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Restructuring the Long-Term Care System
In order to fully serve the housing needs of two priority underserved populations in the state’s housing plan -- low-income seniors and persons with disabilities – it is important to transform the entire system of long-term care (LTC).
In the past, Illinois made substantial investments primarily in LTC beds in “institutional” settings, such as state-operated facilities and nursing homes. However, in 1999 the U.S. Supreme Court, in Olmstead v. L.C. Ex Rel. Zimring (119 S. Ct. 2176), held that states must allow persons with disabilities to move to the least restrictive setting that is appropriate to their desires, needs and capacity. Illinois has not yet fully implemented this landmark decision and there are three class action lawsuits pending related to the Olmstead decision.
To restructure LTC, we must consider all levels of care available in residential settings for seniors and persons with disabilities. Click here for Table I and Table II of the November, 2007 Long-Term Care Report to the General Assembly, with the number and type of licensed and/or certified LTC facilities and beds.
In addition to these LTC facilities and beds, the state provides residential programs:
For seniors: Supportive Living Facilities (SLF), Comprehensive Care in Residential Settings (CCRS) and home-based services through the Community Care Program.
For persons with mental illness: State-operated facilities, Institutions for Mental Diseases (IMD), mental health CILAs, supported residential programs, supervised residential programs, and permanent supportive housing.
For persons with developmental disabilities: State-operated facilities, group homes or CILAs, and home-based services.
A committee hearing of the House Appropriations-Human Services committee was held on February 15, 2008 to review the status of long-term care restructuring in Illinois. The following documents with pertinent state data were distributed and are available here:
Department of Healthcare and Family Services
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Comparison of Medicaid waivers
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Supportive Living Facilities liability |
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Nursing home liability and nursing home days |
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Census data for persons with serious mental illness (SMI) in HFS-funded nursing facilities, IMDs |
Department of Human Services, Division of Mental Health
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Census data and budget for persons with mental illness in DHS-funded residential servicesComparison of Medicaid waivers |
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State hospital census data |
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Restructuring activities |
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Department of Aging
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Essential elements of LTC reform |
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Older Adult Services Act elements and achievements |
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Restructuring activities |
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Enhanced transition/Home Again |
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Alternative senior services |
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Cash and counseling |
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Community Care Program |
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IDOA next efforts and interagency efforts |
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