Maybe elephants can dance : two decades of progress in delivering long-term services and supports in Ohio

"This report was funded by a grant from the Ohio Department of Aging and the Ohio Legislature through support from the Ohio Long-Term Care Research Project."; "July 2013."; Includes bibliographical references (p. 47-48).For many years Ohio's system of long-term services and supports was criticized for having an institutional bias. In 1993, more than nine of ten older people (60 and over) with a severe disability who received Medicaid long-term services did so in a nursing home. With one of the largest aging populations in the United States and growing and unsustainable Medicaid expenditures, state policy makers charted a course to change Ohio's system. This longitudinal study, initiated by the General Assembly in 1993 and continuously funded by the Ohio Department of Aging, tracks how long-term utilization has changed over the past two decades. Recent data indicate that the ratio of institutional care to home and community-based services for older people with severe disability using Medicaid has now changed to 55/45. Over the last 15 years, while the age 85 and older population grew by 50%, Ohio decreased nursing home use for older people by 11%. During this same 15-year time period, the state increased the number of older people receiving home and community-based services by 150%, while holding the Medicaid long-term services budget relatively constant (7% increase over 15 years, in 2011 dollars)