Long-Term Care - Illinois General Assembly

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.
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