the generations project working to inform, educate, organize, and offer creative solutions to...
TRANSCRIPT
The Generations Project
Working to inform, educate, organize, and
offer creative solutions to rebalance Indiana’s long
term care system
Established in 2001
Collaborating Partners
AARP Indiana Alzheimer’s Association The Arc of Indiana Citizens Action Coalition of
Indiana CICOA, Aging & In-Home
Solutions
COVOH - Council of Volunteers and Organizations for Hoosiers with Disabilities
Indiana Alliance for Retired Americans
Indiana Association of Area Agencies on Aging
Mental Health Association in Indiana
United Senior Action of Indiana.
The Issue
Rebalancing Indiana’s public spending for long term care: Medicaid
Balancing spending on home and community-based services with spending on institutional care.
Quality of Life Issue Wise use of public money Providing services that are preferred
Critical Constituencies
Seniors Persons with
disabilities Minorities Service Clubs Neighborhood &
senior centers
Labor & retirees Business
organizations Academia Local
Neighborhoods Faith-based
organizations
Progress
Spring 2003:– Passage and signing into law of Senate
Enrolled Act 493
Spring 2004:– Little or no progress on behalf of state to
implement the law. Delays, excuses.
Long Term Care
Rebalancing Indiana’s Long Term Care System
June Holt, Outreach Coordinator The Generations Project
Long Term Care
What is long term care? Who needs long term care? Where do people prefer to receive LTC? Who pays for LTC? Why should we be concerned about long
term care?
Defining Long-Term Care
Long term care encompasses a broad range of help with daily activities that chronically disabled individuals need for a prolonged period of time– Primarily low-tech services– Assistance with ADLs and IADLs– Hands-on or supervisory human assistance– Assistive devices– Home modifications
Definitions
What are they talking about?
or
Some terms you should know.
CHOICE Program
Community & Home Options to Institutional Care for the Elderly & Disabled
Totally funded by state of Indiana Served 10,000 in 1999 Model program for home care
HCBS = Home & Community Based Services
Medicaid Waivers
Allow Indiana to provide a variety of in-home and community-based services to individuals who would otherwise require the level of care provided in an institutional setting
Each client is assigned to a “waiver slot”– One can not receive services unless assigned to
a waiver slot Served 7,615 in FY 2002
SSISupplemental Security Income
Pays monthly benefits to the poor who are blind, disabled or elderly.
2003 SSI:– $552/month for individual
300% SSI = $1656
Used as a qualifying amount for Medicaid services
SEA 493:Long Term Care Reform Act
2003 Senate Bill 493 A bill designed to rebalance the way Indiana spends
Medicaid dollars on long term care. Passed without a negative vote by Indiana House
and Senate Senate Enrolled Act 493: SEA 493 Signed into law in May 2003 Public Law 274-2003 IC 12-10-11.5
Institution or Home?
System is out of balance
2002 Medicaid funds Indiana spent $1.1 billion on institutional care Indiana spent $194 million for home and
community based care HCBC costs taxpayers 65-80% less than
institutional care
$0
$200
$400
$600
$800
$1,000
$1,200
$1,400
All home & community based care Nursing homes
Annual tax dollars in millions spent on long term care in Indiana (2001/2002)
$1.174 billion
$194 million
Indiana long term care costs
Average per person per year cost for home and community based care vs
nursing home care, 2002
$0
$5,000
$10,000
$15,000
$20,000
$25,000
$30,000
$35,000
$40,000
CHOICE Program Nursing Home
Spending on Home & Community Based Care
vs Institutional Care
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
90.00%
Indiana Wisconsin Washington Oregon
HCBC Institutions
Balanced spending in other states
Hoosiers prefer home care
More than 27,000 on waiting lists for HCBC– Many qualify for NH bed but don’t want to go
Many empty nursing home beds– In 2001 nearly 25% of nursing homes were empty
#1 reason to get off waiting list is death
#2 reason is going into nursing home
Why has this happened?
Used to think NH or institutional care was best for the disabled – young or old
Laws written with “Institutional Bias”– Mandated NH/institutional care
These laws have created barriers for low income Hoosiers to receive HCBC
Laws force many into nursing homes who would be better served at home
SEA 493: The Law
Rebalances the way public money (Medicaid) is
spent on long term care
Eliminates barriers
Allows Medicaid dollars to follow the client from nursing homes to home care.
Makes the income eligibility standard for Medicaid home care services the same as for nursing home care at 300% of SSI.
Directs the state to apply for an additional 20,000 Medicaid waiver slots.
Supports families
Protects the spouse from becoming impoverished when services are provided at home.
Establishes a caretaker support program.
Expands services to include personal care services and more.
Respects the person
Expands client rights under Medicaid waivers.
Establishes the right to self-directed care.
Establishes a comprehensive array of home and community based services.
Provides for future needs
Indiana must establish a system of integrated services to facilitate Home and Community-based care including:
– Improved transportation, – More choices in housing– Enhanced education – Expanded workforce development
Implementation of the Law
Indiana is slow in implementing this law
Waiting lists are too large and are growing
People are dying instead of getting the care they need and deserve.
2004 Legislation
Passed Senate Bill 449
Gives Health Finance Commission (Joint Senate & House committee) the charge to monitor implementation of SEA 493
Will allow legislators to follow the implementation process of SEA 493
Opportunities for Hoosiers
Keep the issue alive until the law is working for us
Let the governor and your legislators know that you want this law to be implemented as quickly as possible
SEA 493 will save lives and save money
Questions, Discussion & Action
Call the Governor at
317-232-4567 orE-mail at [email protected]
1. Ask him to implement SEA 493, the Long Term Care Reform Act of 2003
2. It’s good for taxpayers, it’s good for the state and it’s what Hoosiers want
Rebalancing Indiana’s Long-term Care SystemSEA 493: It’s the law!
Thank You