Visiting Nurse Service of New York Identifies Strategies for Improving Long-Term Care

The Center for Home Care Policy & Research of the Visiting Nurse Service of New York conducted a project designed to:

  • Improve the accessibility of policy-relevant research and technical information to state and local decision-makers whose actions affect the availability of long-term-care services and the ways in which these services are organized and delivered.
  • Improve dialogue and strengthen links between long-term-care researchers and policy-makers.
  • Make research more policy relevant.

The methods used to achieve these objectives included identifying key issues in long-term care, commissioning papers on these topics, convening topic-focused meetings with the participation of researchers and decision-makers and producing special reports and policy briefs synthesizing the findings of these activities.

Key Results

  • Staff at the Center for Home Care Policy & Research:

    • With the input of an advisory committee and Robert Wood Johnson Foundation (RWJF) staff, selected two substantive long-term-care issues ("leveraging resources for home- and community-based services in a time of fiscal retrenchment" and "linking housing and long-term-care services for older adults") that could benefit from discussion informed by state-of-the-art knowledge and analysis.
    • Convened researchers, technical experts, decision-makers and opinion leaders with diverse perspectives, experience and skills to examine these issues and the evidence available for addressing them at two meetings in 2003 and 2004.
    • Commissioned papers to be used as background for these meetings and as the basis for stand-alone publications.
    • Produced and disseminated two summary reports on the selected topics and issued a series of policy briefs synthesizing the findings of project activities.
      • Linking Housing and Long-Term Services for Older Adults.
      • Leveraging Resources for Home- and Community-Based Services in a Time of Fiscal Retrenchment. (Available online.)

Key Findings

  • Despite fiscal crises and budget cuts, some states continued to develop and expand home- and community-based service options in response to popular demand and the desire to reduce long-term-care costs.

  • Access to affordable, elder-friendly housing is a key predictor of whether older adults can remain in their own homes as they grow older.

  • "Service-enriched housing" provides alternatives to costly institutionalization, enables local service providers to deliver services more efficiently and benefits residents, who can retain their independence longer in settings of their choice.

  • From 2000 to 2002, the number of Medicaid beneficiaries receiving long-term-care services in group residential settings outside of nursing homes increased by 75 percent. States generally do not regulate the nomenclature used by residential care settings-for example, a term such as assisted living often is used indiscriminately to describe a range of housing and service types.