Long-Term Care - Illinois General Assembly

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LIBERTY VILLAGE OF MARION The present proposal to reimburse facilities from the MDS assessment tool will not work without adequate funding. With insufficient funds to provide an adequate wage, long-term care facilities are unattractive alternatives for nursing professionals and other caregivers who can pursue higher paying jobs. Give attention to attracting qualified caregivers into the honorable profession of long-term care with adequate funding and careful regulation. ILLINOIS CITIZENS FOR BETTER CARE (WENDY MELTZER) Illinois should be making it possible for people who want to stay home to do so, when staying home would cost no more than nursing home care. This is a partial list of how to do this: • Revise the formula used to determine for how many hours of home care the state will pay for people over 65, so it is an honest comparison of home care vs. nursing home care for each individual. • Instead of capping the hours at the theoretical maximum, Illinois should be exploring creative use of the Medicaid waiver to help families who are caring for their relatives: for example, the state would pay for one hour of care over 6, for each hour the family paid for or did themselves, up to some maximum. • Expand the availability of adult day care, especially for people who are incontinent. Expand the availability of accessible transportation to and from adult day care. This can be done not by buying a lot of new accessible vans, but by facilitating dual use of existing accessible vans owned by, for example, day training programs and nursing homes. • Illinois should expand the number and breadth of its existing home-sharing programs, both for full-time residences and for day-time only care, so elderly adults can be cared for while their family members are working. Tie home-sharing into the Assistive Technology project, and existing Medicare funding for occupational therapists, who can do home visits, assess individuals, and make recommendations about what equipment and home adaptations can allow disabled elderly people to stay home safely. • Create a central clearinghouse of available services, especially housing with supportive services and personal care services. • Put supportive services into existing senior housing, such as CHA senior buildings. • Make the services available under the Medicaid waiver programs, uniform for all groups. • Work with high schools that require community service credit for graduation, to refer students to programs that do shopping and home-delivered meals for home-bound people. 81
• Make doing home care, and working in equivalent programs — day training, adult day care — more attractive by providing health insurance to the people who do this work. • Stop using nursing homes as housing of last resort, sticking people in them because there is no place else to go. These are some of the things what needs to be done: • As a general rule, Illinois should require a minimum percentage occupancy to participate in the Medicaid program. There have to be exceptions to this in rural areas, where closing a nursing home would mean that families would have to travel unreasonable distances to visit their relatives. When exceptions are made, the priority should be on funding the county homes and the not-for-profits, at least those not-for-profits that agree to admit residents on Medicaid. • Increase the number of Public Health nursing home surveyors. So many have taken early retirement, the department has lost its ability to do thorough complaint investigations, or initiate surveys of facilities that have repeated serious violations. • Expand the IDPH legal staff, so that the department does not feel pressured to settle cases because it does not have the staff to try them. • Inform families and guardians of residents when a violation occurs in a nursing home that affects them. • Teach families of residents how to help their relatives when they move into a nursing home, including what nursing homes” obligations are to their residents. Tie this into the universal prescreening. • Since Medicaid reimbursement is going to be based on the “MDS,” we need to be checking on the accuracy of the information nursing homes enter in the “MDS.” “MDS” refers to the new Minimum Data Set methodology that has been recently promulgated by the Department of Public Aid that will be used to determine payments to nursing homes for the cost of patient care. • Future Medicaid rate increases should be “targeted” — that is, their use restricted — to salary for direct care staff and food. • While in some ways the IDPH website is helpful, the majority of nursing home violations are not posted, despite the legal mandate that they be there. IDPH should either do the work itself, or contract with an entity able to do the job. • Strengthen the ombudsman program. • While having the ombudsmen function as friendly visitors is inappropriate, it would improve residents’ lives if high school mandatory service programs expanded to include having students assigned to specific residents and visit them regularly. • The Office of State Guardian needs both the resources to spend enough time on all its wards, and the mandate to function with the same vigor as would any private guardian concerned with a ward’s welfare. 82
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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
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eligibility determinations. Most of
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didn't matter if he or she had a lo
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folks are looking at other kinds of
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Trying to get just workers and acco
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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 and 76: ≡ Eliminate asset tests for home
Page 77 and 78: The escalating demand for long-term
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: modern, quality living space for re
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
Page 127 and 128: What’s Working • 39% of LTC bud
Page 129 and 130: Other Essential Ingredients • Goo
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Long-Term Care - Illinois General Assembly

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