DEVELOPMENT OF THE OREGON LTC SYSTEM

1
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

4
HARD TIMES

• Special session
• Plan to cut 20 of each agencys budget
• Relocation
• Pre-admission screening
• No waiting lists

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RESULTS
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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

7
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