Core Values For a Good Long Term Care System Persons with disabilities and their families are

entitled to maximum feasible choice/participation in selecting care settings and providers.

Persons with disabilities have the right to expect “quality of life”, personal dignity, maximum feasible independence, health, security and quality of care.

Persons with disabilities have the right to choose and/direct a care plan involving “managed risk”, in exchange for the advantages of personal freedom.

The array of public service options and individual client choices may be bonded by reasonable considerations of cost-effectiveness.

Three Tenets of a Balanced LTC System

No One Service is Most Important Washington provides an array of services– the most

important service is the one the client needs . Nursing home Adult family home Boarding home Personal care in-home Assisted Living Supportive services such as adult day health, respite, client

training, skilled nursing, home delivered meals, etc.

A Good Long-Term Care System……

• Supports family caregivers as primary resource for long term care

• Consolidates a full array of options: in-home, community residential, nursing home

• Controls & coordinates entire LTC budget (nursing home, home & community, AOA/AAA funding)

• Controls and coordinates residential care QA and regulatory compliance

Core Values for a Good Long-Term Care System Persons with disabilities and their families are

entitled to maximum feasible choice/participation in selecting care settings and providers.

Persons with disabilities have the right to expect “quality of life” including personal dignity, maximum feasible independence, health and security and quality of care.

Nursing Home Caseload 1972-2005

10,000

11,000

12,000

13,000

14,000

15,000

16,000

17,000

18,000

19,000

20,000

Jan-72 Jan-75 Jan-78 Jan-81 Jan-84 Jan-87 Jan-90 Jan-93 Jan-96 Jan-99 Jan-02 Jan-05

Estimate of number of Nursing Facility Clients if Washington Had not done LTC Reform

0

5,000

10,000

15,000

20,000

25,000

30,000

FY 1992 FY 1994 FY 1996 FY 1998 FY 2000 FY 2002 FY 2004

If 3% Annual Growth Actuals

Washington Home and Community LTC Caseload Trend

15,000

20,000

25,000

30,000

35,000

40,000

Jul-87 Jul-89 Jul-91 Jul-93 Jul-95 Jul-97 Jul-99 Jul-01 Jul-03 Jul-05 Jul-07

C a s e lo a d T re n d s

1 0 ,0 00

1 5 ,00 0

2 0 ,00 0

1 0 ,0 00

1 5 2 5 ,0 0 0

,0 0 0

2 0 ,00 0

2 5 ,00 0

3 0 ,00 0

3 5 ,00 0

7 - 8 7 7 - 8 8 7 - 8 9 7 - 9 0 7 - 9 1 7 - 9 2 7 - 9 3 7 - 9 4 7 - 9 5 7 - 9 6 7 - 9 7 7 - 9 8 7 - 9 9 7 - 2 0 0 0 7 - 2 0 0 1

M e d ic a id N u rs in g H o m e C a s e lo a d

H o m e & C o m m u n i ty C a s e lo a d

2 0 ,0 0 0

3 0 ,0 0 0

3 5 ,0 0 0

2 5 ,0 0 0

1 5 ,0 0 0

1 0 ,0 0 0

Give Consumers what they want and it will probably save money. Over the past 12 years, Washington LTC reform

policy encouraging development of client-preferred home and community based options has resulted in an annual reduction of 401 clients per year and allowed community placements to increase by an annualized caseload of 1,309 clients.

If Washington had not reformed its’ LTC system it is projected that the NF caseload today would be over 24,000 instead it is less than 13,000

An additional 14,000 consumers have been served in HCBS settings.

The cost to serve this increased HCBS population has been paid in large part with savings from the nursing home budget.

What it takes to have a good State Long-Term Care System. A clear State Vision that consumer choice

should drive the long-term care system. A belief that quality of life is as important as

quality of care. A belief that no one service is more important

than another. The most important service is the one the consumer wants and needs.

The Ideal State Long-Term Care System A single organizational unit in State

Government to plan, develop and operate the long-term care system.

A single budget with flexibility and authority to spend on a varied array of long-term care services to meet consumer needs and preferences.

A single point of entry with a fast, timely and standardized automated way to access financial and functional eligibility and collect data.

A case management system with capacity to provide assistance and oversight for consumers.

Fair rate setting and contracting process for providers.

A process for assuring quality oversight throughout the system.

A process for resource development that meets consumer demand.

A well organized articulate, sophisticated group of consumers/families who advocate for the long-term system.