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Advisory Council October 2019 Meeting Presentation: Expanding Access to LTSS

Monday, October 21, 2019

Printer Friendly Version in PDF Format (5 PDF pages)


Expanding Access to LTSS through Caregiver Support

Susan Engels, Office Chief, State Unit on Aging
Aging and Long-Term Support Administration
Washington State Department of Social and Health Services

Serving People with Dementia

At DSHS, we make a conscious effort to weave supports for people with dementia and their families into our infrastructure and programs.

Family Caregiver Support Program

  • There are over 850,000 unpaid caregivers in Washington state.
  • The Family Caregiver Support Program has $14 million in annual funding.
  • The program serves less than 1% of the caregivers.
  • 53% of caregivers served are caring for individuals with Alzheimer’s disease or dementia.
  • 32% are caring for individuals with memory or cognitive problems.
Used Medicaid Long-Term Care services in 12 months following TCARE screen?
PIE CHART: No 89%, Yes 11% (Nursing Home 4.2%, Community Residential Services 2.5%, In-Home Services Only 4.5%). PIE CHART: No 91%, Yes 9% (Nursing Home 3.4%, Community Residential Services 1.9%, In-Home Services Only 3.6%).

Family Caregiver Support Outcomes

Source: Bridge Lavelle, PhD; David Mancuso, PhD; Alice Huber, PhD, Barbara E.M. Felver, MES, MPA; DSHS Research and Data Analysis, April 2014.

Expanding Supports: 1115 Waiver

  • Medicaid Alternative Care (MAC). Designed to support unpaid caregivers in continuing to provide quality care.
  • Tailored Supports for Older Adults (TSOA). New eligibility group to support individuals who need Long-Term Services and Supports and are at risk of spending down assets to impoverishment with or without unpaid caregivers.

Long-Term Care Trust Act

  • All W-2 workers contribute.
  • They pay 58 cents per $100 of income.
  • The trust fund invests the money.
  • Each person who is eligible to receive the benefit can access services and supports costing up to $36,500.
  • The value of this benefit will increase over time.

The benefit can be used for a range of services and supports, including:

  • Professional care in your home, a licensed residential facility or a nursing facility
  • Adaptive equipment and technology like wheelchair ramps and medication reminder devices
  • Home safety evaluations
  • Special training, consultation, pay and other supports for family caregivers
  • Home-delivered meals
  • Rides to the doctor

The Long-Term Care Trust will help delay and defer enrollment into Medicaid and the use of costly long-term services and supports.