Long-Term Care - Illinois General Assembly

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Terrance Sullivan Illinois Council on Long Term Care There is a consensus emerging through this Summit on Long-Term Care. Nursing home care needs to be better-integrated and supportive of the continuum of home and community-based care; and no one wants to see the quality of care in nursing homes go downhill. That is a good two-pronged approach. There is consensus that there should be a single source for case management and central referral system; a consistent patient assessment system; a universal licensing system; and an active, acuity-focused, patient-centered reimbursement system across the entire continuum of care. Wherever a person is placed, they should have the same accountability, the same funding based on their needs, and the funding should follow the patient in whatever setting. The right person should get the right amount of care in the right setting for the right funding. The council provided a detailed statement at the regional meetings, a summary of which is attached to this report. * * * There's been considerable discussion about a provider assessment and how it's raised. If we follow the federal limit, we're probably talking about raising 160 million from providers and 160 million federal matching funds, or about 320 million. There's been considerable discussion on how to structure the tax, so that as few private pay providers as possible would not be covered. If a facility accepts Medicaid residents, they would probably have to pay the tax, even if they are 20% Medicaid and 80% private pay. So it's going to hit everybody. In terms of the distribution of the assessment revenue, the heart of the discussion is about what gets funded with the $320 million. I don't think anyone has decided that, yet. Nursing homes would be asking for $320 million as a starting point, but there are different opinions on how that might get spent. The council would like to see increases in home care; increases for nursing home care; and certainly restoration of the 5.9% cut in rates effective in state fiscal year 2003 before anything else. The remainder could provide more home and community-based services. It could cover the cost of the “MDS” (Minimum Data Set) reimbursement system. It could provide quality of care incentive grants. It could be for career ladders. The advantage would be that these improvements could be implemented without any additional cost to the state General Revenue Fund. The details would have to be worked out by the legislature, including assurances that this new money is not reallocated to supplant General Revenue. In terms of cost shifting, whether it's a provider assessment or a rate cut, costs now get shifted to private pay residents. When there is a rate cut, when state and federal funding is lost, there is far more cost shifting to a private pay resident than if we have a provider assessment. A provider assessment is the best way to bring in federal funding with the least amount of cost shifting to private pay residents. 59
Steve Nussbaum Life Services Network, Winchester House Illinois needs a comprehensive plan; and a single-point-of-access. There needs to be oversight across the entire spectrum of services to make sure that each portion is adequately observed at all times. Illinois needs a quality assurance component that is unified across the entire spectrum of care. There is also a need for staff programming to ensure that we have a sufficient quantity of both Certified Nurse Assistants (CNAs) with a career ladder, as well as a sufficient quantity of nurses. Legislators are going to have to think long and hard about money. Maine and Minnesota have daily reimbursement rates for Medicaid for long-term care well in excess of what is provided in Illinois. In 2001, the average daily reimbursement rate in Illinois was $90.06 a day. In 2001, in Maine, that same provider was getting $119.60, and in Minnesota, $123.18. Those states had to shift some money to community-based services. Illinois is nowhere near close to getting adequate reimbursement for the services provided. A comprehensive program needs to have all components, but should not be implemented until all are present. Until that point, there should be a bridge of funding to help the existing programs keep going until that comprehensive plan is completed. One example is the “FMAP” money — the additional $356 million from the federal government — that is not yet obligated. This Medicaid money should be going to medical programs. It is important that Illinois honors the seniors of the state, by making a full effort to make the long-term care system successful. Kelly Schleich Adult Day Services Illinois Adult Day Services Association expresses its appreciation for this summit and regional meetings. Karen Cripps Illinois Adult Day Services Association The Illinois Adult Day Services Association has approximately 75 members and serves approximately 3,500 participants statewide. The association appreciates the advocacy that assisted in the reimbursement rate crisis, which was addressed by a recent increase. 60
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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
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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 and 62: offered to facilities to convert mu
Page 63: providers, and the state by streaml
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
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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
Page 91 and 92: • The Supportive Living Program n
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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%
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Page 109 and 110: Long-Term Care Policy Directions
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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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