# Presentation: 311589

## State of MaineLong-term Care Reform

- Presented by Mollie Baldwin
- Bureau of Elder and Adult Services
- July 26, 2001

## History

- Budgetary crisis forces Legislature and policy makers to examine state’s long-term care system
- Department must commit savings toward state budget
- Medical & financial eligibility took up to 90 days
- Consumers and Advocates Want
- Long term care choices/options
- Help in navigating complex eligibility system
- Fewer barriers in eligibility process and accessing services

## LONG-TERM CARE REFORM

- Governor’s initiative
- improve access to information about long-term care options
- Free assessment available to give consumers LTC advice
- improve home and community based care
- better allocate resources across care settings
- improve consumer’s understanding of their options
- reduce reliance on costly institutional care

## BLUEPRINT for REFORM

- Universal preadmission screening regardless of funding source
- Legislatively mandated pre-admission screening for nursing home placement.
- Screening must include recommended community based care plan.
- Single entry point for eligibility determination
- Ease of access for consumer
- Forces collaboration between agencies & providers

## Systems Challenge

-  To quickly determine medical and financial eligibility for long-term care services
- To communicate between different parts of system and link information to work efficiently and effectively for the consumer
- State bureaus
- Agencies, providers
- Consumers, families

**Notes:**
Mapping strategic goals/plan to project

## Development of Technology Solution

- Develop user friendly, expandable and portable system with the following features
- Calculate eligibility based on medical & financial information provided to assessor
- Portable- may be moved to a different agent who serves as single entry point
- Track referrals, assessments
- Interfaces with medical & financial legacy information systems via daily feeds
- Daily feeds with statewide home care coordination agency
- Assessors use untethered laptops

## Financial Information Tab

## DATA BENEFITS

- Linked data across care settings improves policy decisions and resource allocations
- Data shows system serving people in different settings with same characteristics
- Data allows development of acuity based reimbursement systems as mandated by the Legislature
- Development of quality indicators for home care programs now underway

## STATE BENEFITS 

- Maine’s LTC system has changed and grown rapidly between 1995 and 2000
- total persons served has increased from 19,803 to 26,767
**52%** of consumer receive home care in FY 2000 compared to 32% in 1995
- Significant new funding appropriated for home care & residential alternatives
- spending for home and community care, *up *from 16% to 35%
- Responsiveness, accountability for providers delivering services to consumer

## Long-term Care	State and Medicaid Spending

**Total Expenditures: $309,655,678**

- Long-term Care	State and Medicaid Spending

## CONSUMER BENEFITS

- Consumers find single entry point simplifies application process
- Consumers receive eligibility decision on the spot & home and community based options at time of assessment
- Improved consumer interaction with nurse assessors freed up from paper burden
- Assessment outcome data transmitted electronically to improve access and expedite services care getting started
- Financial resources have been diverted to home care programs