Success from the session: Testing long-term care options

Last Friday, Gov. John Hickenlooper signed into law Senate Bill 12-128, which will create a pilot program to help determine whether assisted-living facilities represent a cost-effective alternative for providing long-term care, as well as a better choice for residents and their families who are weighing their options.

Colorado faces an impending crisis over long-term care for the simple reason that the state's population is growing older. Unless the state legislature explores new and less costly ways of financing long-term care support services, the impact on future state budgets will be increasingly unmanageable.

General Fund spending for the state agency that manages Medicaid is expected to triple by 2024-25, from nearly $1.8 billion to about $5.5 billion, according to Financing Colorado's Future, a study by the University of Denver. A major contributor to that budget expansion will be the increased number of Medicaid enrollees who will require skilled-nursing facilities or home and community care.

Currently, individuals often are admitted to more costly nursing-home facilities when less-demanding and less-costly care would be sufficient. Alternative-care facilities are less likely to admit these individuals because of comparatively lower reimbursement rates.

This new law creates a pilot program that allows the state's Medicaid agency, the Department of Health Care Policy and Financing, to create an enhanced reimbursement program for alternative-care facilities that admit individuals who choose to leave their skilled-nursing facility. These individuals would also have to qualify for assisted-living care in order to ensure that they will get the appropriate level of care that they require. The agency would also create a program to identify Medicaid clients who are headed for nursing homes and redirect them to alternative-care facilities and services.

As we said in our testimony on this legislation, the results of this pilot program will help the state to determine whether Medicaid clients can be cared for more cheaply while at the same time being enrolled in a facility that best meets their needs and provides them the best quality of life possible.

We are very pleased that SB 12-128 has become law and believe that it represents an important step in pursuing new options for taking care of individuals that require long-term care. We thank the bill's sponsors, Sen. Ellen Roberts and Rep. Ken Summers, for sponsoring this legislation and the governor for signing it.