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The Next Revolution: The Role of Informatics in Improving Health Care

State of Maine Long-term Care Reform

Slide Presentation by Mollie Baldwin (Text Version)

On July 26, 2001, Mollie Baldwin made a presentation during the Web-assisted teleconference, The Next Revolution: The Role of Informatics in Improving Health Care entitled "State of Maine Long-term Care Reform."

This is the text version of Ms. Baldwin's slide presentation. Select to access the PowerPoint® slides (155 KB).

Slide 1

State of Maine Long-term Care Reform

Presented by Mollie Baldwin
Bureau of Elder and Adult Services
July 26, 2001

Slide 2


  • Budgetary crisis forces Legislature and policymakers to examine State's long-term care (LTC) system:
    • Department must commit savings toward State budget.
  • Medical & financial eligibility took up to 90 days.
  • Consumers and Advocates Want:
    • Long-term care choices/options.
    • Help in navigating complex eligibility system .
    • Fewer barriers in eligibility process and accessing services.

Slide 3

Long-term Care Reform

Governor's initiative:

  • Improve access to information about long-term care options:
    • Free assessment available to give consumers LTC advice.
  • Improve home and community based care.
  • Better allocate resources across care settings.
  • Improve consumers' understanding of their options.
  • Reduce reliance on costly institutional care.

Slide 4

Blueprint for Reform

  • Universal pre-admission screening regardless of funding source:
    • Legislatively mandated pre-admission screening for nursing home placement.
    • Screening must include recommended community based care plan.
  • Single entry point for eligibility determination:
    • Ease of access for consumer.
    • Forces collaboration between agencies & providers.

Slide 5

Systems Challenge

  • To quickly determine medical and financial eligibility for long-term care services.
  • To communicate between different parts of system and link information to work efficiently and effectively for the consumer:
    • State bureaus.
    • Agencies, providers.
    • Consumers, families.

Slide 6

Development of Technology Solution

Develop user-friendly, expandable and portable system with the following features:

  • Calculate eligibility based on medical & financial information provided to assessor.
  • Portable—may be moved to a different agent who serves as single entry point.
  • Track referrals, assessments.
  • Interfaces with medical & financial legacy information systems via daily feeds.
  • Daily feeds with statewide home care coordination agency.
  • Assessors use untethered laptops.

Slide 7

Financial Information Tab

This slide shows what the computer screen looks like where financial and eligibility information is kept.

Slide 8

Data Benefits

  • Linked data across care settings improves policy decisions and resource allocations:
    • Data shows system serving people in different settings with same characteristics.
  • Data allows development of acuity based reimbursement systems as mandated by the Legislature.
  • Development of quality indicators for home care programs now underway.

Slide 9

State Benefits

  • Maine's LTC system has changed and grown rapidly between 1995 and 2000:
    • Total persons served has increased from 19,803 to 26,767.
    • 52% of consumers received home care in FY 2000 compared to 32% in 1995.
  • Significant new funding appropriated for home care & residential alternatives:
    • Spending for home and community care,
    • up from 16% to 35%.
  • Responsiveness, accountability for providers delivering services to consumer.

Slide 10

Long-term Care State and Medicaid Spending

This slide shows two pie charts displaying total State expenditures for long-term care in 1995 and 2000.

In 1995:

  • Total Expenditures = $248,715,157.
  • 6% ($16,711,742) for Residential Care.
  • 10% ($28, 434,251) for Home Care.
  • 84% ($239,569,164) for Nursing Facilities.

In 2000:

  • Total Expenditures = $309,655,678.
  • 14% ($43,198,380) for Residential Care.
  • 21% ($65,921,949) for Home Care.
  • 65% ($200,535,349) for Nursing Facilities.

Slide 11

Consumer Benefits

  • Consumers find single entry point simplifies application process.
  • Consumers receive eligibility decision on the spot & home and community-based options at time of assessment.
  • Improved consumer interaction with nurse assessors freed up from paper burden.
  • Assessment outcome data transmitted electronically to improve access and expedite services care getting started.
  • Financial resources have been diverted to home care programs.

Current as of August 2001

Internet Citation:

Baldwin, M. State of Maine Long-term Care Reform. Slide Presentation (Text Version) presented at The Next Revolution: The Role of Informatics in Improving Health Care, Web-Assisted teleconference, July 26, 2001. Agency for Healthcare Research and Quality, Rockville, MD.

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