Retirement News : Seniors : Senior options could grow in state

Senior options could grow in state

Date Added: 29-06-2005

Gov. Kathleen Blanco made providing residents more living options outside nursing homes and other institutions a key part of changing Louisiana's health-care delivery system.
So where does the move to diversify and offer more home and community-based services to the elderly and developmentally disabled stand after the legislative session?

Interviews with those keenly interested in the movement point to two key steps taken as the Legislature approved bills that would:

Provide financial incentives to nursing home owners so they'll diversify into more home and community-based care. The idea is to convert institutional beds to a new type of apartment-style residential care.

Allow personal-care attendants to do more as they care for people in their homes.

The proposed law would allow the attendants, instead of just feeding and bathing, to perform limited medical duties such as dispensing prescription drugs.

It's another step aimed at keeping more people at home and out of institutions.

The state Department of Health and Hospitals must draft rules before either program can be implemented, and more legislative approval is needed, too.

For instance, changes in nursing home finances must be adopted to free dollars to pay for what would be a new residential care pilot program. Exactly what shape that residential care program would take is yet to be decided.

In addition, DHH must develop rules that address what "non-complex" medical tasks in-home workers can do and set up training parameters and a registry for in-home workers.

"The devil is going to be in the details," said AARP Louisiana governmental affairs director Craig Eichelman.

Louisiana spends 82 percent of its $1.2 billion invested in long-term care for the old and disabled on institutional care, compared with 18 percent on programs that provide services to people in their homes.

That's far off the national pace, where 67 percent of long-term care dollars go to nursing homes and other institutions and 33 percent to home-based programs.

The only change to shift that balance came with legislative approval of $2.6 million so another 100 people can be served through a community program for the developmentally disabled. The increase will mean 4,600 developmentally disabled citizens in Louisiana could get help.

"It's a long run. It's not a sprint," said Department of Health and Hospitals Secretary Fred Cerise. "We are putting pieces in place right now to give people choice.

"We know we are not going to reach the balance that other states have right away."

Cerise said the legislative agenda on long-term care was more about beginning to build a system that will allow the elderly and disabled to have "real time," or immediate care, living choices that meet individual needs.

Much of Blanco's agenda amounted to moving jurisdiction for Medicaid-funded care programs under one roof so there is a "single point of entry" for people seeking services. The idea is to make it easier for citizens to see what's available and to be assessed as to their needs.

For instance, licensing authority for personal care attendants, supervised independent living, adult day care, family support services and respite care was moved to DHH.

In another change, an Office for Citizens with Developmental Disabilities will be established in DHH to design, coordinate and develop services.

"It's not something that will bring sweeping changes in the landscape tomorrow. But I think it does begin to lay the foundation for positive change in long-term care," said Barry Erwin, president of the Council for a Better Louisiana and a member of Blanco's health care panel.

DHH Deputy Secretary Raymond Jetson pointed to another bill that rewrote the two-decades-old law establishing rights of the mentally retarded and developmentally disabled to live as independently as possible.

"We recognize that times have changed for life and support for people with developmentally disabilities," he said.

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