Long-Term Care - Illinois General Assembly

enables the person to more easily access other services in their home. The person might have
other potential, including employment. The department may be able to address all the needs of
the person.
The program has also developed good relationships with the disability community. This helps to
guide the agency in doing the right thing and developing a program that is responsive to the
needs of persons with disabilities.
The department also recognizes SEIU-Local 880, representing personal care attendants that
work for our customers. An Executive Order was passed this year, and companion legislation,
that has made them the sole representatives of our personal care attendants, and that has
allowed us to sit down at the table and start serious negotiations. Everyone is at the table.
Martha Holstein
Health and Medicine Policy Research Group
A focus on long-term care has been important throughout our history because of its importance
to local communities and ultimately to all of us as citizens and taxpayers. There is particular
concern about developing new and better ways to keep people living in the community for as
long as possible. Nursing homes are essential, but many people currently there can thrive in
the community with adequate support.
The way any society delivers long-term care is important for many reasons: It signals the value
of the oldest and frailest members. Major tax dollars are needed to pay for care for the growing
number of the elderly and disabled populations. Many older people need care no matter how
well they have cared for themselves over their life times. Physical and mental changes are
common features of old age, especially advanced old age. When faced with these losses, the
moral importance of home escalates. The desire to stay home is as important as the deep
resistance that older people have about going to nursing homes. Home means something to
everyone, and that meaning becomes even more significant as a person’s life in the world
narrows because of disabilities. Inappropriate nursing home placement is a contributing factor
to morbidity and mortality of elderly.
• Financing is an unavoidable issue. Reallocation of resources from nursing homes to the
community is a beginning, but other means to finance LTC must be explored with the
retirement of the baby boom generation just around the corner.
≡ Individuals are deeply concerned about their ability to finance their own long-term care
needs and those of their older family members. This fear is particularly strong in the
working middle class who have saved, but not enough to cover the costs of any
extended need for care. The entire middle class feels disenfranchised.
≡ State Medicaid recovery policies create considerable conflicts of interest for elders,
families and providers. The idea of a financial legacy is very important to people. State
recovery under Medicaid after death is like the estate tax for the wealthy. Repeal of the
estate tax is designed to let individuals pass something on to heirs. That may not be
possible for people who have some resources, but are on Medicaid. This is an area that
needs to be re-examined.
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