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DEVELOPMENT OF THE OREGON LTC SYSTEM

MAKING THE SYSTEM WORK IN HARD TIMES

INDIANAPOLIS---MAY 6, 2002

Richard Ladd, Ed.M.

Ladd and Associates

Salem, OR

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Pre-implementaiton

• Joint HCFA-AOA demonstration

• State integration proposal

• Advocates’ ad-hoc committee

• State policy on aging

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IMPLEMENTATION

• First home and community based based waiver (1915(c))

• Decentralization

• Implementation of the state policy on aging

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HARD TIMES

• Special session

• Plan to cut 20% of each agency’s budget

• Relocation

• Pre-admission screening

• No waiting lists

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RESULTS

OREGON PUBLIC LTC CLIENTS NOVEMBER 2001

15%

85%

NURSING HOMES

Ladd &HCB

Associates

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Lessons from the Oregon experience

• Get the advocates on your side

• Must go to war with the nursing homes

• Need nurse delegation

• Need a working philosophy

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Lessons learned...

• Need to limit services to those most in need

• Transfer those in less need out of Medicaid

• Development of out-of-home placements• Need to review all Medicaid nursing

home residents