Long-Term Care

The author of this policy brief presents his perspective on the future challenges of long-term care (LTC) in the U.S., with a focus on family caregivers, public policy, and funding. Noting the strain placed on caregivers and the market dynamics that discourage the purchase of LTC insurance, he encourages a broader role for the public sector. These include more funding for the National Family Caregiver Support Program and expanding Medicare to cover comprehensive LTC services.

This paper examines the extent to which states have balanced the delivery of Medicaid-funded LTC services and supports to people in their homes and in institutions. What is unique about this report is its primary focus on older people and adults with physical disabilities separate from other LTC populations, such as people with developmental disabilities. Explore what has been accomplished under current Medicaid law and review how federal policies impact the ability to balance service delivery.

This report presents the results of a survey of state developmental disabilities agency officials regarding the determination of initial eligibility/level of care and the “annual level of care” for services furnished under Medicaid waiver and ICF/MR programs. Forty-seven (92%) states provided information on state waiver eligibility criteria and practices. The report describes state level of care assessment approaches and provides legislative cites and contact information for state staff.

AoA announced the availability of $10,900,000 for two ADDGS Program Announcements: "Innovation Grants to Better Serve People with ADRD" and "Evidence-Based Intervention Translation Grants to Serve People with People with ADRD and their Caregivers." The goal is demonstrate how the Aging Services Network can effectively implement evidence-based service interventions that help people with ADRD to remain at home and in the community. Closing dates for applications are August 11th, 2008.

Medicaid exception trusts are generally exempt under federal law from the usual rules of counting trust income and resources. A Special Needs Trust (SNT) is a type of exception trust established by certain third parties for the benefit of a disabled individual under age 65. This report highlights examples of state laws, forms, eligibility rules, and operating practices states use to properly administer the statutory SNT provision and make recoveries.

AoA announced $13 million to support state efforts to help individuals with long-term care needs to avoid unnecessary nursing home placement. This includes $10 Million for an AoA Nursing Home Diversion Modernization Grants Program and a special $3 Million funding opportunity made available by the Veterans Health Administration. Only State Units on Aging are eligible to apply, but must involve AAAs and community-based organizations in projects. The application deadline is August 14, 2008.

These short documents provide information on common health concerns for elderly people that can be caused or exacerbated by environmental factors. Elderly people, caretakers, and educators can use these resources to identify and prevent potential health threats. The fact sheets are available here in English and Spanish. They are available in 13 additional languages as well as large print and easy to read formats on the EPA website provided.

This guide identifies special skills needed specifically in the care for patients with dementia. The document is organized by competency areas, allowing direct care workers or trainers to focus on areas of improvement. Additional resources are also listed by competency areas as well as in alphabetical order and are complemented by a glossary and notes for trainers and supervisors.

This resource presents ten key facts showing the economic and health insecurity of the direct care workforce. It can be used to advocate for improved public policies and increase public awareness of the needs and importance of caregivers. The figures presented also illustrate the linkage between quality of care available to the growing population of older Americans, recruitment and retention of workers, and wage and benefits levels.

This paper models the effect of occupancy rates on nursing home reimbursement. It surveys nursing home methodologies generally and specifically models the rate setting systems of California, Indiana and Pennsylvania. The modeling indicates that much of “the fixed costs” would not get calculated back into the rates. The costs that do would be allocated across all resident days used in rate setting regardless of payer source, including Medicare and private pay, limiting the Medicaid impact.