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Care In All Shapes and Sizes: Choice Is What We Want

January 2007

If we all wanted the same things, grocery stores would be small shops instead of the mega-stores we see on every street corner. Department stores would have sweaters in one style and one color, instead of racks and racks of every shape, size and color. We know Americans value choice.

We also know that most people, if given the opportunity and means, would choose to remain in their own homes and communities as long as possible. It is a decision that many take for granted until the day we need care or assistance with a seemingly ordinary task.

One size does not fit all, and this is especially true when it comes to long-term care. If one size did fit all, our nursing homes would be filled to capacity. By enabling people of any means to access the long-term care services they need in home and community-based settings, we give them a degree of independence simply not available in institution-based care. As a result, they can contribute to their communities in new ways.

Giving people with Medicaid more home and community options also helps the state serve more people at less cost and makes the most of our Medicaid dollars. Ultimately, coordinating all long-term care options could eliminate fragmentation in our delivery systems, enhance access to available resources, reduce duplication and maximize our resources. Care in home and community settings often costs a fraction of institutional care.

The Ohio Department of Aging offers several programs that give Ohioans on Medicaid choices in long-term care:

• PASSPORT is a home- and community- based Medicaid waiver program that provides in-home services for Medicaid-eligible seniors who must be 60 or older and need assistance with personal care. It enables folks to remain in their own homes safely and independently for as long as possible. All at an average cost of $13,300 per client- less than one-quarter of what it would cost to serve the same individual in a nursing home.
• The Home First Initiative helps seniors in nursing homes who wish to return to the community do so in a timely manner. It allows qualifying seniors who are in a nursing facility to be assessed and to transition to in-home care, by-passing any waiting lists.
• Choices is a consumer-directed waiver program in which enrollees take an active role in directing their own care by hiring their own caregivers, including family members, friends or other individuals. Currently, the Choices program is offered in certain central and southeastern Ohio counties.
• The Program of All-Inclusive Care for the Elderly (PACE), a managed care program available in Cleveland and Cincinnati, provides participants with all of their needed health care, medical care and ancillary services. PACE receives full capitation from both Medicare and Medicaid.
• The Residential State Supplement program provides cash supplements to pay for approved living arrangements in qualified adult care facilities.
• The Assisted Living Program is the newest option for seniors and adults with disabilities on Medicaid. Participation is open to nursing facility residents and existing Medicaid waiver consumers who would otherwise permanently remain in or enter a nursing facility. Participants must be at least 21 years old and determined to need a nursing facility level of care.

To learn more about your choices in long-term care or to schedule a free assessment contact your Area Agency on Aging at 1-866-243-5678.