Medicaid Long-Term Care: Successful State Efforts to Expand Home Services While Limiting Costs

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DIANE Publishing, 1995 - 68 pages
Analyzes how far the three states had gone in shifting their long-term care to home & community-based settings & what controls they had in place to manage the growth of home & community-based programs & what impact the shifts & controls have had on the ability to deliver long-term care services.

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Page 24 - But services are to be directed to individuals who, "but for the provision of such services ... would require the level of care provided...
Page 7 - Aging and Adult Services Administration Washington Department of Social and Health Services Mailstop HB-11 Olympia, WA 98504 Phone: (206)753-3339 Covers: About 450 nursing homes in Washington.
Page 25 - Examples of Home and Community-Based Services Service Description Case management Assists beneficiaries in getting medical, social, educational, and other services. Personal care Includes bathing, dressing, ambulation, feeding, grooming, and some household services such as meal preparation and shopping. Adult day care Includes personal care and supervision and may include physical, occupational, and speech therapies. Also provides socialization and recreational activities adapted to compensate for...
Page 1 - Long-term care, which includes an array of health, personal care, and social and supportive services, is provided to individuals who are at least partially unable to care for themselves because of a disability or impairment resulting from a chronic illness or condition — such as heart disease or diabetes. Presento Financing Challenge
Page 4 - Congress authorize the Secretary of Health and Human Services through the Health Care Financing Administration (HCFA...
Page 2 - Despite deliberate limits on program size, one impact of the shift to home and community-based care is that the three states have been able to provide services to more people with the dollars available. This is because home and community-based care is generally less expensive per person than institutional care, although the gap between the two narrows when other government expenditures for home and community-based recipients — such as Supplemental Security Income (ssi) payments — are added to...
Page 28 - ... all state programs to make home health services available to certain eligible Medicaid beneficiaries who are entitled to nursing facility services. Home health services generally are provided in an individual's place of residence — not in a hospital or nursing facility. Services must be provided on a physician's orders as part of a written plan of care that is reviewed by a physician every 60 days. Home health services include part-time nursing care, home health aide care, and medical supplies...
Page 25 - ... (D) under such waiver the average per capita expenditure estimated by the State in any fiscal year for medical assistance provided with respect to such individuals does not exceed the average per capita expenditure that the State reasonably estimates would have been made in that fiscal year for expenditures under the State plan for such individuals if the waiver had not been granted ; and...
Page 12 - This is because on a per-beneficiary basis, home and community-based care is considerably less expensive than nursing facility care.
Page 2 - States we contacted in the course of this work have expanded the use of such services as part of a strategy to help control rapidly increasing Medicaid expenditures for institutional care.

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