Long-Term Care

Need an overview of the basic components of the nation’s largest health coverage program? Medicaid covers 55 million low-income individuals and is the dominant source of long-term care financing. Examine the structure of the program, who it covers, what services it provides, and spending. Because Medicaid is jointly financed by the federal and state governments programs vary across states. Tables examining the state-to-state variation in eligibility, enrollment, and spending are included.

Thirteen states and the District of Columbia will get more than $547 million in grants over five years to build Medicaid long-term care programs that will help keep people at home and out of institutions. This “Money Follows the Person” initiative was included in the Deficit Reduction Act of 2005 (DRA), currently being implemented by CMS. The press release lists the states and the amount of money committed over the next five years.

This study projects to 2040 the number of people ages 65 and older with disabilities and their use of long-term care services. Declining family sizes, increasing childlessness, and rising divorce rates will limit the number of family caregivers. Rising female employment rates may further reduce the availability of family care, increasing the need for paid home care. The simulations show that under the most optimistic scenario, LTC burdens on families and institutions will increase substantially.

This updated report provides the latest data on the 37 key indicators selected by the Forum for its 2004 report to portray aspects of the lives of older Americans and their families. It is divided into five subject areas: population, economics, health status, health risks and behaviors, and health care.

As part of the Georgia QA/QI Real Choice Systems Change grant, an evaluation of the Person-Centered Planning (PCP) program was conducted. Part of this includes the outline for planning and creating PCP groups, and a list of resources for effective use of PCP. Also included is the final survey given to PCP participants and information on sustaining person-centered planning.

This report describes the hospital discharge planner (HDP) survey conducted in the beginning of 2006. The HDP questionnaires were disseminated to gather information about the awareness of choice and access to continuum of care services for the elderly and people with disabilities as well as to gather ideas about how to optimize choice and improve access to these services. Review the results and read about the barriers faced by discharge planners.

Interviews were conducted to identify current perceptions, patterns, themes, and suggestions for improving the choice and self-direction, quality and access to long term care supports. This research also identified ways to develop a mechanism to balance state resources for services, and to identify elements for the design and structure of a single point of entry mechanism. Groups included: consumers of HCBS, elderly and younger nursing home residents, family members of consumers, and providers.

Completed over an 18 month period in 2004-2005, this project was conceived of as an activity that met the objectives of the Maine Real Choice Systems Change grant and the mission of the Maine Personal Assistance Services Association to build recognition and opportunity for the direct care, direct support, and personal assistance workforce through education, public awareness and professional development. Each story evolves out of a series of in-depth interviews and is told in the worker’s voice.

The 7th CMS New Freedom Initiative Conference was held March 5-7 in Baltimore. Presentations are available in both PDF and text formats. “Choice and Independence” is a key pillar of CMS’ vision for a person-centered long term services and supports system for the future. The 2007 conference focused on the policies, programs, and tools -including opportunities authorized by the Deficit Reduction Act– available to shape and carry out the vision.

This paper reports the outcome of focus groups, interviews and written surveys conducted in 2003 by a consultant working for the Northern Area Agency on Aging in Wisconsin under a contract with the Department of Health and Family Services. Groups of elders, family members and long-term care professionals were asked to address the question of how, when and why older people make the decisions they do about long-term care.