Connecticut Governor Proposes Use of Internet to Help Families Find Homecare Agencies

Posted on 10. Feb, 2012 by in Blog, community, connecticut, Health

Hospital discharges web-based information system to keep individuals out of nursing facilities in the first place. By providing information on the availability of home and community-based services, this system will facilitate the transition of care from the hospital to the community, promoting individualized person-centered planning.*

Here is the Governor’s proposed Long-term Health Care Initiative for the Legislature to approve:


“Governor Malloy recognizes the need to move away from past practice of over-reliance on institutional long-term care settings and to create a system that better supports consumers’ informed choice. By further aligning long-term services and supports with consumer choice and control, the state will not only improve the quality of life for Medicaid participants by providing options but will also reduce unnecessary expenses and institutionalization.

Under the Money Follows the Person (MFP) Rebalancing Demonstration, the federal government encourages states to reduce their reliance on institutional care for Medicaid recipients by moving individuals out of institutional settings and into community settings with appropriate supports. But, for the six month period ending December 2010, Connecticut accounted for 30 percent of the closed cases nationally that did not result in transitions to the community because care plan costs exceeded the individual’s institutional costs under MFP. The cost of medication administration is not the only cost driver; but it is one of the primary cost drivers and one of the primary barriers to community placement.

Governor Malloy’s budget includes four initiatives that will reduce the high cost of medication administration by $20.5 million in FY 2013 or $28.6 million when fully annualized: (1) reducing the reimbursement rate for medication administration, (2) permitting nurses at home health agencies to delegate administration of medication to home health aides, (3) allowing agency-based personal care assistants to administer medications in the home, and (4) allowing clients to gain a higher level of independence by utilizing assistive technology such as medication reminders and automatic pill dispensers when it is cost-effective. 18

The Governor’s budget reflects the addition of Adult Family Living under the Connecticut Home Care Program for Elders and the Personal Care Assistance (PCA) waiver, providing a cost-effective alternative to clients in need of 24 hour supervision and assistance with activities of daily living. The budget also reflects the addition of Independent Support Broker to the menu of services available under the PCA waiver. By helping consumers design and direct their own supports, more persons under the age of 65 will have access to long-term services and supports in the community.

Funding of $300,000 has been proposed to create a standardized level of care assessment across long-term services and supports, which will include the development of an automated needs assessment tool, screening tool and care plan budget methodology. Needs assessments will be coordinated with the comprehensive assessments that are federally mandated for all nursing home residents. Greater standardization of long-term care assessments will promote administrative efficiencies and increased equity.

Governor Malloy recognizes the importance of housing in allowing individuals to go back to the community and in keeping individuals in the community in the first place. The Governor’s budget includes $10 million in bond funds for modifications of existing housing. These funds, administered by DECD, will create additional accessible housing, allowing individuals who are institutionalized to return to their family homes or apartments.

In addition, Governor Malloy is recommending expanding the Private Pay Assisted Living Pilot. This program subsidizes the service costs for persons age 65 and older who reside in participating private assisted living communities and who are eligible for the Connecticut Home Care Program for Elders. Currently, the pilot can serve a total of 75 individuals who, after living in a private assisted living facility, have spent down their assets and now require help with their living expenses. The Governor is proposing to increase this pilot from 75 to 125. Also, as discussed under the section regarding housing initiatives, Governor Malloy is making significant investment in congregate housing to promote aging in place and prevent premature institutionalization of the state’s growing elderly population.

*Hospital discharges are also important in keeping individuals out of nursing facilities in the first place. In  Connecticut, approximately half of the persons requiring long-term care after hospital admission are  currently discharged to nursing homes and only a third of Medicaid participants who are discharged to a  nursing home eventually return to the community. Governor Malloy’s budget includes $250,000 to create a  web-based information system. By providing information on the availability of home and community-based  services, this system will facilitate the transition of care from the hospital to the community, promoting  individualized person-centered planning.”

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