Long-Term Care - Illinois General Assembly

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FINDINGS There was repeated and consistent testimony at both the regional and state meetings affirming that Illinois’ long-term care system is sorely in need of reform. There is substantial agreement regarding the goals and objectives for achieving reform. Presentations by the Illinois Department on Aging and Association of Area Agencies on Aging, the AARP-Illinois, the Health & Medicine Policy Research Group, nursing home trade associations and other long-term care providers, as well as health care advocacy organizations, included several specific recommendations that provide a framework for comprehensive reform, which are included in summaries of the regional and state meetings (Attachments A and B). The directors of senior programs in Maine and Minnesota demonstrated the success of reform strategies that can serve as models for restructuring the existing long-term care system in Illinois. Summaries of their presentations are also included (Attachment A). The directors of aging programs in Maine and Minnesota reported that the most critical factors in their success were the leadership of the Governor and the General Assembly in the development of a strategic reform plan, and the cooperation of each, together with all other interested parties, in shaping and carrying out the plan. The historic priority and preference of the existing systems for institutional care could not have been broken without that leadership and cooperation. In addition to other specific recommendations, the Illinois Department on Aging submitted a LONG-TERM CARE REFORM PROPOSAL on November 30, 2003, that generally embodies recommendations included in much of the other testimony. This proposal was not originally delivered at the state meeting in October, but was subsequently drafted and transmitted to the Speaker’s office. This proposal provides an important framework that could be adopted by the Governor and General Assembly as a basis for strategic planning to reform the existing longterm care system. The fact that this proposal was been submitted at this time, in relation to the testimony presented at the Speaker’s Summit on Long Term Care, signals an unprecedented interest and willingness of the Department on Aging to be an active participant in system reform. The department’s proposal is inserted below in its entirety as a primary recommendation. In addition to the proposal of the Department on Aging, the participation of nursing home trade associations, other providers of long-term care services, area agencies on aging, and advocacy organizations demonstrates a shared interest and commitment to system reform. Their proposals for reform are listed below as “Additional Recommendations.” 3
PRIMARY RECOMMENDATION ILLINOIS DEPARTMENT ON AGING — LONG-TERM CARE REFORM PROPOSAL Several states have successfully redirected state spending to help seniors receive the care they need, where they want it, cost effectively. These states have diverted elderly nursing home residents from premature nursing home placement and helped many transition back to the community where they receive high quality care in residential settings. Consistent with the Olmstead Supreme Court decree actual and predicted nursing home spending follows the individual to the community to enhance and expand home and community based service options. This proposal is based on several fiscal, demographic, social, legal, and political realities: • No substantial new state or federal funding is immediately available. • Service expansions and enhancements must be financed from existing spending or new federal or philanthropic funds. • The fastest growing population group is adults over age 85 who will require significant support during their extended lifetimes. • Despite increasingly high public expenditures, families continue to provide the vast majority of care for frail and disabled individuals and feel squeezed by pressures to care for their own families as well as aging parents and relatives and disconnected from services and programs that may help. • There is wide dissatisfaction with currently limited amount and scope of services, access procedures, qualification requirements, and funding levels. • Seniors nearly universally prefer to spend their final years living at home, with family, or in housing settings that offer privacy, flexibility, and control of schedule. • Federal law, defined by the Supreme Court’s Olmstead decree, requires states to offer services to support those with disabilities, including frail elderly, in the most communityintegrated settings possible. • Payment rates to providers should cover the costs of delivering high quality services and assure adequate wages and benefits for their employees. LONG-TERM CARE REFORM COMPONENTS This proposal attempts to address the broad array of funding, financing, administration, and service delivery options to fully meet the needs of elderly who might otherwise be placed prematurely in a nursing home. 4
Page 1 and 2: Speaker’s Summit on Senior Servic
Page 3 and 4: PANELISTS AT STATE SUMMIT MEETING G
Page 5 and 6: Interoffice Memorandum January 2004
Page 7: This 2nd stage of the summit focuse
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
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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
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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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