As states confront their most challenging budgets in decades alongside new responsibilities to implement national health reform, many are looking at opportunities to improve long-term care as a way to control costs and serve seniors and people with disabilities in the settings they prefer. This issue of States in Action describes provisions in the Affordable Care Act that assist states in expanding home- and community-based long-term care services, the growing grassroots movement to improve facility-based care, and innovative programs in Colorado, Michigan, and Rhode Island that seek to provide consumer-directed long-term care. Read more »
The following Snapshots illustrate different ways in which three states—Rhode Island, Michigan, and Colorado—are working to promote culture change in long-term care services. Read more »
Some states are using regulatory oversight of nursing facilities to advance the culture change movement and promote resident-centered care. For example, Rhode Island's nursing home survey agency, part of its Department of Health, has prioritized measures of quality of life—in addition to measures of clinical care—in its nursing home survey and certification process. Read more »
Michigan is focusing on the needs of its direct-care workers (e.g., nursing assistants, home care aides) as part of the foundation for its quality improvement activities. Read more »
Colorado Medicaid implemented a pay-for-performance program for nursing facilities, with financial incentives tied to both quality-of-care and quality-of-life measures. Read more »