Human Services

Alternative Care

Statewide Outcome(s):

Alternative Care supports the following statewide outcome(s).

Strong and stable families and communities.

Minnesotans are healthy.

Context:

Between now and 2030, Minnesota will experience the most profound age shift in its history. Along with the rest of the nation and the world, we will become older not just as individuals but as a society. The baby boomers—1.5 million strong in Minnesota—are leading us into this uncharted territory as they begin to age. By 2030, we will have 1.3 million persons over 65, or one out of every four Minnesotans. Later, in 2050, we will have the largest number ever of people over 85. Over two-thirds of persons age 85 and older have at least one disability. Older persons are more likely to have multiple disabilities, and each of these chronic conditions poses a challenge to the individual’s ability to live independently. Therefore, Minnesotans’ need for community-based long-term care services, which are usually not covered by Medicare, will continue to increase. Alternative Care services support seniors, their families, caregivers and communities to enable seniors to stay in their homes and communities and avoid costly institutionalization.

The Alternative Care (AC) Program is a state-funded, cost-sharing program that supports certain home- and community-based services for eligible Minnesotans age 65 and over. The program provides services to prevent and delay transitions to Medical Assistance-funded services, such as Elderly Waiver and nursing home care. The program helps prevent the impoverishment of eligible seniors and shares the cost of care with individuals on the program by maximizing use of their own resources. It is available to individuals who need the level of care provided in a nursing home but choose to receive services in the community, and whose income and assets would be inadequate to fund a nursing home stay for more than 135 days.

The AC program served a monthly average of 3,086 older Minnesotans in FY 2011, at an average monthly cost of $769. The program is funded with state funds along with monthly program participation fees paid by the client. Payments made by the state for AC services are subject to estate recovery.

Strategies:

Alternative Care services are delivered in a person’s own home. AC covers the following services: adult day services, caregiver assessment, case management, chore services, companion services, consumer-directed community supports, home health aides, home-delivered meals, homemaker services, environmental accessibility adaptations, nutrition services, personal emergency response system, personal care, respite care, skilled nursing, specialized equipment and supplies, training and support for family caregivers and transportation.

DHS partners with community providers, counties, tribal health entities and the Department of Health in administering and monitoring AC services.

More information is available on the Alternative Care fact sheet:

 https://edocs.dhs.state.mn.us/lfserver/Public/DHS-4720-ENG.

Results:

Improvement in the percentage of seniors supported in their own homes rather than institutions contributes to the Statewide Outcome of strong and stable families and communities. We monitor performance measures that help us see how our strategies in this program are working. Measures we track include the percentage of elderly receiving publicly funded long-term care services who receive home and community-based long-term care services through the Elderly Waiver, Alternative Care, or home care programs instead of nursing home services; and the percentage of public long-term care funding for seniors that is spent on Elderly Waiver, Alternative Care or home care services instead of nursing home services. We also measure the proportion of AC spending that is used for Consumer-Directed Community Supports, which is a newer approach that gives participants more flexibility and responsibility for directing their own services and supports - compared to services provided through the traditional program – including hiring and managing direct care staff.

Performance Measures Notes:

1.     Compares FY 2007 (Previous) to FY2011 (Current) data. Source: DHS Data Warehouse

2.     Compares 2007 (Previous) to 2011 (Current) data. Source: DHS Data Warehouse

3.     Compares FY 2007 (Previous) to FY2011 (Current) data. This is a 197 percent increase over five years. Source: DHS Data Warehouse.

More information is available on the Continuing Care Performance Reports webpage at

http://www.dhs.state.mn.us/main/dhs16_166609# and the DHS Dashboard: http://dashboard.dhs.state.mn.us.