CAHSA: Organization Calls for Revised Long Term Care System
Noting that the current long term care system in California is in disarray, while the number of seniors dependent on that system continues to increase, the California Association of Homes and Services for the Aging (CAHSA) is advocating a new system that combines the strengths of managed care and social services for seniors. In this week's California Health Care Monitor, Barbara Hood, president and CEO of CAHSA, writes that if the current system is left unchanged, it will collapse "under the weight of a massive senior population." From CAHSA's viewpoint, the "need for coordinated senior services and integrated finances is glaring," as complex government programs, gaps in coverage and nonexistent, but needed, services plague California senior care. CAHSA believes that combining the "traditional medical model of care and the emerging social model of care" would establish the optimal system of care for seniors. Traditional managed care would benefit seniors because it focuses on prevention and wellness to contain costs. Hood compares managed care to continuing care retirement communities, since both focus on the preventing problems, rather then waiting to treat problems as they arise.
An important step in establishing an improved long term care system, Hood says, is the "integration of existing funding streams such as Medicare and Medicaid." She argues for the expanded use of Medicaid waivers to cover eligible seniors home health or personal health services in their homes or assisted care facilities. Currently, waivers are only used for seniors in nursing facilities. AB 499, a bill sponsored by CAHSA, would establish a pilot project to assess the state's interest in the waiver proposal. In addition, CAHSA proposes changes to the current Medi-Cal program, including increased reimbursement levels for licensed nursing facilities. California currently has one of the nation's lowest reimbursement rates and continues to use a "flat rate" system. But CAHSA contends that the low reimbursement levels lead to inadequate care. Since the recent passage of the nursing reform bill AB 1160, which mandates higher nurse-to-patient ratios, the organization believes that the quality of care will increase. Training and developing a skilled workforce will also enhance the quality of the long term care system. CAHSA co-sponsored the nursing reform bills AB 655 and A B 656, which develop new education programs while expanding current training programs for skilled nursing and nursing assistants. To accomplish the lofty goal of revamping the long term care system, CAHSA calls on physicians, nurses, health plan administrators and lawmakers to work together toward the goal of improving seniors' health care (Hood, California Health Law Monitor, 10/11 issue). This story is referenced with the permission of M. Lee Smith Publishers LLC.