This proposal would also rebalance Colorado’s long term care system, putting an increased emphasis on home-based and assisted living care, which both meets the preferences and dignity of elderly residents (80 percent of the Colorado AARP members surveyed in 2005 said it is extremely or very important to have long term care services that enable them to stay at home as long as possible) and reduces our dependence on nursing home facilities, which result in higher cost care.

The premise is that all individuals (Medicaid funded, state funded, and private pay) will have the freedom to choose between long term care models, but all models must have strong and integrated care management design to provide services in the least restrictive setting and most cost effective manner.  This is consistent with and builds upon the findings of the Long-Term Care Advisory Committee’s July 2006 final report to the Colorado Department of Health Care Policy and Financing, which called for a system that could serve as many Coloradans needing long term care services as possible in a high quality setting and cost effective manner, encourage services in the least restrictive and clinically appropriate environment and deliver services in a person-centered and consumer directed manner.

Development of Special Needs Plans and Other Integrated Models.  Special Needs Plans (SNPs) could be used by Colorado to integrate Medicare and Medicaid primary care, acute care, prescription drug, behavioral health and long term care services for dual eligibles (Medicaid and Medicare).  The state should also develop other integrated models that ensure access to well-coordinated and high quality long term care.   GOAL: Meet the important 3 H’s of long term care - keeping the individual healthy, happy and at home. 

Consumer Directed Care.  Current enrollees, but especially baby boomers want more control of their health and support program. A CMS-sponsored study found that consumer directed care is less costly than other forms of home care, may postpone nursing facility placements, and results in higher consumer satisfaction rates.  For example, many consumers prefer assisted living care over institutional care, and such care tends to be less costly.