Suggestions for Olmstead Reform

1. Implement a mandatory review of IHSS patients who end up in SNFs to develop statistics as to how many have custodial vs. skilled nursing needs: useful data that can be used to promote Olmstead.

2. Implement nursing home transition immediately. Not all the components (e.g. what to with a younger disabled person who cannot return home when there are, as of yet, no community based settings that cater to younger people) need to be in place when certain populations (the elderly who choose to go to RCFEs) can quickly take advantage of Olmstead. 

3. Implement a cost efficient nursing home transition program that uses cost savings to offset expenses associated with Olmstead measures that require new medi-cal dollars (e.g. aging in place, ALWPP expansion, etc.)

Suggestions for Rapid, Low-Cost Nursing Home Transition (according to the method used in Texas)

1. Send medi-cal SNF residents and their families’ letters informing them of nursing home transition options.

2. Send letters to all providers encouraging them to participate with nursing home transition. 

3. Use existing state social workers/case managers to interview and determine eligibility of interested candidates.

4. Provide a list of community based care options to transition-eligible patients who choose to live in this type of setting. 

5. Provide state funding for one-time moving expense assistance.

6. Provide incentives for small providers to cater to specific populations (e.g. younger disabled people who cannot return home would most likely appreciate living in community based settings with peers of more or less of the same age).

7. Use existing state resources, e.g. Community Care Licensing, to monitor the status of patients who go to RCFEs who have only custodial care needs.