Long-Term Care - Illinois General Assembly

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≡ Increase collection of fines and penalties for violations and target for quality improvement. • Identify revenue source to sustain regular rate increases at end of 4-year period. • Expand use of long-term care insurance. ≡ Educate public about long-term care costs for purpose of encouraging purchase of long-term care insurance for those who can afford it at younger ages. ≡ Explore public/private partnerships to expand affordability of insurance for lowerincome populations. • Establish fund through sale of bonds to finance structural developments and modifications, including: ≡ ≡ ≡ ≡ Nursing homes conversions and remodeling; Affordable assisted living (SLF); Adult day services; and Affordable housing for seniors. • Decrease rate of placements through moratorium on new bed construction. • Consider plans to increase federal financial participation. •Develop administrative structure within state government to assure quality, facilitate coordination, cooperation, and integrated service delivery. • Eliminate barriers to transfer of funds from institutional to home and community-based service line items during budgeting and appropriation process to reflect changing client demand. • Establish governor’s office task force or deputy responsible for integrating long-term care. • Enhance role of Ombudsman and other consumer-directed quality control mechanisms. • Consider integrating aging and long-term care in single state agency or other approaches to assure coordinated services regardless of funding stream. • Establish locus of long-term care policy expertise. AARP A comprehensive long-term care delivery system encompasses community and facility-based health and supportive care, including but not limited to in-home services, adult day care, medical transportation, senior centers, nursing homes, and assisted living in individual or small group homes. 71
The escalating demand for long-term care services has created a crisis in care for which a longterm solution must be found. Seniors will demand increased funding for services that allow them to remain independent longer. State budget problems dictate the need to reduce (or contain) state long-term care expenditures. Families of the frail elderly continue to demand high quality nursing homes for those elderly needing 24-hour care. The current delivery system presents several pressing problems. Home and community-based care is inadequate to deter unnecessary nursing home placements Adult day programs are closing due to stagnant reimbursement rates. Sixty counties are not served by such programs. There is a lack of community-based medication management and other home health options. <strong>Illinois</strong>’ service delivery system is fragmented, so that essential services may not be available in every area of the state. All providers face critical workforce pressures in their efforts to recruit, train and retain qualified staff. Over-regulation and inadequate oversight plague both home and community-based and facility-base services. Funding constraints necessitate a rethinking of how and what services should be funded. • Establish an interagency GOVERNOR’S TASK FORCE ON LONG-TERM CARE AND SUPPORT SERVICES to develop a plan and oversee the development of a comprehensive delivery system. • Shut down empty Medicaid nursing home beds and reallocate those funds to home and community-based services. • Establish incentives and opportunities for retro-fitting traditional nursing homes to meet the changing service demands. • Investigate other states’ practices in reducing Medicaid expenditures and preserving the quality of nursing home care. Reimbursement rates alone do not translate into quality care. The state should not assume responsibility for subsidizing a financially failing industry without specifically examining the impact on consumer access to care and gaining a detailed understanding of the actual costs associated with direct care. • Inspect poor quality nursing homes more frequently. Shut down nursing homes that have both low occupancy and poor quality. • All funding should follow the client regardless of service setting. • Integrate acute and long-term care services. Allow clients to manage their own care and in-home workers. • Initiate nursing home diversion programs, such as those in New Jersey and Colorado. • Bed taxes or provider assessments should be carefully evaluated. Any such proposal should link rate increases to quality factors, require empty Medicaid beds to be eliminated and dedicate a portion of the feel to fund home and community-based care. Assisted living oversight is an immediate priority. Budget cuts for fiscal year 2003 eliminated funds necessary to hire investigators and facility inspectors. Failure to fund these positions places the frail elderly at risk and takes the enforcement teeth out of the consumer protections and residents’ rights recently enacted. 72
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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
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financial participation, as well as
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as the “baby boomers” reach the
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• Expand the range of services av
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materials should emphasize 3 key ar
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• Develop a state medication tech
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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 and 64: providers, and the state by streaml
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: ≡ Eliminate asset tests for home
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
Page 93 and 94: homes is important. In-home care se
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
Page 113 and 114: Reshaping Long-Term Care How long-t
Page 115 and 116: Long-Term Care Benchmarks Benchmar
Page 117 and 118: Percent of Public LTC Spending on E
Page 119 and 120: Percent of older persons in nursing
Page 121 and 122: Other Measures of Success Paradi
Page 123 and 124: Conclusions Promoting non-governme
Page 125 and 126: 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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