Building on the Promise of Home and Community-Based Services

In just 12 short years from now, in the year 2020, almost one in six Americans will be age 65 or older and the size of the age 85 or older population will have doubled. That is why the National Association of Area Agencies on Aging (n4a) and the National Association of State Units on Aging (NASUA) have joined forces on the Project 2020 initiative, which is a coordinated national long-term care campaign to enable the Aging Services Network to strengthen and build upon the non-Medicaid community-based care system embodied in the Older Americans Act — while reducing federal Medicaid and Medicare costs.

Project 2020’s Goal:

Provide the resources to implement consumer-centered and cost-effective long-term care strategies authorized in the 2006 reauthorization of the Older Americans Act. Empower the Aging Services Network to implement these strategies through a three-pronged program encompassing person-centered access to information, evidence-based disease prevention and health promotion activities, and enhanced nursing home diversion services.

The key elements of this approach include:

1. Person-Centered Access to Information
2.Evidence-Based Disease Prevention and Health Promotion
3.Enhanced Nursing Home Diversion Services

ProgramComponents

Person-centered access to information—
Due to the fragmentation in public programs and information asymmetry, too many individuals currently lack access to quality information on community-based long-term care services. This long-standing condition is a significant factor in over-utilization of institutional care. Through the use of a single entry point system, such as the Aging and Disability Resource Centers (ADRCs) developed by the AoA and CMS, the Aging Services Network will provide individuals and their families with streamlined, comprehensive and reliable information that will help consumers make informed decisions about their long-term care. ADRCs integrate outreach, information, and options counseling for home and community-based long-term care in the community. Forty three states currently receive AoA grant funding to initiate ADRCs in their states. This component builds on the current nationwide network of SUAs and AAAs, as well as complementary programs such as AoA’s Eldercare Locator.

Evidence-based disease prevention and health promotion—

Health and behavioral science has developed significant interventions for evidence-based disease prevention and health promotion that have been demonstrated to improve the health and well-being of elderly individuals, and do not require application through expensive medical and health care settings. Through this program component, individuals will be assisted with interventions provided by the Aging Services Network at the community level in areas such as falls prevention, physical activities, nutrition, chronic disease management and medication management.

Enhanced nursing home diversion services—

At any given time, a small, but critical, population of elderly individuals is at high risk of losing their independence and financial stability through nursing-home entry and spend down to Medicaid eligibility — individuals who would prefer to remain in the community if possible. Eligible individuals participating in this program component will be prescreened and receive intense case management through the single point of entry system to help coordinate personalized services and supports that will allow them to remain in their homes. This needs-based portion of the program will provide home and community- based services such as home-delivered meals, homemaker services, personal care, medical transportation, home modification, assistive technology and adult day care. These traditional services provided by the Aging Services Network, when coupled with case management and the flexibility of consumer-directed models of care, provide an excellent
alternative to nursing home care.

For more about Project 2020
http://www.n4a.org/advocacy/campaigns/?fa=project-2020