Ladd1 DEVELOPMENT OF THE OREGON LTC SYSTEM MAKING THE SYSTEM WORK IN HARD TIMES INDIANAPOLIS---MAY...
Transcript of Ladd1 DEVELOPMENT OF THE OREGON LTC SYSTEM MAKING THE SYSTEM WORK IN HARD TIMES INDIANAPOLIS---MAY...
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DEVELOPMENT OF THE OREGON LTC SYSTEM
MAKING THE SYSTEM WORK IN HARD TIMES
INDIANAPOLIS---MAY 6, 2002
Richard Ladd, Ed.M.
Ladd and Associates
Salem, OR
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Pre-implementaiton
• Joint HCFA-AOA demonstration
• State integration proposal
• Advocates’ ad-hoc committee
• State policy on aging
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IMPLEMENTATION
• First home and community based based waiver (1915(c))
• Decentralization
• Implementation of the state policy on aging
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HARD TIMES
• Special session
• Plan to cut 20% of each agency’s budget
• Relocation
• Pre-admission screening
• No waiting lists
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RESULTS
OREGON PUBLIC LTC CLIENTS NOVEMBER 2001
15%
85%
NURSING HOMES
Ladd &HCB
Associates
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Lessons from the Oregon experience
• Get the advocates on your side
• Must go to war with the nursing homes
• Need nurse delegation
• Need a working philosophy
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Lessons learned...
• Need to limit services to those most in need
• Transfer those in less need out of Medicaid
• Development of out-of-home placements• Need to review all Medicaid nursing
home residents