October 8, 2015

The State of Connecticut’s Department of Social Services, with its state evaluator UConn’s Center on Aging, successfully transitioned more than 2,200 older and disabled Connecticut residents from nursing homes and other institutions to their own home or a community setting between 2008 and 2014, as part of the federal “Money Follows the Person Rebalancing Demonstration.”

The goal of this national effort is to reduce Medicaid’s growing expenditures by rebalancing long-term care services from expensive institutional healthcare settings such as nursing homes to lower-cost community settings.

The Connecticut program’s results, published in the October issue of the journal Health Affairs, also show a significant boost in residents’ overall quality of life and life satisfaction after transitioning home to the community.

The Money Follows the Person program works by identifying people in high-cost institutional settings such as nursing homes, rehabilitation hospitals, and group homes of five or more, who wish to voluntarily transition back to a community setting such as their own private home or apartment, an assisted living facility, a group home with four or fewer people, or living with a family member. Each participant receives a personalized Medicaid benefit and healthcare services community care plan that meets their needs while also costing less than an institutional setting.

“Connecticut is becoming a true leader in long-term care services enhancements for those who need them,” says Dawn Lambert, Project Director of Medicaid Rebalancing Initiatives in Connecticut’s Department of Social Services and a co-author of the Health Affairs article. “We thank Governor Malloy and the State Legislature for helping us make such huge strides in empowering thousands of Connecticut’s older adults and citizens with disabilities to live more independently in their communities with the Medicaid support they need following them home. This program is also helping to improve the infrastructure of our State’s community services.”

In 2015, Connecticut’s Money Follows the Person program recently reached the milestone of 3,000 successful transitions. It is set to continue, with increased federal funding, to transition and track residents returning to their communities through 2018; and will continue after that as a state-funded program.

“The program’s outcomes tell a consistent story of improved quality of life,” says co-author Noreen Shugrue, research associate at UConn’s Center on Aging. “Thousands of people have returned to community living and the vast majority have thrived with the bonus of higher quality of life and satisfaction.”

Connecticut statistics show the rate of institutional care versus home care in a community setting in 2008 was 48 percent to 52 percent. However, thanks in part to the Money Follows the Person program by 2014, these rates were rebalanced to 41 percent of persons in an institution to 59 percent in a community setting. In addition, the rebalancing program has helped the percentage of institutional long-term Medicaid expenditures in the state of Connecticut to drop from 67 percent in 2008 to 55 percent in 2014.

Blogger Comment:

I commend the State of Connecticut for its spending emphasis recognizing that paying for quality of life not blindly dictating some meaningless Quality of Care standards invoked by the Enforcement System practiced across America for 40 years has failed miseably.

The motto of the Enterprise Model of my company All-American Care was “get them in, get them well, get them out” to their homes or community based programs.  While Shari, Kip and I owned our three facilities we discharged 57% of our admissions back to the community.  The problem we had was the survey process administered by State of Iowa Department of Inspections and Appeals which doesn’t give stars for results just blind compliance with meaningless rules.  In the 37 years I have been involved in nursing homes I have never, I repeat never seen the surveyors improve anything but the amount of allegations and fines … sad but true that the public is buffaloed on how little the regulators do for reinforcement versus harmful, fearful, subjective, arbitrary and capricious enforcement on selected providers that in my opinion is the problem

.  Jerry Rhoads