Long-Term Care Consultation (LTCC) Services include a variety of services designed to help people make decisions about long-term care needs. This service helps people stay in their homes and receive long-term care services. Long-term care consultants help people and their families choose services and supports that reflect their needs and preferences. Legislation enacted in 2001 reformed this service to incorporate the federally mandated Pre-Admission Screening (PAS) program and additional services intended to provide more direct assistance to consumers and families at the point when they begin looking for long-term care services and housing options.
LTCC services are provided by county agency staff and require the expertise of both social workers and public health nurses. Tribes and health plans also provide some LTCC services to people they serve under contracts with the Department of Human Services.
• Long-Term Care Consultation activities include early intervention visits, information and education about local long-term care service options, pre-admission screening prior to nursing home admission, information about public and private programs that can provide services, transition assistance to relocate people currently in nursing facilities, and assessment and support planning for people considering community-based services.
• Community or “face-to-face” screenings are required in some situations, such as determining eligibility for waiver services. Activities are conducted in hospitals, nursing facilities, other supported living situations such as housing with services settings, and in peoples’ homes.
• LTCC services are also intended to reduce nursing facility admissions and subsequent costs by ensuring only appropriate admission to these facilities. In Minnesota, state law requires that all applicants to Medicaid-certified nursing or boarding care facilities, or a hospital swing bed, be screened prior to admission. The Pre-Admission Screening program assesses an individual’s health status and level of independence in key areas of daily living to determine if he or she needs this level of service, and follow-up visits are required for people under age 65 admitted to nursing facilities.
• This assessment also provides “screening” for people for possible mental illness or developmental disabilities in order to prevent inappropriate admissions to nursing facilities of people who need different services. These assessments must be completed for all applicants to facilities, regardless of assets, income or the potential source of payment.
• Counties, tribes and health plans, also are required to use the assessment and support planning process to determine the appropriateness of Medicaid or state-funded alternatives to nursing facilities (NFs) for people who need NF level of care. These alternatives include the Medicaid-funded home and community-based waivers to serve elderly people (Elderly Waiver), people with traumatic brain injury (TBI), people under age 65 with disabilities (Community Alternatives for People with Disabilities), people with hospital-level of care needs (Community Alternative Care) and the state-funded Alternative Care program. These community alternatives can cost no more than institutional services, and typically cost much less.
• During fiscal year (FY) 2010, LTCC staff completed over 57,000 screenings and/or assessments. Telephone screening, primarily reflecting admissions to NFs from hospitals for rehabilitative or sub-acute care comprised 46 percent of the LTCC activity reported. Seventy-two percent of people served were over age 65.
• The total allocation for LTCC for FY 2010 was approximately $6.7 million, with about one-third of the cost borne each by the federal government, state government and privately paying individuals. An additional $4.9 million was paid to counties for face-to-face visits with people under age 65.
For more detailed information about Long-Term Care Consultation Services, including activities required for all nursing facility admissions, consult Minnesota Statutes 256B.0911 or your local social service or public health office.
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