Many of us in the health policy world are well aware that Medicaid consumes a significant proportion of the state budget every year. What some of us may not realize is that elders and people with disabilities comprise over half of the Medicaid budget, with a large proportion of spending on this group going toward long-term care. A majority of the Medicaid long-term care budget is spent on nursing home care,which is the most expensive form of long-term care.
Last fall, we released the final report of the Colorado Alzheimer’s Coordinating Council. The CACC was set up by the Colorado legislature to evaluate the state of the state in terms of gaps and needs in caring for individuals with Alzheimer’s disease. It is estimated that 70 percent of nursing home residents have some degree of cognitive impairment, yet very little dementia care training is required of health professionals and direct care workers in Colorado.
Anecdotal evidence suggests that only a few hours of training in dementia care increases staff satisfaction, which, in turn, reduces turnover and resident behavior problems, two of the most difficult situations facilities face. It might be a leap to say that with these two problems remedied the state could see savings in the Medicaid budget. But with better dementia care training, there may be less strain on the long-term care system and facilities might run more smoothly with fewer disruptive and expensive events.
The CACC has continued a subgroup to develop a voluntary program for individual health professionals and facilities to become recognized as competent in dementia care. This market-driven program aims to increase dementia competency in Colorado’s health care workforce by providing an incentive for consumers to choose a facility recognized as competent over one that is not. The change, CACC believes, will drive a widespread adoption of dementia training programs throughout the state. With this approach, as opposed to a mandatory set of training regulations, the group hopes to get buy-in from the long-term care community and see real change in the coming years.