Long-Term Care - Illinois General Assembly

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BACKGROUND Long-term care of the elderly poses the greatest challenge for national and state governments in terms of meeting the demand for services that enable individuals and families to maintain independence. As the primary payer and regulator of long-term care, states must make a concerted effort to meet this responsibility. Illinois must take the initiative to provide the best possible care for its citizens. A recent report to Congress by the U.S. Department of Human Services highlighted the following points about the demand for long term care in this country: • In 2000, there were approximately 13 million Americans — including children, working age adults with disabilities and the elderly — who needed long-term care. • By 2050, the total number of individuals in need of long-term care services will double, increasing to 27 million, with the aging of the baby boomer generation being the most significant factor contributing to the demand. • Over the next 50 years, the number of elderly individuals is expected to more than double, increasing from approximately 8 million to 19 million. • Working age adults with disabilities needing long-term care will also increase from around 5 million in 2000 to about 8 million in 2050. Many of these individuals will need specialized assistance to return or remain in their communities, as well as to return to work. • According to the Department of Human Services report, 13 million Americans received long-term care services in community-based settings and 2 million Americans received long-term care services in institutional settings in 2000. A decision by the U.S. Supreme Court (Olmstead v. L.C.) requires that services be provided in the most integrated setting appropriate to the individual--which in many cases are home and community-based care settings. As the number of elderly individuals using either nursing facilities, alternative residential care facilities such as assisted living facilities, or home care services is expected to double over the next 50 years, the task of serving this growing population is going to be more complicated. Illinois must develop a comprehensive long-term care strategy to guide future policies and procedures in meeting the increasing demand for services. A Long-Term Care Summit was conducted as the 2nd stage of a Summit on Senior Services announced in January 2003 by the Speaker of the Illinois House of Representatives, Michael J. Madigan. The purpose of the summit was to discuss key issues confronting the elderly. The 1 st stage held in the spring of 2003 focused on prescription drug relief. That stage helped craft what today is the state’s prescription drug buying club through which all seniors can get substantial discounts on their medications. One initiative was implemented January 1, 2004. 1
This 2nd stage of the summit focused on “Long-Term Care.” It consisted of 30 regional hearings conducted this past summer and a culminating state meeting in Springfield on October 7, 2003. Testimony was received from senior citizens, senior service organizations, senior advocacy groups, care providers, payers of care, state agencies and other health experts regarding the availability of services in Illinois and the need for additional programs and resources, as well as recommendations for system reform. Witnesses were asked to address the following topics: • NEED: Determining the types and levels of care required to meet demand. Inventory existing services. Estimate future needs. • CONSUMER CHOICE: Enabling consumers to actively participate in care decisions. Balancing cost, access and quality. • WORKFORCE: Ensuring the availability of a trained staff. • INFORMAL CARE GIVING: Strengthening family and in-home care giving. • QUALITY ASSURANCE: Performance review of state regulation and quality assurance programs. • GOVERNANCE: Making program and service administration more effective. • FINANCE: Ensuring consumer choice and quality. Information gathered at the regional hearings was summarized and is included as an attachment to this report (Attachment B). Many of the organizations, agencies and some individuals who participated in the regional meetings were represented at the state meeting in Springfield. Two special keynote speakers were also invited from other states that have already been involved in the aggressive reform of the long-term care systems. The directors of senior programs in Maine and Minnesota shared their success stories as a possible guide to Illinois’ reform. The testimony of these experts and other participants is also attached to this report (Attachment A). 2
Page 1 and 2: Speaker’s Summit on Senior Servic
Page 3 and 4: PANELISTS AT STATE SUMMIT MEETING G
Page 5: Interoffice Memorandum January 2004
Page 9 and 10: 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
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documented the assaults, but nobody
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The SEIU report, “Facing a Crisis
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offered to facilities to convert mu
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providers, and the state by streaml
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Steve Nussbaum Life Services Networ
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We have a program that many of our
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Putnam County has 1,264 seniors, wi
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our director. We went back into the
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8/26 Palatine State Representative
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≡ Eliminate asset tests for home
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The escalating demand for long-term
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changes that can improve health; he
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• In 2002 Medicaid rates were cut
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Additionally, it is far more cost e
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modern, quality living space for re
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• Make doing home care, and worki
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ILLINOIS HEALTH CARE ASSOCIATION Th
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• The Supportive Living Program n
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homes is important. In-home care se
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STATE FARM INSURANCE 100% of LTC co
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• Seek expansion of the Medicaid
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Develop a mental health system whic
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Minnesota’s Long-Term Care Reform
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Who Provides Long-Term Care? 5% 95%
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Long-Term Care in Minnesota State o
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Long-Term Care Issues Minnesota Lo
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Long-Term Care Policy Directions
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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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