Long-term Care in Oregon: Home and Community-based Services
Oregon is a recognized leader in home and community-based care and has more than 20 years of experience in moving long-term care clients from institutional settings to home and community-based settings. In 2002, 82 per cent of Oregon's Medicaid long-term care clients were served in the community. Additionally, Oregon was the only state in the nation whose spending for institutional care was less than half of the state's total Medicaid long-term care spending in 2000, with only 37.2 per cent spent on institutional care compared to the national average of approximately 70 per cent. Oregon officials recognize that with the aging population and increasing cost, they may need to rethink the design of their current system. They hope to incorporate a concept of 'bounded choice' where a person's wishes are considered within the boundaries of service capacity and fiscal constraints.
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Federal Legislative Perspective
Report on Oregon
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85 and older administrative adult foster agencies on aging area agencies assistance with mobility assisted living facilities bounded choice Brian Burwell calculations based client employed provider community-based waiver Congressional Research Service delegation program Department of Human developmental disabilities elderly eligible for Medicaid functional eligibility funds habilitation home and community home and community-based home health Human Services ICFS/MR income increase intermediate care facilities Lewin Group long-term care clients long-term care programs long-term care services long-term care spending long-term care system Medicaid clients Medicaid Expenditures Medicaid long-term Medicaid services Medicaid spending Medicare mental retardation number of nursing nurse delegation nursing facilities nursing home Oregon Department Oregon Project Independence Oregon’s long-term persons with developmental persons with mental physical disabilities registered nurses Research Service CRS retardation and developmental Seniors service priority levels services for persons Spending in Oregon state-funded Total Medicaid U.S. Census Bureau unlicenced caregivers waiting lists waiver program waiver spending