2008 House Bill 108 (Create long-term care facility education and improvement fund)

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Introduced by Rep. Carl Rollins on January 8, 2008, to increase civil penalties at long-term care facilities and create long-term care facility education and improvement fund as the recipient of civil penalties collected.
- Referred to the House Health and Welfare Committee on January 11, 2008.

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Introduced by Rep. Carl Rollins on January 8, 2008. New Comment

1) dash [by Anonymous Citizen on December 8, 2007]
By their sheer numbers, Baby Boomers have consistently managed to transform the nature of American life since their arrival.

In the 1950's, they reshaped our educational system, and in the 1960s and '70's, they changed the housing market and virtually remodeled cities throughout the nation.

As the first boomers turn 60 this year, they'll soon redefine how society views growing older. As Kentucky's elder population doubles to more than 1 million by 2025, are we ready to meet their needs?

Long-term care for older adults used to mean the neighborhood nursing home.

Today, it means independent living in retirement communities, senior and adult day care centers, assisted living facilities, personal care, home care and more. It's a system that would ideally offer choice and seamless services as needs change. Unfortunately, that's where reality intervenes.

As boomers are beginning to discover, the "system" in place is akin to a tattered patchwork quilt that desperately needs creative new features.

There are steps you can support now.

The numbers are daunting and time is short, but through sound public policy, for which you can push, Kentucky can begin to mend its long-term care system and create a legacy of responsible compassion for older Kentuckians, especially for those in frail health and financial need. We don't have to risk getting caught in the "paralysis of analysis" trying to re-design the whole long-term care system at once.

Our state can begin with four public policy changes that are relatively easy to implement, and would deliver instant, meaningful and sustainable improvements by applying a little common sense.

None of the steps listed is "bold" -- that is the point. They are very doable.

Kentucky's Cabinet for Health and Family Services should modify Certificate of Need requirements for home health care, so that continuing care retirement communities can provide in-home services to those who already live on their campuses. These residents literally live footsteps apart…why is it that the regulations that govern their care are so different? As it stands today, Kentucky artificially limits access to these home health services in favor of a system that pays unnecessarily for a provider's travel between client locations -- even when they live under the same roof.

Ask your legislator to help cut the bureaucratic red tape between assisted living and licensed personal care. The distinctions between the two are minuscule, but the latter is much more heavily regulated and is permitted to accept state optional supplement payments for the care of frail, low-income elders.. Not only does this confuse the public, boomers included, it also means that licensed personal care homes bear a disproportionate share of the burden of caring for the poor. It's time to creatively combine these two levels of care.

Kentucky also needs to seek a federal waiver to include this combined level of care in the state's Medicaid long-term care program. These federal matching Medicaid funds (currently three new federal dollars for every dollar Kentucky commits) would make a recognizable difference in the quality of life and health for older adults in Kentucky and slow the growth of more intensive and costly long-term care services.

Encourage adult day care in long-term care facilities. Think about it: in all 120 Kentucky counties, there are long-term care facilities offering recreational programs, therapies, medication administration, medical treatment, and nutritious meals that can accommodate physician-ordered special diets.

For older adults in need of day care and their caregivers who need a respite, it sounds like an ideal model. But for a long-term care facility to open its doors to a limited number of adult day care consumers, current regulations require a designated area and a separate staff. That's just counterproductive and hinders access needlessly.

Push to train the Caregivers of Tomorrow, today!

The time has come to actually use civil monetary penalties collected from long-term facilities by the Office of Inspector General for their intended use -- caregiver training.

Since monetary penalties began more than 10 years ago, an estimated $2 million has been collected by the OIG. Legislation called for the money to be used for nursing scholarships, yet guidelines for awarding the scholarships to prospective long-term care nursing professionals have never been developed and published. It's a mystery how an interested school, provider or student could apply for such a scholarship, so the money remains unused and unavailable for its originally intended purpose.

It's time to ensure that regulations serve originally intended purposes and move this state toward a long-term care system that is truly effective and sustainable. It's time to exercise some common sense. Boomers will demand no less.

KEITH R. KNAPP
Christian Care Communities
Louisville 40243

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