State Study Shows Progress on Long-Term Care

Alzheimer's Association
Wednesday, 20 October 1999

A wide array of health care initiatives on long-term care and caregiver support have been adopted by state legislatures in 1999, according to a new analysis by the Alzheimer's Association.

The 1999 study includes such items as a doubling of the Ohio budget to $7.5 million for respite care over the next two years and several states have moved to improve long-term care with increased funds and staffing levels.

"States are not waiting for Congress to act but are moving to expand and improve services for people with Alzheimer's disease and their families," said Stephen McConnell, vice president for public policy of the Alzheimer's Association. "The progress documented in this report is the direct result of effective work by Alzheimer advocates across the county."

"But we will never solve the long-term care crisis that Alzheimer's poses by relying solely on separate action in the 50 states. We must have a national solution that pulls together all of our resources — federal, state and families — in a system that makes sense."

The annual study, titled "State Policy Clearinghouse," reports that 13 states took caregiver actions including:

Respite Care

- Connecticut increased the maximum days for out-of-home respite from 21 to 30 days, with adult day care services not subject to that maximum.

- Nebraska adopted a program to recruit and train respite care providers and assist families in identifying respite needs.

- New Jersey appropriated $8 million for caregiver assistance programs.

- New Mexico provided $1.2 million for its state agency on aging, including $614,000 for respite care programs.

- South Carolina included $450,000 for respite and diagnostic services and $390,000 for respite family service programs.

Adult Day Care

- Mississippi approved $1 million for adult day care.

- New Jersey adopted a budget that included $700,000 for dementia specific adult day care and also passed separate legislation that provided $803,000 for adult care services.

Assisted Living

- Arizona established a pilot project that provides funding for eligible residents of Arizona's model assisted living facilities and targets residents who wish to remain but can no longer afford the facility's fees.

- Illinois established regulations for assisted living and shared housing.

- Missouri adopted assisted living legislation and created a demonstration project for facilities for individuals with Alzheimer's.

- North Carolina adopted standards of care related to medication and supervisor qualifications.

- Oregon revised its rules on assisted living and advocates are working with the state to revise rules for Alzheimer facilities.

- Texas legislation adopted minimum acceptable levels of care, including license and minimum standards for assisted living facilities.

Nursing Home Reimbursement and Staffing

- Kansas authorized wage increases for nursing home staff.

- Maryland established a task force on the quality of care in nursing homes and required a state commission to develop a quality evaluation system.

- Mississippi authorized a system to use in reimbursing a nursing home facility for the additional cost of caring for a resident with Alzheimer's disease or a related dementia.

- South Carolina improved wages for personal care aides and adjusted Medicaid reimbursement rates for direct care workers in nursing homes.

- Texas appropriated $15.8 million of state funds and almost $25.2 million in federal funds for reimbursement increases for nursing homes and hospice care this year, with another $15.8 million of state funds and $25 million of federal funds for next year.

Special Care Units

- Arkansas, Illinois and North Carolina required new disclosures from adult day care programs that market themselves as special care units for individuals with Alzheimer's.

Home and Community -Based Services

- Indiana increased funding to its home services program by $10 million over the next two years.

- Maryland directed its mental health agency to apply for a federal waiver to match state dollars, including home health care, respite and assisted living.

- Mississippi mandated expansion of its programs over the next five years, including a program to screen clients to determine appropriate care.

- Texas appropriated $27.5 million for its community-based program for the next two years.

Long-Term Care Issues

- Missouri approved a $500 state income tax credit for caregivers.

- Oregon and Missouri approved income tax credits for long term care insurance premiums.

Prescription Drug Assistance

- Missouri approved a $200 income tax credit for prescription drugs purchased by income qualified citizens and Vermont expanded its program to provide maintenance drug benefit to seniors and disabled individuals with incomes under 250% of the federal poverty level.

Alzheimer Research

- California expanded its network from 7 to 10 Alzheimer research centers with $1.5 million in new funding.

- Arizona continued funding of $1 million for its Alzheimer research center.

Alzheimer Specific Actions, not included in other categories

- Michigan increased funding for its information and referral by $240,000 for a total of $440,000.

- Texas established a consortium of Alzheimer's disease centers to offer clinical services, establish a database for research and inform patients and caregivers of research or therapeutic trials open for participation.

- Vermont reinstated the Alzheimer Commission.

- Virginia funded local initiatives for services to individuals with Alzheimer's and related disorders.

The Alzheimer's Association is the largest national voluntary health organization dedicated to research for the causes, treatments, prevention and cure of Alzheimer's disease and to providing education and support services to the four million Americans with the disease, their families and caregivers. You can reach the Alzheimer's Association at (800) 272-3900.

For more information, or to contact Alzheimer's Association, see their website at: www.alz.org