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Center for Long-Term Care Reform Backs Enhanced Home- and Community-Based Services for People with Dementia

Sharon Post
December 14, 2016
Medicaid pays for both institutional and home- and community-based long-term services and supports (LTSS). In 2014, the federal government issued new rules setting standards for what kind of LTSS setting qualifies as “community-based” rather than institutional. Some services are provided in settings that have characteristics of both institutions and community-based sites, and the new rules establish criteria for distinguishing a truly community-based setting that allows independence for program participants from those that restrict participants’ freedom to interact with the broader community.

Health & Medicine’s Center for Long-Term Care Reform has advocated for enhancing access to home- and community-based services and reducing the institutional bias in Illinois’ long-term care system. We therefore welcomed the new federal rules and have followed closely the State’s development of a Statewide Transition Plan to come into full compliance with the them.  In our comments on the latest revised Statewide Transition Plan, the Center highlighted two key issues in implementing the settings rule:
  1. Applying the rules carefully but rigorously to adult day centers that serve people with dementia,
  2. The need for rate reform to reflect the true cost of person-centered, community-integrated services for older adults and people with disabilities. 
These are two of many significant challenges facing Illinois’ long-term care system, and the Center expects to work together with advocates and State agencies to move forward with these reforms.