151-E:1 Purpose. –
I. The purpose of this chapter is to provide medicaid eligible elderly and chronically ill adults with a continuum of care appropriate to their needs and affordable to the state and its taxpayers.
II. To a great extent, the current system relies on nursing facilities to provide care for this group. While the quality of this care is high, an increasingly elderly and disabled population and a constrained public financial resource base require the state to reevaluate how long-term care services are provided. Moreover, many long-term care recipients and potential recipients prefer to be cared for at home or in other settings less acute than a nursing facility. Because far more may be spent on nursing facility care than on home and community-based care, there is an inherent difference between the state's present long-term care system and what recipients prefer.
III. This chapter is an essential step toward rebalancing the long-term care system and expanding choices available to recipients. It increases the continuum of care by adding mid-level care, including but not limited to, assisted living and residential care services. Through an acuity-based reimbursement system , a comprehensive needs assessment process, and an information and assistance process, it provides those eligible for Medicaid nursing facility services the opportunity to choose more appropriate, less costly mid-level services and home and community-based care. In this way, the state intends to serve this increasing Medicaid eligible population more appropriately and more economically.