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The long-term care system shall recognize that aging is not a disease, but rather a natural process that often includes increasing needs for assistance with daily living activities. To the maximum extent possible and appropriate, the system shall be based on a model of care delivery that acknowledges that services delivered in home and community-based settings are not primarily medical in nature, but rather support services that will provide needed assistance with activities of daily living and that will allow persons to age in place in their homes and communities.
The long-term care system shall also recognize that persons who are elderly or who have physical disabilities, or both, are more likely to have chronic health care conditions and to need preventive, acute and chronic health care services in order to promote healthy living and improve quality of life. The system shall be designed to focus on the needs of the whole person, with coordination of care across the continuum to ensure that medical, behavioral and non-medical long-term care support needs are met.
The long-term care system shall promote independence, choice, dignity and quality of life for elderly or people with physical disabilities, or both, who need long-term care supports and services and shall include consumer-directed options that offer more choices regarding the kinds of long-term care services people need, where they are provided and who will deliver them, with appropriate mechanisms to ensure accountability for taxpayer funds.
The long-term care system shall be designed to reduce fragmentation and to offer a seamless approach to meeting people's needs, including one-stop shopping for information, counseling and assistance regarding long-term care programs in order to support informed decision making, simplified eligibility processes and one-stop shopping for all of the different kinds of services a person may need.
The long-term care system shall recognize and value the critical role of the family and other caregivers in meeting the needs of the elderly and people with physical disabilities and shall offer services such as caregiver training, adult daycare and respite that wrap around the natural support network in order to keep it in place, thereby delaying or preventing the need for more expensive institutional care.
The long-term care system shall deliver needed supports and services in the most integrated setting appropriate and cost-effective way possible in order to utilize available funding to serve as many people as possible in home and community settings.
The long-term care system shall utilize a global budget for all long-term care services for persons who are elderly or who have physical disabilities that allows funding to follow the person into the most appropriate and cost-effective long-term care setting of their choice, resulting in a more equitable balance between the proportion of medicaid long-term care expenditures for institutional, i.e., nursing facility, services and expenditures for home and community-based services and supports.
The bureau of TennCare shall report to the general assembly and shall make available to interested persons a separate accounting of long-term care expenditures for:
Nursing facility services;
Home and community-based services made under the CHOICES long-term healthcare program; and
Employment and Community First CHOICES services, under a waiver amendment to the TennCare II demonstration.
The accounting shall, under subdivision (g)(2), include prior fiscal year actual expenditures and projected current fiscal year expenditures no later than February 1 of each year. Projected upcoming fiscal year expenditures and the percentage of nursing facility services and home and community-based services relative to total expenditures for the CHOICES long-term healthcare program shall be provided by June 30 of each year.
The long-term care system shall offer a continuum of long-term care services that includes an expanded array of home and community-based options, including community-based residential alternatives to institutional care for persons who can no longer live alone, and that also includes nursing facility services as an integral part of the long-term care continuum for persons with the highest levels of need.
The long-term care system shall include a comprehensive quality approach across the entire continuum of long-term care services and settings that promotes continuous quality improvement and that focuses on customer perceptions of quality, with mechanisms to ensure ongoing feedback from persons receiving care and their families in order to immediately identify and resolve issues and to improve the overall quality of services and the system.