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Senior Services & Public Benefits
15 2013-Mar Community Forum with Director John HoltonDeveloper: KACS Views: 27527 Korean American Community Services Community Forum February 25, 2013 Hello, it’s a great pleasure to be here with you today. I want to thank Korean American Community Services for inviting me to participate in this Forum. Since October 2012, I’ve had the honor to serve as the Director of the Illinois Department on Aging. Our mission is to serve and advocate for older Illinoisans and their caregivers. The Department administers programs that promote independence, dignity and quality of life for older adults. We all know it’s a challenging time in Illinois. The State is experiencing a record deficit. Yet, in this time of fiscal crisis the need for long-term care services and supports continues to increase. There will be a record number of older adults as baby boomers age and people live longer than ever before. In fact, in the past decade, Illinois’ older population has grown from 1.9 million to approximately 2.2 million. By 2030, it is estimated that the number of individuals over the age 60 in Illinois will increase to 3.6 million and represent 24 percent of the population. And, it’s expected that at least 70 percent of people over age 65 will require some long-term care services at some point in their lives. The Illinois Department on Aging, working with the 13 Area Agencies on Aging and it other funded partners, delivers critical services to help older adults remain in their homes and communities. The Aging Network is a backbone of a system that allows seniors to remain independent and avoid more costly nursing home placement. There are much needed services that prevent individuals at risk of entering an institution available through the Department’s largest program – the Community Care Program. I will talk more about the Community Care Program in a moment, but first I will highlight a few other services administered by the Department that are essential to older adults’ health and independence. For example, the Department with its partners in the Aging Network, delivers services funded through the federal Older Americans Act. These services include transportation, information and assistance, outreach, congregate and home delivered meals. Last year, nearly 500,000 individuals received services funded by the Older American’s Act. We also administer the Family Caregiver Support Program. The program provides support such as training and technical assistance to caregivers of older adults and older relatives caring for young family members. In Illinois, we estimate that there are more than 200,000 children being raised by their grandparents. Last year, the program served more than 46,000 caregivers. The Department is also committed to preventing abuse, neglect and financial exploitation of older adults who live the community through the Elder Abuse and Neglect Program. The program provides investigation, intervention and follow-up services to victims. Efforts are coordinated locally through 41 provider agencies that work with older adults to resolve abusive situations. We are also concerned with the treatment of older adults living in long term facilities. Quality resident care and resident’s rights are top priorities for the Department. The Long Term Care Ombudsman, as mandated by the federal Older Americans Act and the Illinois Act on Aging, advocates for residents. The Long Term Care Ombudsman Program investigates thousands of complaints from nursing home residents and their families each year. Recently, the Department launched the new online Benefits Access Application. The application is used to deem older adults and persons with disabilities eligible for the Rides Free Transit Program and a license plate discount from the Secretary of State. In the past, the Department processed applications for the Circuit Breaker property tax grant and Illinois Cares Rx prescription assistance but unfortunately due to budget restrictions those programs have been eliminated. However, the Department on Aging still funds Senior Health Assistance Program sites across the state to assist with the Benefits Access Application, as well as Medicare Part D and other public benefits. All these programs administered by the Department are very important, but as mentioned the Department’s largest program is the Community Care Program. The program serves more than 82,000 older adults a month and represents nearly 90 percent of the Department’s Fiscal Year 2013 General Revenues Fund. The number of older adults enrolled in the program has more than doubled in the past 10 years. CCP provides care coordination, in-home care, adult day and emergency home response services to eligible seniors age 60 and older. To qualify, an individual must have less than $17,500 in assets (excluding a house and a car). In addition, an individual must apply for Medicaid although they do not have to be deemed eligible to participate in the Program. Currently, about 63 percent of CCP clients are enrolled in Medicaid. The program is a cost effective alternative to institutional care as all CCP recipients are eligible for nursing home placement. It’s estimated that CCP cost nearly a quarter of the cost of a nursing home. Policy-makers on both the federal and state level are encouraging a rebalancing of long term care from institutional settings to home and community based services. And, the Patient Protection and Affordable Care Act includes incentives for states to expand and improve Home and Community Based Services Programs. The financial incentives are in the form of enhancements to the Medicaid matching rate that determines the federal share of the program’s costs. The State of Illinois in an effort to combat rising Medicaid costs and in hopes to provide a more holistic approach to caring for patients is implementing managed care. The Medicaid reform law adopted by the Illinois General Assembly in 2011, Public Act 96-1501, requires that by January 1, 2015, at least 50 percent of the individuals covered under Medicaid be enrolled in a care coordination program that organizes care around their medical needs. To meet this goal, the Illinois Department of Healthcare and Family Services (HFS), in collaboration with the Department on Aging and the Department of Human Services (DHS), is moving eligible older adults and persons with disabilities to risk-based managed care programs. HFS introduced the first Integrated Care Program – or ICP- on May 1, 2011. The Program is for older adults and persons with disabilities. Enrollees in ICP are eligible for Medicaid, but not Medicare. The program is mandatory and operates in the areas of suburban Cook, DuPage, Kane, Kankakee, Lake and Will Counties. ICP brings together healthcare for participants through local primary care providers, specialists, hospitals, nursing home and other providers. The participants receive the same health services that are available through Medicaid. Currently, there are two MCO providers for ICP. Those providers are Aetna Better Health and IlliniCare Health Plan (Centene Corporation). On February 1, 2013, ICP expanded beyond medical services to include institutional care and home and community based waiver services. This includes the Community Care Program. Approximately 1,200 former CCP participants are now receiving their in-home and community services through the managed care organizations. ICP will further expand to include additional regions and MCOs beginning July 1, 2013. Regions impacted will include Chicago, Central Illinois, Qaud Cities, and Metro East, as well as the Rockford area and Winnebago, Boone, McHenry counties. With ICP, the Care Coordination Units that the Department on Aging traditionally contracts with for case management activities will remain responsible for determining a participant’s annual eligibility for services. However, the MCOs will be responsible for administering the care assessment and care planning functions. MCOs are currently contracting with the Department’s certified CCP providers of in-home, adult day and emergency home response services. So, in most cases those former CCP participants will not experience a change in their provider agency or in-home service aide. The Department on Aging will continue to be the operating agency of the Home and Community Based Service waiver. However, MCOs are under the direction of the Department of Healthcare and Family Services. Aging and the Department of Healthcare and Family Services will work together to ensure the successful implementation of ICP, including providing quality oversight of the services delivered by MCOs. The CCP program will remain operational for all non MCO participants. And, program administrative rules and related policies remain in effect and must be adhered to for both CCP and MCO programs. You may have recently seen in the news, that on February 22 the Department of Healthcare and Family Services received approval from the federal Centers for Medicare and Medicaid Services to implement the Medicare-Medicaid Alignment Initiative. This initiative known as the “Duals” will impact those who are dually eligible for both Medicaid and Medicare. It is expected to enroll up to an estimated 137,000 Seniors and Persons with Disabilities in the Chicagoland area and throughout Central Illinois beginning October 2013. The Medicare-Medicaid Alignment Initiative will have a greater impact on the Department on Aging and the CCP Program. The Department of Healthcare and Family Services estimates that approximately 23,000 CCP participants will be eligible for the Initiative. So, with the implementation of managed care the service delivery for healthcare and long term services and support in Illinois is changing. Hopefully, managed care will not only save money but most importantly improve care for older adults and persons with disabilities. The Department’s work ahead includes coordinating with our sister state agencies to ensure that beneficiaries have access to providers and services that are of high quality, as well as patient-centered by respecting individual choices and preferences. And, by working with our Aging Network, we can help ensure that beneficiaries understand the choice of plans, providers, and services available. In addition, we can help individuals understand enrollment and disenrollment procedures, and their legal right to receive full access to benefits. Stakeholders must work together to ensure that the promise of managed care may be fulfilled without compromising the health and well-being of those individuals enrolled in the programs. If implemented thoughtfully, managed long term services and supports has the potential to improve care through coordinated services, more efficient use of resources, and increased emphasis on preventive services and home and community-based care. Thank you. | ||||
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