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Project 2020 Home and Community Based Services Long-Term Care Plan

by EG

The National Association of State Units on Aging (NASUA) and the National Association of Area Agencies on Aging (N4A) have proposed a national long-term care service strategy that intends to save Medicaid and Medicare dollars while allowing elders to age in their homes longer through home and community based services. Project 2020 is quickly gaining the attention of aging professionals and elected officials in Washington. The demographic trends within the United States means more older adults using more services at higher cost, and Project 2020 is hoping to address those costs through nursing home diversion programs, programs that assist elders remain healthy and receive care in their homes. Project 2020, if successfully enacted, would not only save federal and state tax dollars, but ensure that people are able to age where they want, in their home and community.

The Project 2020 Overview of the Proposal states they are seeking $2.5 billion over 5 years to be administered through the Aging Services Network of State Units on Aging and Area Agencies on Aging. Thus, the funds would go to their own member organizations, which would cause any logical person to pause and question the proposal’s true intent. Is it to fund their own organizations or is it to save tax dollars and help elders age in place? Well, it’s both. They think their organizations can play an important role in lowering the costs of long-term care.

The Overview of the Proposal states:

According to our initial estimates, the program has the potential to reach over 40 million Americans and will reduce federal Medicaid and Medicare costs by approximately $2.8 billion over the first five years of the initial investment requested, resulting in a net savings to the federal government of nearly $250 million.

The program would also generate significant savings for state governments. Financial performance is expected to improve in years five through ten of the program, as all systems reach full scale operations nationally, with the net federal savings over ten years reaching over $1.1 billion.

What exactly is the 2020 strategy? It’s built upon a three-pronged approach:

  1. Person-Centered Access to Information – The proposal calls for increased use of a “single entry point system.” This is technical jargon that means there would be one source for aging information, Aging and Disability Resource Centers (ADRCs), which people would go to. The advantage being that the persons working in those ADRCs would know about all aging services, thus better able to deliver information specific to the individual, and not specific to one service.
  2. Evidence-Based Disease Prevention and Health Promotion – This approach calls for increased outreach to assist elders with preventable conditions that would otherwise lead to increased use of long-term care services. These outreach programs include falls prevention, promoting physical activities, nutrition counseling, medication management and effectively managing diseases like diabetes.
  3. Enhanced Nursing Home Diversification Services – This entails increased use of home and community based services that extend the period an elder is able to remain in his/her home without the need of residential placement in a nursing home. Programs that help an elder remain home include: home-delivered meals, personal care in the home, medical transportation, home modification and adult day care.

Project 2020 approaches are not new, but they are gaining attention and traction as policy makers and aging professionals seek to address the coming elder wave that will put significant strains on social systems.

To learn more about Project 2020, contact NASUA or N4A, or visit the Project 2020 blog.

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