The Generation Project

Strategic Statement on the Long Term Care Services and Fiscal Crisis in Indiana

by John Cardwell
Indiana Home Care Task Force

The Indiana Legislative Summit on Real Long Term Care Solutions is occurring at a critical juncture for lawmakers, taxpayers, and persons who need long term care services. Today, Indiana's deep seated manufacturing and agriculture recession continues to grow the state budget deficit. The impact of the latter is dramatically straining the capacity of the state to properly fund essential health and human services.

A closer examination of the state's emerging human services delivery crisis indicates Indiana is grossly inefficient in using public dollars to supplement and to provide long term care services for its citizens who are in need. Unlike most states, Indiana has been slow to take advantage of the care and cost efficiencies found in publicly supported home and community based long term care. For example, the state's nationally recognized CHOICE program remains underfunded and Medicaid waivers for home care services remain under utilized. Or, as The Generations Project noted in May, 2002, Indiana continues to use "an outdated state funding formula," that over invests public dollars in nursing homes and like institutions while under investing in home and community based care. As a result, "Indiana's imbalanced long term care investments force many Hoosiers to live in nursing homes when they could receive the care they need in their own homes," notes the project.

Fortunately, workable and affordable solutions are at that have been employed for years in states throughout the nation. These solutions will be addressed at the Legislative Summit by three of America's foremost experts on state long term care policy: John Luehrs from AARP in Washington, D.C., Dr. Susan Reinhard of Rutgers University, and Dick Ladd, who has directed state Medicaid programs in Oregon and Texas.

As Luehrs, Reinhard and Ladd will discuss at the Summit, Indiana can address and solve the critical long term care problems facing the state and its citizens. Indiana can put in place a comprehensive system of home and community based care. Indiana can provide the long term care that is most appropriate and when that care is needed without having to place people on waiting lists. Indiana can improve the quality of life for its citizens, and strengthen its economy, by implementing comprehensive consumer driven long term care reform. Very importantly, during these stressful economic times, Indiana can do these things and save taxpayers and the state of Indiana money.

The question is, when will the state act, and when it does what will that action be? The O'Bannon administration is taking small but important steps to shift more resources into home and community based care. But small steps are not enough when over 27,000 Hoosiers are on waiting lists for home and community based care. That sets the stage for the General Assembly to take dramatic action. That is why the Legislative Summit will feature a panel presentation regarding legislation that will be introduced into the 2003 General Assembly by Senator Greg Server. The Server legislation, the consensus product of the Indiana Home Care Task Force, would put into statute the actions that Indiana can take now to end the waiting lists, to provide the comprehensive array of services that citizens need, and to bring fiscal balance and cost efficiency to Indiana's long term care system. If the Server legislation is passed by the General Assembly, the crisis in long term care costs and services can finally be resolved in this state.