Niki Kelly has a good story for the Fort Wayne Journal Gazette entitled Senior care focus shifting: State pushing service delivery as alternative to nursing homes.”
State officials are doing more than just trying to pay Medicaid bills. They are transforming the long-term care model for seniors in Indiana, including a strong push to reduce the number of people living in nursing homes.
Specifically, there is a focus on making it easier for seniors to choose community-based and home-based alternatives.
In general, this seems like a positive development, both because the alternatives to nursing homes are generally less expensive over all and because they generally provide a better quality of life to the senior. (Or at least, so I’ve been told; I don’t have any expertise or direct experience myself.)
The devil, as always, is in the details. I suspect if the government were so inclined, it would be easier to shave services and costs at the expense of the senior in a way which is less noticeable under the alternate models than under the nursing home model.
For those who are interested, there are other angles to the story and details in Ms. Kelly’s article.
It seems positive until you realize that assisted living facilities are not nearly as tightly regulated as nursing homes. Many times they take in patients that they have no business accepting. And as we all know, all the regulations in the world have not always been effective in keeping nursing homes safe.
The state’s main concern is keeping seniors out of nursing homes and off of Medicaid. I attended a meeting several months ago when this “plan” was discussed. The underlying premise was that people end up on medicaid and in nursing homes because of lack of taking personal responsibility for their health when they were younger. There was no recognition that many chronic illnesses have a genetic component and no acknowledgement that lack of preventive care may be due to low wages and lack of adequate health benefits. There was actually talk of making “incentives” for adult children of seniors to care for their aged parents at home. As we know of course, many of those adult children have had to leave Indiana to find decent jobs. Sorry to ramble.
Doug, didn’t I see you post an article about the state trying to move the aging population out to places like FL and focus on the “workers” here? It sounds like they might have decided it is better to keep everyone around, and that is a good thing.
Caveat Hoosier. To the extent that many in need of long-term care do not need the level of care delivered in a nursing home setting, a home- and community-based care focus offers potential. However, there is an inherent dynamic conflict between bean-counters and those who deliver services. It is entirely possible that the Division of Aging, the FSSA and the Daniels Administration may be entertaining motives that are not nearly as benign as those articulated in the story.