What options are available to legislators who are seeking to reform their states long-term care system in their respective states?
State legislators across the country are using multiple, incremental strategies to improve the financing and delivery of LTC services. Options include the following. Consolidate state agencies. In most states, a variety of agencies administer LTC services, resulting in delivery structures that are fragmented, duplicative and difficult for consumers to negotiate. To reduce redundant services and confusion, state legislators could designate a single state agency to take responsibility for all LTC services and financing. Such consolidations typically involve transferring programs like the Medicaid home and community-based waiver programs from an agency that handles Medicaid-supported services to the state department on aging. In 1981, Oregon became the first state to move toward consolidation with the creation of the Senior Services Division (renamed the Senior and Disabled Services Division in 1989, when the agency assumed administration of programs for both the elderly and adults with d
