Utah: Health and Human Services Legislative Hearing 2014

Utah RepresentativeRebecca Chavez-Houck

Mallory BatemanScott McBethAlan Ormsby

Michael S. StylesNan Mendenhall

Anne Palmer

M I N D T H E G A POPTIMIZING QUALITY of L IFE

for AGING UTAHNS

H E ALT H and H UMAN SERV ICE S IN TE R IM COMMIT T EE PRE SE N TAT ION

R E B E C C A C H A V E Z - H O U C K Democratic Assistant Whip, Utah House of Representatives

M I N D T H E G A POPTIMIZING QUALITY of L IFE

for AGING UTAHNS

OPTIMIZING QUALITY of L IFE for AGING UTAHNS

M I N D T H E G A P

ACTUAL / PROJECTEDSENIOR POPULATION

85+ YearsA C T U AL

85+ YearsP R O J E C T ED

65–84 YearsA C T U A L

65–84 YearsP R O J E C T E D

DELIVERY of CARE to OLDER ADULTS in UTAH

3M A I N T Y P E S

AGING in PLACE at HOMEwith MINIMAL SUPPORTIVE

SERVICES

RECEIVING HOME and COMMUNITY-BASED

SERVICES

MOVING INTO aSKILLED NURSING FACILITY

CONTINUUM of SERVICESfor OLDER ADULTS

Agencies recognize and support the need

for a full CONTINUUM of CARE to meet the complex and varied needs of

older adults.

Many older adults can REMAIN IN THEIR OWN HOMES

with a minimal amount of supportive services

Many can remain in HOME AND COMMUNITY-

BASED SETTINGS with more structured supports

Others receive services in NURSING FACILITIES when

the complexity of the individual’s needs cannot be safely met in

a home and community based setting

Many older adults can REMAIN IN THEIR OWN HOMES

with a minimal amount of supportive services

CONTINUUM of SERVICESfor OLDER ADULTS

Many can remain in HOME AND COMMUNITY-

BASED SETTINGS with more structured supportsOthers receive services in NURSING

FACILITIES when the complexity of the individual’s needs cannot be

safely met in a home and community based setting

TYPICAL ANNUAL COST of PUBLICLY-FUNDED SERVICES

$30 – 60,000

FACIL ITYBASED

S E R V I C E S

AGING inPLACE

With limited support services

When services provided in home

HCBSH O M E and C O M M U N I T Y-

B A S E D S E R V I C E S

<$1,000 $250 – 10,000Alternatives Aging Waiver Including Publicly-

funded ServicesMeals on WheelsRespite

C H A N G I N GD E M O G R A P H I C S

M A L L O R Y B A T E M A N Research Analyst, Utah Foundation

© Deseret News

1990 2000 2010 2013

8.7 8.5 99.8

12.6 12.4 1314.1

Percent of Population 65 years or older

Utah U.S.

Source: U.S. Census Bureau

MEDIAN AGE, UTAH AND U.S.

Source: U.S. Census Bureau 199

0200

0201

0201

3UT 26.

327.

129.

230.

2US 32.

935.

337.

237.

6

UTAH DEMOGRAPHICS 2010

Source: U.S. Census Bureau

UT U.S.

Boomer 18.7

24.9

Gen X 20.9

21.2

Millennial

26.0

27.7

1946–1964

1965–1980

1981–1995

%%%

YOUTH, WORKING AGE, AND 65+ POPULATION

PROJECTIONS (UT)

1990 2000 2010 2020 2030 2040 20500

1,000,000

2,000,000

3,000,000

4,000,000

5,000,000

6,000,000

18 to 64 0 to 17 65 to 84 85 and over

Source: Governor's Office of Management and Budget

2013 Population2,900,872

2050 Population5,257,242

1990 to 2000 2000 to 2010 2010 to 2020 2020 to 2030 2030 to 2040 2040 to 2050

13% 17% 14%6% 11% 12%

29% 19% 15%

15% 14% 10%

21% 24% 27 % 38 % 22% 23%

0 to 17 18 to 64 65 and over

PERCENT CHANGE by DECADE1990 to 2050

Source: Governor’s Office of Management and Budget

1970 1980 1990 2000 2010 2020 2030 2040 2050 2060

76.067.0 65.8

54.2 53.0 52.4 47.5 46.2 47.1 46.7

14.013.0 15.8

14.4 15.2 17.6 24.2 26.7 31.1 33.7

Youth Retirement Age

DEPENDENCY RATIO1990 – 2050

90.0 80.

081.6

68.5

68.2

70.0

71.7

72.9

78.2

80.4

Source: Bureau of Economic and Business Research analysis of Governor’s Office of Management and Budget, 2012 Projections. Note: Dependency Ratios are computed as the number of nonworking age persons per 100 working age (18-64 years old) persons in the population. Youth are less than 18 years old and retirement age is 65 years and older.

2010M A L E

2000M A L E

Under 55 – 9

10 – 1415 – 1920 – 2425 – 2930 – 3435 – 3940 – 4445 – 4950 – 5455 – 5960 – 6465 – 6970 – 7475 – 7980 – 84

85 and over

150,000 100,000 50,000 0 50,000 100,000 150,000Under 5

5 – 910 – 1415 – 1920 – 2425 – 2930 – 3435 – 3940 – 4445 – 4950 – 5455 – 5960 – 6465 – 6970 – 7475 – 7980 – 84

85 and over

UTAH POPULATION by AGE and SEX

2000 and 2010

2010F E M A L E

2000F E M A L E

Source: Bureau of Economic and Business Research analysis. U.S. Census Bureau, 2000 and 2010 Census.

0 to 4

5 to 17

18 to 29

30 to 39

40 to 64

65 to 84

85 and over

80% 60% 40% 20% 0% 20% 40% 60% 80%2010-2030 Female 2010-2030 Male

0 to 4

5 to 17

18 to 29

30 to 39

40 to 64

65 to 84

85 and over

-0.8 -0.6 -0.4 -0.2 0 0.2 0.4 0.6 0.8

2000-2010 Female 2000-2010 Male

POPULATION CHANGE2000 to 2010 actual

and projections for 2010 and 2030

Source: Governor's Office of Planning and Budget

AGING in PLACE at HOMEwith MINIMAL SUPPORTIVE

SERVICES

A G I N G I N P L A C EA T H O M E

S C O T T M C B E T H Director, Mountainland Aging & Family Services Department

Mountainland Area Agency on [email protected]

© Deseret News

WHO ARE WE?12 AREA AGENCIES ON AGING IN

UTAH (AAA’S)

LOCAL PROVIDERS OF SENIOR SERVICES ASSOCIATED WITH:

CountiesAssociation of Governments

UTILIZING STATE, FEDERAL, AND LOCAL MONIES TO PROVIDE

SENIOR SERVICES

SERVICES PROVIDED THROUGH AAAs Meals-on-Wheels

Senior activity centers / mealsInformation and referral

for services and resourcesTransportation

Non-medical, in-home services programs

Volunteer programsHealth insurance

information / guidanceOmbudsman services in assisted and skilled nursing home facilitiesCaregiver programs

© Enigma/Alamy

© Deseret News

WHAT DO SERVICES ACCOMPLISH?Help seniors REMAIN AT HOME as they lose

independence and face challenges of aging such as declining health, having less income, losing a spouse or not having family members nearby to assist them.

Help seniors REMAIN INDEPENDENT in the community as they face transportation systems and community infrastructures that are not adequately designed for an aging population.

Benefit tax payers by REDUCING ADDITIONAL GOVERNMENTAL SERVICES as family resources and informal social structures in the community are supported.

C A R E G I V I N G

ONE IN FOUR are CAREGIVERS in the US

365,000,000 HOURS

382,000 CAREGIVERS in UTAH

382,000 CAREGIVERS in UTAH

365,000,000 HOURS of WORK

$4.2 Billion

S E RV I C E S W O RT H

H O U R S

C A R E G I V E R S

C A R E G I V E R S

FOREGO MEDICAL

TREATMENT

HIGHER MORTALITY

RATE AMONG SENIORS

DEPRESSION

67% 63% 40 –70%

C A R E G I V I N G FA C T S

46Y/O

20HOURS / WK

More years spent caring for parents

than children in lifetime

C A R E G I V I N G FA C T S

2010 2020 2050

8.3 5.8 3.4

LOST REVENUE for BUSINESSES

$11 – 29 Billion / yr.

R E S P O N S I B I L I T I E S

RELATED TO EMPLOYEE CAREGIVING

WHAT IS THE SOLUTION?

I N V E S Tin IN-HOME CAREGIVING

support

CURRENT CAREGIVING PROGRAMS TAT E / A A A s

YEAR$1,500

O R

CURRENT CAREGIVING PROGRAMS TAT E / A A A s

A C C E S S T OInformation and

Resources for Caregivers

Support Groups

Educational Classes

Short-Term Respite. Help with:

Identifying needs and services

Personal Care Light house-cleaning Daycare for Adults

Supplemental Services

CURRENT COST / SERVICE LEVELSF Y 2 0 1 3

$1,186,905

4,700CURRENT COST / SERVICE LEVELS

F Y 2 0 1 3

CAREGIVERS ASSISTED

$252PER CAREGIVER PER YEAR

CURRENT COST / SERVICE LEVELSF Y 2 0 1 3

LOCAL SURVEY of CAREGIVER NEEDS

50%

REQUESTED

HELP WITH

ReducingStress

Education

Respite

P R O P O S E D B U D G E T I N C R E A S E

2015LEGISLATIVE SESSION

$600,000ADDED TO BASE BUDGET

Division of Aging and Adult Services

TOMORROW

M E A L S: O N-G O I N G F U N D I N G

CURRENT

$300,000 ?PROPOSED

$350,000

ON- GOING

PROPOSED

C A R E G I V E R P R O G R A M S

$250,000

ON-GOING

= 1,000more Caregivers

assisted with:

Education / Training / Info.

Support Groups

Respite Care

Volunteer Respite Programs

W E H A V E A N A G I N G P O P U L A T I O N

IT MAKES ECONOMIC SENSE

WE ARE NOT MEETING THEIR NEEDS

I F W E D O N ’ T A C T

WE WILL NOT MEET THEIR NEEDS

IT MAKES MORAL SENSE

MAKES NO SENSED O I N G L I T T L E O R N O T H I N G

© Deseret News

W E C A N D O B E T T E R

© Deseret News

S A F ES T R E E T S

A L A N O R M S B Y State Director, AARP Utah

PROMOTE AGING IN PLACETHROUGH SAFE, WALKABLE COMMUNITIES

aarp.org/ livable

OVER HALF of CAREGIVERS PROVIDE:

COMPLEX CARE

Multiple Medication Management

Wound Care Specialized Diets Operation of Medical

Equipment

ENSURING ADEQUATECAREGIVER TRAINING

Limits Hospital Readmission Reduces Caregiver Stress

P O L I C YC H O I C E

ENACT

CARE

Caregiver Advise, Record, Enable Act

Records family Caregiver NameNotifies Caregiver in the event a

loved one is hospitalizedEnsures adequate Caregiver

education upon discharge of loved one from

Hospital

EMPOWER CAREGIVERS to DO MORE

UTAH is RANKED

50th

IN SUPPORT for FAMILY CAREGIVERS

EMPOWER CAREGIVERS to DO MOREAdminister Oral Medications

Administer Medication on an as Needed BasisAdminister Medication via Pre-Filled Insulin or Insulin PenDraw Up Insulin for Dosage MeasurementAdminister Intramuscular Injection MedicationsAdminister Glucometer TestAdminister Medication through TubesInsert SuppositoryAdminister Eye/Ear DropsGastrostomy Tube FeedingAdminister EnemaPerform Intermittent CatheterizationPerform Ostomy Care Including Skin Care and Changing AppliancePerform Nebulizer TreatmentAdminister Oxygen TherapyPerform Ventilator Respiratory Care

Administer Oral MedicationsAdminister Medication on an as Needed BasisAdminister Medication via Pre-Filled Insulin or Insulin PenDraw Up Insulin for Dosage MeasurementAdminister Intramuscular Injection MedicationsAdminister Glucometer TestAdminister Medication through TubesInsert SuppositoryAdminister Eye/Ear DropsGastrostomy Tube FeedingAdminister EnemaPerform Intermittent CatheterizationPerform Ostomy Care Including Skin Care and Changing AppliancePerform Nebulizer TreatmentAdminister Oxygen TherapyPerform Ventilator Respiratory Care

Perform Ostomy Care Including Skin Care and Changing Appliance

UTAH is ONLY ALLOWED ONE

In other states, 16 medical tasks

are commonly

delegated to home health

workers

P O L I C YC H O I C E

ALLOW DELEGATION OF

16TO NURSE PRACTICE

ALL TASKS

www.longtermscorecard.org

RECEIVING HOME and COMMUNITY-BASED

SERVICES

Medicaid Waivers and Services for Older Adults

MEDICAID AGING WAIVER&

ALTERNATIVES PROGRAMCOST SAVING PROGRAMS

M I C H A E L S . S T Y L E S Assistant Director, Division of Aging and Adult Services

© PhotoAlto/Alamy

The goal of the Medicaid Aging Waiver

and Alternatives Program is to provide services for low-income,

medically frail seniors that would otherwise be placed in a nursing home or care facilities enabling

them to be cared for safely, independently, and cost

effectively in their homes.

MEDICAID AGING WAIVERand the ALTERNATIVES PROGRAM

COST SAVING PROGRAMS

The Utah Division of Aging and Adult Services is tasked with overseeing the Medicaid Aging Waiver and Alternatives Program which are

carried out at the local level by county based Area Agencies on

Aging.



On average, these individuals can be served

at home for about one fifth the cost of nursing home

placement.



Be 65 years of age or older

65 NURSING FACILITYLOC

ADLIADL

MEDICAID ELIGIBLE

MEDICAID AGING WAIVER 1915 (c)The bulk of the funding is overseen by the DEPARTMENT of HEALTH CARE FINANCING .

The Waiver is tasked with providing services statewide to help older adults who are nursing home eligible remain in their homes and live as independently as possible, provided it is cost effective to do so.

ELIGIBIL ITY REQUIREMENTS

Require nursing facility level of care approval (LOC)


ADLIADL

MEDICAID ELIGIBLE




ADLs and IADLs score


ADLIADL

MEDICAID ELIGIBLE




Meet financial eligibility requirements for Medicaid


ADLIADL

MEDICAID ELIGIBLE




2004 2005 2006 2007 2008 2009 2010 2011 2012 20133,000,000.00

3,500,000.00

4,000,000.00

4,500,000.00

MEDICAID WAIVER EXPENDITURESFY2004 Through FY 2013

CLIENT SERVICES AND ADMINISTRATIVE COST

$3,059,963

$3,362,053

$3,750,840

$3,922,632

$4,065,417 $4,065,417

$3,489,004 $3,506,592

$4,051,119

$4,289,625

500

600

700

800

900

C L I E N T S

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013$2,000

$4,000

$6,000

$8,000

$10,000C O S T P E R C L I E N T

UNDUPLICATED CLIENTS SERVED and AVERAGE COST PER CLIENT

506$9,606

150

225

178 185

350

225

135

200161

140

362

192

135

225

155 140

362

203

Salt Lake City Rest of Utah Averaged

Source: The 2012 MetLife Market Survey of Nursing Home, Assisted Living, Adult Day Services, and Home Care Costs, November 2012http://www.massmutual.com/mmfg/pdf/Nursing_Home_Costs.pdf

MASS MUTUAL INSURANCEAVERAGE $184 PER DAY, $67 ,343 PER YEAR

UNDUPLICATED

CLIENTS

AVERAGEANNUAL

COST

1 $67,343

$184 per day

NURSING HOME STAY

1 $9,315MEDICAID AGING WAIVER 1915(c)

499 $4,648,815

499 $33,604,157

UNDUPLICATED

CLIENTS

AVERAGEANNUAL

COST

1 $67,343

$184 per day

NURSING HOME STAY

1 $9,315

499 $4,648,815

499 $33,604,157

MEDICAID AGING WAIVER 1915(c)

MEDICAID AGING WAIVERCOST SAVINGS 2014

COST SAVINGS$28,955,342

Current Medicaid Aging- Waver Client

UNDUPLICATED

CLIENTS

AVERAGEANNUAL

COST

1 $67,343

$184 per day

NURSING HOME STAY

1 $9,315MEDICAID AGING WAIVER 1915(c)

499 $4,648,815

499 $33,604,157

MEDICAID AGING WAIVER 1915(c)

MEDICAID AGING WAIVERCOST SAVINGS 2014

COST SAVINGS$28,955,342

Current Medicaid Aging- Waver Client

60 DISABILITY

ADLIADL

POVERTY

SLIDINGSCALE

ALTERNATIVES PROGRAMIn 1977 the Older American Act allowed states to develop programs for Home Community Based Services /supportive Services.

The Alternatives Program is a state-funded, non-Medicaid assistance program.ELIGIBILITY REQUIREMENTS

60 years of age or older, or

60 DISABILITY

ADLIADL

POVERTY

SLIDINGSCALE

ALTERNATIVES PROGRAM

ELIGIBILITY REQUIREMENTS

It’s goal is to provide services to help older adults who are not nursing home eligible, but who are at risk for facility based care, remain in their homes and as independent as possible.

18 – 59 years of age with a disability

60 DISABILITY

ADLIADL

POVERTY

SLIDINGSCALE




Utilizes Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs)

score

60 DISABILITY

ADLIADL

POVERTY

SLIDINGSCALE




Meets financial eligibility based on the federal poverty level.

60 DISABILITY

ADLIADL

POVERTY

SLIDINGSCALE




Means tested

60 DISABILITY

ADLIADL

POVERTY

SLIDINGSCALE




CLIENTDIAGNOSES

10%

LUNG /PULMONARY

35%

42%

13%

MUSCULOSKELETAL

HEART /CIRCULATORY

DIGESTIVE

FallsER VisitsHospital Stays

OUTCOME MEASURES UTILIZEDHomemaker

Personal CareBathing HelpER Visits

QUICK FACTS

627 CURRENT CLIENTS$750 MONTHLY MAXIMUM$9,000 yearly

MOST COMMON SERVICES

FallsER VisitsHospital Stays

OUTCOME MEASURES UTILIZED

QUICK FACTS

627 CURRENT CLIENTS$750 MONTHLY MAXIMUM$9,000 yearly

HomemakerPersonal CareBathing HelpER Visits

MOST COMMON SERVICES

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 20143750000

3800000

3850000

3900000

3950000

4000000

$3,784,824

$3,909,906

$3,884,503

$3,945,226

$3,932,184

$3,950,492$3,937,409

$3,881,090

$3,975,916

$3,883,473

In-Home ALTERNATIVES EXPENDITURES FY 2004 through FY 2014

$3,855,166

UNDUPLICATED

CLIENTS

AVERAGEANNUAL

COST

1 $30,000Cost varies based on LOC

ASSISTED LIVING FACILITY

1 $5,000

645 $3,225,000

645 $19,350,000

Source: Utah Assisted Living Association

ALTERNATIVES PROGRAMCOST SAVINGS$16,125,000

UNDUPLICATED

CLIENTS

AVERAGEANNUAL

COST



1 $5,000

645 $3,225,000

645 $19,350,000


ALTERNATIVES PROGRAMCOST SAVINGS 2014

Current Alternatives Program Clients

UNDUPLICATED

CLIENTS

AVERAGEANNUAL

COST



1 $5,000

645 $3,225,000

645 $19,350,000


ALTERNATIVES PROGRAMCOST SAVINGS$16,125,000

ALTERNATIVES PROGRAMCOST SAVINGS 2014

Current Alternatives Program Clients

TOTAL COST SAVINGS

For both Medicaid Aging Waiver Program and the Alternatives Program

$45,080,300

With a current waiting list averaging around 165, an increase of ongoing funding of $250,000 for the

Medicaid Aging Waiver Program could serve

throughout the state

111AN ADDITIONAL

CLIENTS

WITH an INCREASE in the AGING POPULATION

and an INCREASE IN NURSING HOME CARE and ASSISTED LIVING CARE

IS THE INCREASE in FUNDINGWORTH the COST SAVINGS?

A D U L T P R O T E C T I V ES E R V I C E S

N A N M E N D E N H A L L State Director, Adult Protective Services

© Chariclo/Alamy

Investigate referrals of abuse, neglect, or exploitation;Conduct assessments of

vulnerability and functional capacity as it relates to the

allegation.

POWER and DUTIES of APS

Investigate referrals of abuse, neglect, or exploitation;Conduct assessments of

vulnerability and functional capacity as it relates to the

allegation.

Coordinate with and refer to community resources for

services;Provide short-term limited services when family or

community resources are not available to provide

protection.


Provide short-term limited services when family or

community resources are not available to provide

protection.

Coordinate with and refer to community resources for

services;


Adults have the right to make personal choices and decisions — APS respects the lifestyle that is

knowingly and voluntarily chosen by the vulnerable adult (VA)

2008 2009 2010 2011 2012 2013 2014

678 7441247 1306

17281416

19572248

30023258 3266

3027 3029

4196

2926

3746

4505 4572 47554445

6153Unaccepted Referrals Accepted Cases Total Reports

TOTAL APS REPORTS to INTAKEFY 2008 – 2014

2008 2009 2010 2011 2012 2013 2014

2926

37464505 4572 4755

4445

6153

3 3 3 3 3 3 3

REPORTS COMPARED to FTE INTAKE STAFFFY 2008 – 2014

T O TA L R E P O RT S

N U M B E R of F U L L T I M E

I N TA K E W O R K E R S

2008 2009 2010 2011 2012 2013 2014

847

12611367 1342

1236

1423

1979

499

740848

690600

669

1195

444

674 718666 686 697

976886

1036 1066

1229

869736 786

Exploitation Abuse Neglect Self Neglect

WHO ARE the PERPETRATORS?

vs

of THOSE EXPLOITING SENIORSARE FAMILY MEMBERS

72%

UTAH LOSES

$52 millionA YEAR TO EXPLOITATION

APS CASESFY 2008 – 2014

2008 2009 2010 2011 2012 2013 201432.5 25 26 22.5 24 23 23

2248

30023258 3266 3027

3029

4196

N U M B E R of C A S E S

I N V E S T I G AT O R S

2008 2009 2010 2011 2012 2013 2014

32.5 25 26 22.5 24 23 23

69.17

120.08125.31

145.16126.13

131.70

182.43

C A S E S perI N V E S T I G AT O R

I N V E S T I G AT O R S

CASES PER INVESTIGATORFY 2008 – 2014

A D D E D C A R E A TH O M E

M I C H A E L H A L E S Deputy Director, Utah Department of Health, Director, Medicaid and Health Financing

UTAH MEDICAID SERVICES that SUPPORT OLDER ADULTS

Medicaid services for older adults range in intensity from intermittent home-health care, to chronic care provided in home and community

based waiver programs, to skilled nursing facility services and palliative care provided through the hospice

benefit.

MEDICAID HOME AND COMMUNITY BASED WAIVER PROGRAMS THAT SERVE OLDER ADULTS FY 2013

Home and community based services (HCBS) are provided to individuals who, absent the availability of HCBS, would be eligible to receive care in a nursing

facility. The following HCBS waivers are part of the CONTINUUM of CARE for older

adults.

MEDICAID HOME AND COMMUNITY BASED WAIVER PROGRAMS THAT SERVE OLDER ADULTS FY 2013

PROGRAM NAME TOTAL#

55+%

55+AGING WAIVER (Serves People 65 or Older) 523 523 100

%

NEW CHOICES WAIVER

1,476

1,289 87%

ACQUIRED BRAIN INJURY WAIVER 109 13 12%

PHYSICAL DISABILITIES WAIVER 133 26 20%

COMMUNITY SUPPORTS WAIVER for Individuals with Intellectual Disabilities

4,540 497 11%

TOTAL NUMBER SERVED in Medicaid HCBS Aged 55 or Older 2,348

Home health, personal care and hospice services are among the array of services that assist older adults.

MEDICAID HOME HEALTH AND HOSPICE SERVICES

FY 2013

SERVICE TYPE TOTAL#

55+%

55+

HOME HEALTH

5,122

2,336 46%

HOSPICE

1,346

1,167 87%

PERSONAL CARE 770 316

TOTAL NUMBER SERVED Aged 55 or Older

3,819

MEDICAID HOME HEALTH AND HOSPICE SERVICES

FY 2013

MOVING INTO aSKILLED NURSING FACILITY

MEDICAIDNURSING FACILITY SERVICES

Nursing facility services continue to be

an important component of services available to older adults.

Nursing facility services are available to meet a variety of

needs such as a SHORT-TERM STAY when a person

requires intensive rehabilitation after an illness, injury or

surgery.



Services are also provided on a LONG-TERM basis when

the complexity of the individuals needs can not be

safely met in a home and community based program.


FY 2013

TYPICAL MONTHLY MEDICAID CENSUS

2,900 people

AVERAGE LENGTH OF MEDICAID NURSING FACIL ITY STAY

206 days

4626

83%

55+ Years

M O V I N G I N T O A S K I L L E D

N U R S I N G F A C I L I T Y

A N N E P A L M E R Executive Director, Utah Commission on Aging

THE UTAH LEGISLATUREHAS ASKED CoA TO:

Study, evaluate, and report on the impact of the aging population on government

services

Identify and recommend implementation of specific policies, procedures, and

programs to respond to the impact; and


Encourage state government to analyze, plan, and prepare for the impacts on services

and operations


Helped in passage of state law creating LIFE WITH

DIGNITY orders

OUR ROLE in ADVANCED CARE PLANNING

UT Code § 75 – 2a - 106

Utah Physician Orders for Life-Sustaining Treatment


Established POLST

Facilitator of BEST PRACTICES

training


Support COMMUNITY ENGAGEMENT in crucial

conversations around advance directives and end

of life care

POLICYSETTING

Support end of life COMFORT /

PALLIATIVE CARE

POLICYSETTING

Invest in the expansion of the ePOLST from pilot

stage to the broader healthcare and electronic medical record systems

POLICYSETTING

Mature Endorsed Developing None

WHY arewe HERE?

“There are only four kinds of people in the world,those who have been caregivers,those who are currently caregivers,those who will be caregivers,those who need caregivers.”

—Rosalyn Carter

Government & Nonprofit

Utah: Health and Human Services Legislative Hearing 2014