Long-Term Care - Illinois General Assembly

The United States healthcare system is about to implode, and Alzheimer's disease is going to
be the detonator. At the federal level, Alzheimer's disease is an epidemic that is already driving
Medicare costs out of control. At the state level, Medicaid is just as vulnerable. Nearly 60% of
nursing home residents are there because they have Alzheimer's or another form of dementia.
The same holds true for the explosive growth in assisted living. Half of all Medicare
beneficiaries with dementia also receive Medicaid because they have exhausted their own
resources paying for that care.
By 2010, Medicaid expenditures for persons with Alzheimer's will increase by over 80%, to $33
billion. Even though families provide nearly 70% of Alzheimer's care, no sector of our economy,
public or private, escapes. Alzheimer's disease cost American businesses $61 billion last year,
twice as much that was estimated just four years ago, an amount that's also equivalent to the
net profit of the ten Fortune 500 companies. This is just the beginning. It will get much worse.
As the baby boomers enter the age of greatest risk, Alzheimer's will become the public health
crisis of the 21st century. By the middle of the century, the number of new cases will increase
by nearly 1 million each year. We are in a race against time. It is a race that we can win, but
only if we work together to find appropriate solutions for the dilemmas that we're under today.
Wendy Meltzer
Illinois Citizens for Better Care
Illinois Citizens for Better Care (ICBC) has 2 interests with respect to long-term care:
• that people who do not "need" to be in a nursing home are not forced into institutional living
by unnecessary and artificial barriers, and
• that people who do live in nursing homes receive competent and appropriate care and
services, and have decent lives.
It is important to understand that nobody "needs" to go into a nursing home. Entering a nursing
home is a socioeconomic decision, not a medical one. If your last name is Rockefeller, you will
never "need" to go into a nursing home. Usually, when we speak of somebody "needing" to
enter a nursing home, we mean that they are so sick that they can only be taken care of in an
institutional setting. In Illinois, however, this is not the case. Illinois, perversely, has been
committed for years to acting as if it were the State of Rockefeller, using the Medicaid program
to subsidize nursing homes by giving people who need much less than total nursing care, no
choice but to move into a nursing home, even when staying home is cheaper — sometimes by
half or more — than helping those people stay home.
Forcing this non-choice on people is fiscally and morally irresponsible. Illinois does it by
artificially capping the number of hours available for the home care that the Department of
Public Aid and Department on Aging will pay, even when we could pay for more hours at a
decent wage, and still pay less than the state's current share of nursing home care.
At a minimum, Illinois should be making it possible for people who want to stay home to do so,
when staying home would cost no more than nursing home care.
This is a partial list of how to do this:
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