Raising Expectations: A State Scorecard (Part II)

Spotlight on the Land of Lincoln

You already know from the last blog that Illinois ended up ranking 23rd overall in AARP's State Scoreboard on LTSS for Older Adults. In the four dimensions it ranked (out of the 50 states) as follows: Affordability & Access 12; Choice of Setting & Provider, 33; Quality of Life & Quality of Care, 24; Support for Family Caregivers, 27.

For those who paid attention to the last blog, there are 25 indicators grouped into the four dimensions. Let's focus on a few of them.

How Effectively a State Facilitates Consumer Choice

Only a handful of states spend more than 50% of their Medicaid (and general revenue funds) on home care and community based services (HCBS) for older people. Presumably, older adults would prefer to receive HCBS than to move into a skilled nursing facility. Minnesota at 64% is in the top five states, the US median is 30% and Illinois is at 28%. Some room to improve for the Illini, although it is important to note that Illinois is performing much better in this indicator than many other Big 10 states. Interestingly, Illinois ranks number one on how effectively it facilitates consumer choice to receive HCBS! It appears that Illinois is doing a great job at offering HCBS alternatives, but it still finds itself paying for a relatively high percentage of older adults to live in a skilled nursing facility. I'll opine in the future on how Illinois struggles with creating a robust HCBS infrastructure in the face of numerous obstacles.

Quality of Life and Quality of Care Dimensions

Illinois ranked in the second quartile on Quality of Life and Quality of Care Dimensions. Frequent readers of the blog may find this score surprising in light of the low Medicaid rate paid to Illinois nusing homes. Professionals working in the industry should be proud of this "in spite of" achievement. Although there is room for improvement, it is heartening to know that the partnership between the providers and the regulators seems to be providing for quailty care in Illinois SNF's.

Illinois ranks 45th in the nation for the number of assisted living and residential care units per 1,000 per population over the age of 65. The availability of  ALF licenses in Illinois is less than 20-years old and Illinois does not offer any residential care facility licenses to serve older adults. This may be a factor in why the Green House movement has yet to make a foothold in Illinois.

The Scorecard is a unique attempt to help states identify gaps in the provision of long term care services and support.  If one has the time, it is worth reading the 17-page Executive Summary (available for download here). It will be interesting to see how advocates, policy makers and providers react to the report. Stay tuned.


Follow me on Twitter for more frequent posts @aginginchicago

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    Bruce Lederman has over 25 years experience in the senior care field as a direct care provider and thought leader. Bruce was CEO and president of his own firm that operated skilled nursing facilities in Illinois. He is a former nursing home administrator and has consulted to numerous elder care providers on planning for strategic growth as well as process improvement. Recently he served as board chair of CJE SeniorLife, a leading non-profit elder care provider in the Chicago area. Bruce is currently employed as chief strategy officer for a company providing skilled nursing services in communities throughout Illinois and Missouri.

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