Long-Term Care

Program history, outcomes and recommendation of areas for future study are summarized. The study was commissioned to compare participant demographics to another IL program; measure cost of services and administration and see what participants purchased; gauge satisfaction and unmet needs; and understand disenrollment rates and reasons.

As part of this Act, requirements were instituted involving the state's ADRCs and the global budgeting process used to support them. The Act provides specific directives that address financing and management plans, implementation and operation of the Medicaid LTC expenditure reforms, and requires an annual report, one of which is also included here, that documents reallocation of funds to home and community based care.

This paper provides an overview of the health coverage interventions tested by CMS DSW demonstration grantees and examines four approaches in more detail through the following four case studies:(1)Subsidizing Employer Based Insurance(North Carolina),(2)Prescription Discounts, Basic Health Insurance and Tax-Free Accounts(New Mexico),(3)DirigoChoice and Outreach to Home Care Agencies(Maine)and (4)Outreach to Consumer-Directed Home Care Workers (Washington).

The authors present evidence in support of states investing in HCBS and nursing home diversion as strategies to deal with declining revenue. They review research reports illustrating how the balance of spending on institutional versus HCBS spending affects future long-term care costs. Using these data and case studies of Washington and Vermont programs, they conclude that HCBS is indeed cost-effective.

The question posed in the title is answered by analyzing state spending data from 1995-2005. The report shows that, for two distinct populations receiving long-term care services, spending growth was greater for states offering limited noninstitutional services than for states with large, well-established noninstitutional programs. Expansion of HCBS appears to entail a short-term increase in spending, followed by a reduction in institutional spending and long-term cost savings.

The trends in state Medicaid HCBS programs, target groups, participants, and expenditures are summarized and policy recommendations are made. The paper shows the progress in providing Medicaid HCBS but also identifies many current problems and policies. Inequities in access to services and limited funds result in unmet needs. Cost issues have been a primary focus of policy makers and quality problems are largely not addressed.

The Handbook was developed to provide state staff, policymakers, service providers, program participants, and other stakeholders with a comprehensive source of information about participant direction programs and policies. Its primary purpose is to explain how States can increase program participants’ choice of and control over their services and supports. In addition to providing detailed information, the Handbook also provides links to additional web resources on the selected topics.

The authors advise Congress on how to meet the growing demand for long-term care and cope with rising health care costs by supporting HCBS. The main recommendations are: promote care coordination and disease prevention; strengthen the nonprofit home health nurse workforce; and ensure the financial viability of home-based care.

This White Paper recommends minimum data sets that states should collect to help assess the magnitude of workforce issues they face and to design and evaluate policy responses. The three basic data elements include: numbers of workers (full time and part time); stability of workforce (turnover and vacancies); and average compensation (wages and benefits). The authors also offer guidance on how to implement data collection.

This curriculum, "Choices for Long-Term Care" was developed by the New York State Office for the Aging in partnership with Albany area institutions. These materials serve as a tool for NY Connects professionals to better understand the philosophy and definition of information and assistance, enhance their communication skills, and become familiar with the call map to better assist callers.