Welcome to The Ohio Department of Aging

Skip Navigation

Please Note: You are viewing the non-styled version of The Ohio Department of Aging. Either your browser does not support Cascading Style Sheets (CSS) or it is disabled. We suggest upgrading your browser to the latest version of your favorite Internet browser.

The Ohio Department of Aging

Ohio Department of Aging Aging Connection

Aging Connection

CONNECT TO | The Network
December 2010
 

Unified Long-term Care System short term recommendations
Addressing the needs of seniors, as well as adults with disabilities

For nearly four years, the state's Unified Long-term Care System Workgroup, which was created by the General Assembly and the Governor, has been working to re-engineer our state's long-term care system into one that controls Medicaid spending and is based on choice, not funding streams. As Ohio's economy continues to recover from the worst recession since the Great Depression, Medicaid spending now consumes 40 percent of the state budget. The elderly and disabled make up 20 percent of those on Medicaid, yet account for 68 percent of costs, including 70 percent of Ohio's nursing home care. Expanding home- and community-based services (HCBS), that most say they prefer, could reduce that expense.

Unified Long-term Care System

For nearly four years, the state's Unified Long-term Care System Workgroup, which was created by the General Assembly and the Governor, has been working to re-engineer our state's long-term care system into one that controls Medicaid spending and is based on choice, not funding streams. As Ohio's economy continues to recover from the worst recession since the Great Depression, Medicaid spending now consumes 40 percent of the state budget. The elderly and disabled make up 20 percent of those on Medicaid, yet account for 68 percent of costs, including 70 percent of Ohio's nursing home care. Expanding home- and community-based services (HCBS), that most say they prefer, could reduce that expense.

After focusing its initial work on today's seniors, the Unified Long-term Care System Workgroup has developed its latest set of recommendations concerning how Ohio's system can better address the needs of the growing number of baby boomers and adults with disabilities while reining in Medicaid spending. The 26 recommendations fall into five categories: balance and funding, eligibility, integration and care management, service array and workforce.

The balance and funding recommendations include an overarching goal about balance - changing consumer distribution between institutional and HCBS, from 60 percent institutional/40 percent HCBS in 2007 for adults with physical or cognitive disabilities, age 60 and older to a 50/50 distribution. For adults age 59 and under, the workgroup recommends a 40/60 distribution; in 2007, this was 50/50. Once these goals are reached, the workgroup plans to recommend new distributions that will put Ohio on track to reaching the national average. Because it costs about one-third as much as similar care in an institutional setting, serving more consumers in HCBS settings can save taxpayer dollars.

The workgroup recommends that the state apply the eligibility criteria and logic that is used in PASSPORT waiver to the Assisted Living Waiver applications. Currently, consumers can only enroll in the Assisted Living Waiver if they are a nursing facility resident, a participant of a Medicaid waiver program that serves Ohioans age 60 and over or who have physical disabilities or a resident of a residential care facility for a minimum of six months. For the PASSPORT program, the PASSPORT Administrative Agency (PAA) can presume that the consumer meets financial eligibility requirements and enroll the consumer immediately. The process for determining financial eligibility can proceed without delaying supports for the consumer. Currently, this method is not possible with the Assisted Living Medicaid Waiver Program. PAAs must wait for a final determination from the County Department of Job and Family Services (CDJFS). Because of staff reductions at many CDJFS, the determination may not be made for several months, during which time the consumer must wait to enroll. Most consumers need care the day they apply, which is why Ohio should change the Assisted Living eligibility determination to the one used in PASSPORT while still ensuring that the waiver requirement to develop a service plan prior to enrollment is met. This will allow for the quicker delivery of needed services.

Provider, case manager and consumer education about the requirements for Medicare, Medicaid and other programs will ensure that program benefits are used to the fullest extent and will aid in program integration and care management. Agency partnerships and long-term care consultants in medical facilities can help adults who need long-term care supports and services. ADRNs can help integrate medical and long-term care services by expanding access to information, assistance and long-term care consultations. In addition, shared consumers need to be identified to support service coordination.

The workgroup developed recommendations about services to support HCBS such as discharge planning, transportation, access to housing, service coordination, consumer direction and telehealth. It also recommended the creation of a Direct Service Workforce Consortium to develop a strategy to link resources, programs, data and direct service workers with potential long-term care service and support provider employers.

The full text of the recommendations is available on the Ohio Department of Aging website.

Connect to More
Network News

Health reform results in savings for Medicare beneficiaries
Analysis from the U.S. Department of Health and Human Services predicts that Medicare beneficiaries on average will save $3,500 over the next 10 years as a result of the Affordable Care Act. Those with high prescription drug spending will save even more - as much as $12,300. The savings will result from the incremental closure of the drug coverage gap, an increase in free preventive services and a slower rate of increase in premiums and co-payments.

Boomers are more likely than older adults to seek help for aging-related needs
A recent survey of adults age 45 and older by the National Association of Area Agencies on Aging found that almost half of respondents indicated that they were likely to seek assistance in coordinating and obtaining appropriate services as they age. Slightly fewer (44 percent) said they would seek help in assessing service needs as they age. Two in five reported they would likely seek long-term care counseling. Boomers were significantly more likely to seek assistance than any other age group, while respondents age 85 and older were significantly less likely to do so, perhaps because they already have identified the services they need.