Guihan M, Munroe D, Hynes D, Edelman P, Clark K, Miskevics S; Association for Health Services Research. Meeting.

Abstr Book Assoc Health Serv Res Meet. 1999; 16: 234-5.

Midwest Center for Health Services & Policy Research, Hines V.A. Hospital, P.O. Box 5000 (151H), Hines, IL 60141, USA.

RESEARCH OBJECTIVE: Assisted living has emerged as a popular and effective model for providing supportive services to older persons. Despite the interest in assisted living among seniors, their families, providers, and policy makers, the development of these programs has lagged in Illinois especially those targeted at low to moderate income elderly. in Illinois, a facility that provides "through its ownership or management, personal care, sheltered care, or nursing for three or more persons" is required to adhere to the more restrictive regulations governing nursing homes. In 1994, a statewide summit was held to address the absence of policy on assisted living in Illinois. One outcome of the summit was a definition of assisted living: "Assisted living combines housing, personal, and health-related services in response to the individual needs of those who need help in activities of daily living and instrumental activities of daily living. Supportive services are available 24 hours per day to meet scheduled and unscheduled needs in a way that promotes resident self-direction and participation in decisions that emphasize independence, individuality, privacy and dignity in a residential surrounding." Another outcome was a consensus on the need to develop and evaluate a wide range of residential models for the delivery of supportive care. To address this need, Illinois Public Act 98-571 mandates that the Illinois Department on Aging (IDOA) develop and implement such models. In collaboration with the Center of Eldercare Choices and the Midwest Center for Health Services & Policy Research, IDOA has established and is evaluating six demonstration projects of assisted living for low to moderate income seniors. The demonstration will compare the efficacy of two different models of service delivery. Services are being provided to residents through the Illinois Community Care Program (CCP), the Medicaid 2176 waiver program for community based long term care services to nursing home eligible elderly living in the community. This demonstration project and evaluation are unique and important given the paucity of long term care options for low to moderate income Illinoisans. STUDY DESIGN: Three demonstration sites are utilizing a staff model, in which services are provided by personal care workers employed by the housing facility, Three additional demonstration sites serve as comparison sites and offer services through a preferred provider arrangement with a community based care agency. Both models will be compared to the customary CCP. Outcome measures for the demonstration include organizational effectiveness, quality of care, resident and family caregiver satisfaction, and cost and other economic impacts. Exploratory regression analysis will be conducted to explain resident service utilization. Possible explanatory variables include facility characteristics (e.g., model type, contracting options, size, previous service delivery experience) as well as resident characteristics. Data collection is underway for all outcome variables. PRINCIPAL FINDINGS: Over 250 residents are receiving assisted living services through the demonstration program. Satisfaction questionnaires that will be administered to residents and their families are in the field. Focus groups were conducted with assisted living residents and their families to identify issues affecting resident satisfaction and quality of life. These issues include security, transportation, food service, availablity of emergency care, opportunities for socialization, and residents' privacy and autonomy in their own apartments. A draft questionnaire based on the findings of the focus groups was developed in collaboration with experienced assisted living managers. The questionnaire is subsequently being pilot tested on approximately 1000 subjects (500 assisted living residents and 500 family members). The pilot test is being conducted at several Illinois residential facilities that offer assisted living services and are not affiliated with the demonstration sites. In addition to discussion of the resident satisfaction survey, key organizational characteristics including case mix, staffing, start-up and recurring costs, and patterns of service utilization will be described and discussed. CONCLUSIONS: Illinois is representative of a sizeable number of states that are trying to find a balance between care and concern for the elderly, respect for consumer preferences, and the drive to avoid over regulation so characteristic of the nursing home industry. (ABSTRACT TRUNCATED)

Publication Types:

• Meeting Abstracts

Keywords:

• Aged
• Consumer Satisfaction
• Diagnosis-Related Groups
• Health Services Needs and Demand
• Housing
• Humans
• Illinois
• Long-Term Care
• Medicaid
• Nursing Homes
• Personal Satisfaction
• Questionnaires
• economics
• hsrmtgs

Other ID:

• HTX/20603002

UI: 102194691

From Meeting Abstracts