by the elderly in the community, in both institutional and non-institutional
services, and the high costs being incurred, means more needs to be done — it needs to be
done differently and better. The Department on Aging is committed to that goal.
35