Expanding Publicly Financed Assisted Living and Other Residential Alernatives for Disabled Older Persons: Issues and Options
Publication Date:
Publisher: Center for Home Care Policy and Research, Visiting Nurse Service of New York
Author(s): D.G. Stevenson; C.M. Murtaugh; P.H. Feldman; M.R. Oberlink
Research Area: Health
Type: Report
Abstract:
Drawing on current research and expert opinion, the authors of this policy brief explore strategies for expanding publicly financed supportive housing for older persons needing long-term care. There are two primary reasons policy-makers are looking to expand public financing of long-term care in assisted living and other residential settings: they want to (1) increase access to non-institutional, community-based settings; and (2) achieve cost savings by shifting care to residential alternatives other than nursing homes. With these as a backdrop, the authors propose the following issues for consideration:
* Identify the range of residential long-term care settings to be targeted and determine whether public funding will be allocated only to those facilities that meet stringent privacy and service criteria.
* Identify the population to be targeted and determine whether the existing nursing home eligibility standard is the appropriate designation for eligibility.
* Determine how services will be financed and consider case-mix adjusted payment methodologies.
* Develop a strategy for ensuring quality of care in residential long-term care settings.
* Given the limited number of quantitative studies and the huge variation in environment and service delivery in residential settings, policy-makers should be cautious when drawing general conclusions based on specific findings.
* States should take a more active role in ensuring the adequacy and accuracy of information that residential facilities provide to consumers.
* State policy-makers developing strategies to regulate residential settings should consider new approaches that encourage flexibility and innovation in service delivery.