US Assisted Living Regulations and Reimbursemeny Policies

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Interesting research paper. One approach to help you with a paper assignment like this one is to look at information from various sources for each section (e.g. the questions can act as a tentative outline from the paper), which you can then draw on for your final copy.this the approach this response takes. I also provided links for further research and two supporting articles to draw on.

RESPONSE:

Topic: State Assisted Living Practices and options policy issues

Thesis: In US, the states should build (and review) their assisted living regulations and reimbursement policies and to increase access to assisted living for low-income older people.

The following questions can act as a tentative outline for your paper, which might look something to the effect...

I. Introduction (e.g., ¼ - ½ page; introduce topic; include thesis or purpose statement)

II. What is the historical perspective/background for this issue?

III. What is the description and characteristics of current policy?

IV. Evaluation of the current policy from a societal perspective , including strengths and weaknesses.

V. Evaluation of the current policy from lobbyists or special interest perspectives, in terms of strengths and weaknesses as perceived by three interest groups for or against the current policy.

VI. Recommend specific changes for this policy from a societal perspective.

V. Conclusion

Now let's look at some information for you to consider for each section related to your thesis or purpose statement:
In US the states should build (and review) their assisted living regulations and reimbursement policies and to increase access to assisted living for low-income older people.

1. What is the historical perspective/background for this issue?

With the aging of the population and the growth in the number of elderly, the demand for long-term care will increase in the United States. States are planning for the growing numbers who will need long-term care, and considering how to best accommodate them. Most publicly financed long-term care is provided by nursing homes, but over the past decade many communities and states have experimented with and developed alternatives to nursing home care.

In the 1980 and 1900s, two trends in healthcare impacting the move towards assisted living are managed care and the development of integrated provider or service systems. There is little doubt that these two health care systems impact each other and are also important in the rise of assisted living programs. The growing interest in private financing alternatives for long term care is the third change in health care that has significance for assisted living programs. The policymakers and consumers realized that the public health system had its limits in meeting the health care needs of the increasing number of aging people. There is a concurrent realization, however, that with longevity and chronic conditions, personal resources can quickly be exhausted without careful planning and preparation (Sloan, 2001, from http://books.google.com/books?id=AmbxephnarQC&pg=PA33&lpg=PA33&dq=state+assisted+living+practices+special+interest+groups&source=web&ots=H3nLx-nMD6&sig=eZhmA5f1FyYfJiwO-vkCWm4-RnI#PPA34,M1).

For example, in one study by StateLine, the researchers examined the efforts of four states to develop assisted living facilities, particularly for low-income residents of rural areas. There is no standard definition of assisted living. Generally, however, assisted living facilities provide residents with care and supervision in a home-like setting. This long-term care option combines some elements of nursing home care with those of community-based care. Personal care and health-related services are available in a residential setting to meet scheduled and unscheduled needs of residents. The concept of assisted living is becoming more popular. It appeals to people who need some day-to- day help, but still want to preserve their independence. Long-term care providers recognize that consumers want choices. By making alternative forms of care available, they attract more people. This is particularly important in existing facilities that have low occupancy rates. Indeed, from a financial perspective, assisted living is often viewed as a potential lower-cost alternative to nursing home care. The average annual cost of long-term individual care in a nursing home is $41,000 (1), compared to $22,000 annually in assisted living facilities. (2) (3). Since states pay a substantial share of publicly financed long-term care, there is much interest in examining alternatives to nursing home care (http://www.nga.org/Files/pdf/000215ASSTLIVING.PDF, attached for convenience as: Creating AssLiving facilities.pdf).

States are therefore trying to create more balanced long term care systems, which means shifting resources from a historical over reliance on institutional care to a blend of institutional, residential, community and in-home services (Sloan, 2001, from http://books.google.com/books?id=AmbxephnarQC&pg=PA33&lpg=PA33&dq=state+assisted+living+practices+special+interest+groups&source=web&ots=H3nLx-nMD6&sig=eZhmA5f1FyYfJiwO-vkCWm4-RnI0.

Four Approaches to Providing Assisted Living Options

States are considering a number of approaches to convert existing health care facilities to assisted living facilities or to develop new assisted living facilities. Although assisted living is generally defined as an option for long-term care that promotes independence while providing care and supervision in a home-like setting, it refers, in practice, to a broad range of settings and circumstances. Some, but not all, states have licensing regulations for assisted living facilities. And some states reimburse assisted living as a Medicaid service.

In this study, the four approaches in this StateLine are all geared to rural low-income populations, but they provide examples of how differently assisted living facilities are developed and operated. Information about the programs was obtained through interviews with state officials, administrators, and community-based program administrators.

? In Illinois, the State Department on Aging sponsors a pilot project through its Community Care Program (CCP), to help create "Community-Based Residential Facilities." The department worked with Shawnee Health Service and Development Corporation, a nonprofit health and social service agency operating in southern Illinois, to develop new facilities. Initially, the Shawnee Corporation applied for a grant from the Coming Home project, an initiative of the Robert Wood Johnson Foundation that helps communities in rural areas develop services and facilities to meet
the long-term care needs of residents. Grants and loans were the primary fund sources for the construction of new facilities. Residents pay their own rent, which is kept low. Monthly SSI program payments help cover the rent, in some cases. Funding for services comes from state general revenues through the State Department on Aging. After one year of operation, the average individual cost for services was $37.50 per day. At the time, Illinois spent $76.30 per day for skilled nursing care. (4)

The Cache Valley Assisted Living Apartments in Ullin, Illinois, is one of the new facilities. The 40-unit complex includes studios, one-bedroom, and two-bedroom apartments, all with kitchens and bathrooms. The facility has a commercial kitchen and communal space for dining and recreation. An on-site case manager screens residents to determine which of seven levels of care they need to perform daily living activities or instrumental activities of daily living, known as ADLs or IADLs. Personal care services to help with ADLs are available to residents 24 hours a day. Other services include three meals daily, laundry, recreation, social services, medication management, housekeeping, transportation, and money management.

? Nebraska's Department of Health and Human Services administers a state grant program called the Nursing Facility ...