Faith Laird, Director of the Division of Aging, met with members of the Hoosiers for Options (HFO) coalition on Friday, July 27th and presented an initial proposal for significant modifications of the preadmission screening program. LeadingAge Indiana chairs HFO which is comprised of provider and consumer organizations involved in aging and long term care issues.
Ms. Laird started by noting that the current system does not lead to a lot of diversions from nursing homes which was the original intent of preadmission screening. When the program began in the 1980s, most admissions to nursing homes were from the community but now the vast majority of admissions are from the hospital for a rehabilitation stay. Less than .5% admissions are currently denied.
Currently, hospital discharge planners can authorize a 25 day stay in the nursing home. The Area Agency on Aging then has up to 120 days to do a complete screen and options counseling unless the individual applies for Medicaid when they are seen sooner. The Level 2 screenings for serious mental illness or developmental disabilities is a federal requirement and would not change.
The proposal would be to extend the hospital discharge planners approval authority to up to 60 days. The Area Agency on Aging would then see the person between 21 and 60 days for option counseling. The 21 day time frame is meant to coincide with the first required care plan meeting. The idea is to target individuals for options counseling during their Medicare SNF stay and prior to permanent placement in the nursing home.
The proposal is still very much in draft form and legislative changes would be required. The Division is seeking input on this proposal.