Long-Term Care - Illinois General Assembly

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.
Illinois’ 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.
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