Long-Term Care - Illinois General Assembly

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Representatives of all provider groups affected by the tax should be at the negotiating table as any provider proposal is considered. If additional taxes are considered for any provider group to fill a budget hole or to increase funding, such a plan should be considered for all qualified Medicaid provider groups. RATES SHOULD BASED UPON A UNIFIED, OBJECTIVE, VERIFIABLE, COST BASED REIMBURSEMENT SYSTEM USING AUDITED PROVIDER COST REPORTS It makes no sense that some providers receive more than their costs, while others receive less than the cost of providing care. Some receive a huge “profit” (up to 27% in some cases), while others do not. As part of a comprehensive planning approach, the state must be able to know what each service costs, and pay providers fairly based upon those costs. Unfortunately, cost information is currently not collected from some groups; while for other it is collected, but not used to establish payment rates, and there are no negative consequences if providers do not submit the information. ESTABLISH A STANDARDIZED COMPLAINT SYSTEM An important aspect of ensuring customer and family satisfaction is the ability to make reasonable complaints and to have those complaints resolved. The current system makes it difficult for an individual to navigate through the complaint process. Currently, IDPH, IDHS, Aging, and the State Police all have complaint hotlines. Individuals contacting these hotlines may not be aware of the appropriate agency to contact when problems arise. Consolidation of these hotlines into a single entity will streamline the process, saving vital time and state resources as well as making the complaint process much easier to access. In addition to a common intake system, it is imperative that common definitions of abuse, neglect and financial exploitation, common complaint investigation procedures, common definitions of types of complaints, standardized mandated reporter guidelines and standard complaint investigation protocols be established. ESTABLISH A WEBSITE THAT CONSUMERS CAN USE The website must be searchable and user friendly. It should include an assessment tool to gauge the needs of the prospective customer, an explanation of the costs of the service options, and a directory of the full range of services available by geographic area. As the site is developed, it could be expanded to include the results of customer satisfaction surveys, quality standards, staffing information, and comments from residents and family members about the service delivered in each setting so that individuals searching the site can get a balanced view. It would be necessary to determine the most appropriate state entity to host and maintain the site, dialog with interested parties about the content of the site and give consideration to what consumer satisfaction information should be contained on the site and the most appropriate method for collecting such data. DEVELOP A SINGLE POINT-OF-ENTRY FOR ALL LONG-TERM CARE SERVICES, AND CONSOLIDATE CASE MANAGEMENT SERVICES Right now individuals spend considerable time just learning how to navigate the system. Many become frustrated and finally enter the system with negative attitudes about how they have been treated. Dealing with health issues of family members is stressful enough without complicating it further. The unification of case management activities would benefit customers, 57
providers, and the state by streamlining the process. Any such process should ensure the fair representation of all types of appropriate services available to the customer, disclosure of the estimated costs of those services, and a clear determination of the personal, health and medical needs of the customer. STANDARDIZE TRAINING, BACKGROUND CHECKS, AND OTHER REQUIREMENTS FOR CAREGIVERS Currently, a number of state agencies are responsible for licensure, employment, or pay for caregiver services, including the Illinois Departments of Public Health, Human Services, Public Aid, and Aging. Standardization of caregivers requirements will save state resources and allow caregivers to easily shift their services along the continuum as necessary or as they desire. IMPROVE WORKING CONDITIONS AND OPPORTUNITIES FOR ADVANCEMENT FOR WORKERS This can be accomplished in part by the following: • Allow long-term care employers to purchase health insurance for their employees through the state employee insurance program. Such proposals in the past have met with considerable resistance from the Illinois Department of Central Management Services. Economies of scale make such insurance less costly than purchasing small group policies and more affordable for financially strapped entities. • Establish career ladder programs that are available for all employees. All entities must have the ability to create these programs and fund the financial incentives provided to employees. • Explore possibly allowing unlicensed personnel to distribute medications in long-term care facilities and assisted living establishments under the supervision of a licensed nurse. INCREASE THE NUMBER OF CITIZENS COVERED BY LONG-TERM CARE INSURANCE There have been attempts in the past to create some incentives for the purchase of long-term care insurance. But, frankly, the incentives proposed in past legislation have proven to be of little benefit. Illinois needs to get serious in its approach to these incentives, so that the average citizen will be encouraged to explore the benefits of such coverage. The state, too, must do a better job of marketing long-term care insurance to its’ employees and their families. IMPLEMENT THE QUALITY IMPROVEMENT GRANTS PROGRAM This program includes a commission to review quality initiatives submitted by long-term care facilities. Monies for the program will come from fines and penalties paid by facilities for noncompliance. The federal government has already indicated that programs of fines and penalties may be used in creative ways, and this could be structured to meet the federal requirements. Regulators, advocates, and providers should work together to develop such a program to improve the lives of individuals living in Illinois’ nursing homes. The lessons learned through the implementation of these quality initiatives may be transferable to other homes as well. 58
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Speaker’s Summit on Senior Servic
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PANELISTS AT STATE SUMMIT MEETING G
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Interoffice Memorandum January 2004
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This 2nd stage of the summit focuse
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PRIMARY RECOMMENDATION ILLINOIS DEP
Page 11 and 12: ENCOURAGE NURSING HOMES TO CONVERT
Page 13 and 14: financial participation, as well as
Page 15 and 16: as the “baby boomers” reach the
Page 17 and 18: • Expand the range of services av
Page 19 and 20: materials should emphasize 3 key ar
Page 21 and 22: • Develop a state medication tech
Page 23 and 24: The changes in occupancy seem to be
Page 25 and 26: eligibility determinations. Most of
Page 27 and 28: didn't matter if he or she had a lo
Page 29 and 30: folks are looking at other kinds of
Page 31 and 32: Trying to get just workers and acco
Page 33 and 34: There is also an automated pre-admi
Page 35 and 36: Personal care was provided as an op
Page 37 and 38: State and Medicaid Spending Total E
Page 39 and 40: Most of all, we want to make sure t
Page 41 and 42: Rick Dees Illinois Department of Pu
Page 43 and 44: dialog with the federal government
Page 45 and 46: enables the person to more easily a
Page 47 and 48: • Take care of the caregiver. For
Page 49 and 50: • Services available in Illinois
Page 51 and 52: Julie Sampson Citizen Action The Lo
Page 53 and 54: The United States healthcare system
Page 55 and 56: • Make doing home care, and worki
Page 57 and 58: documented the assaults, but nobody
Page 59 and 60: The SEIU report, “Facing a Crisis
Page 61: offered to facilities to convert mu
Page 65 and 66: Steve Nussbaum Life Services Networ
Page 67 and 68: We have a program that many of our
Page 69 and 70: Putnam County has 1,264 seniors, wi
Page 71 and 72: our director. We went back into the
Page 73 and 74: 8/26 Palatine State Representative
Page 75 and 76: ≡ Eliminate asset tests for home
Page 77 and 78: The escalating demand for long-term
Page 79 and 80: changes that can improve health; he
Page 81 and 82: • In 2002 Medicaid rates were cut
Page 83 and 84: Additionally, it is far more cost e
Page 85 and 86: modern, quality living space for re
Page 87 and 88: • Make doing home care, and worki
Page 89 and 90: ILLINOIS HEALTH CARE ASSOCIATION Th
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Page 95 and 96: STATE FARM INSURANCE 100% of LTC co
Page 97 and 98: • Seek expansion of the Medicaid
Page 99 and 100: Develop a mental health system whic
Page 101 and 102: Minnesota’s Long-Term Care Reform
Page 103 and 104: Who Provides Long-Term Care? 5% 95%
Page 105 and 106: Long-Term Care in Minnesota State o
Page 107 and 108: Long-Term Care Issues Minnesota Lo
Page 109 and 110: Long-Term Care Policy Directions
Page 111 and 112: Reshaping Long-Term Care Highlights
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Reshaping Long-Term Care How long-t
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Long-Term Care Benchmarks Benchmar
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Percent of Public LTC Spending on E
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Percent of older persons in nursing
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Other Measures of Success Paradi
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Conclusions Promoting non-governme
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Principles of Reform Choice Offer m
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What’s Working • 39% of LTC bud
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Other Essential Ingredients • Goo
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Long-Term Care - Illinois General Assembly

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