Oregon Model of Care

Oregon’s long-term care system is a continuum of support, beginning with family and friends, and continuing with additional services that help individuals to remain at home or in the community, or in a nursing facility care, if needed.

Long-term care makes life worth living for thousands of Oregonians. Long-term care saves lives, and Oregon’s system of long-term care saves money for Oregon taxpayers. The system keeps peoples in their homes as long as possible, instead of moving them to nursing homes, which cost three to four times as much as care at home.

Four main principles make Oregon’s long-term care system work:

Single entry at the local level allows people to locate services easily, and obtain help to plan and pay for services from a single location.
Easy access is provided through a network developed by each Area Agency on Aging, with well-publicized information and referral services, senior centers, meal sites, and connections with community gatekeepers such as doctors, mail carriers, and police.
Staff visit seniors and people with disabilities seeking long term care assistance to help identify needs and determine how much or how little help is needed, who will provide the care, and who will pay. Case managers then assist the individual to arrange for services , and enroll eligible individuals in programs that meet their needs, including Oregon Project Independence, the Oregon Health Plan, Medicaid services, and Food Stamps, Family Caregiver Support Program, Meals Program, Case managers monitoring the quality of services, especially in home and community settings, to assure that services are delivered and working. Adult Protective Service staff investigate and resolve problems when disabled adults or elders may have been abused.
A continuum of services and payment mechanisms are integrated into a single system, allowing people to choose the elements that best meet their individual preferences and needs.

In Oregon, services are provided by locally-controlled Area Agencies on Aging. Long-term Care is provided through both private and public resources. Removing any of these supports would result in a major gap in the system of care. Some resources are not available in sufficient quantities, resulting in a gap in care, particularly for those with low and middle incomes.

Family caregivers: Family and friends often need support to continue as primary caregivers-including training, respite, support groups, and caregiver registries. Family caregiving may need to be supplemented with paid services, especially when caregivers are frail or disabled.

Meals on Wheels Program: Persons 60 and older who are homebound and need help with meal preparation are offered hot, nutritious lunches and regular contact with someone who cares. The program is designed for adults who have long, or short term need for meals delivered to their home.

Community supports: A healthy community offers a range of supports for its citizens-accessible and affordable housing, transportation’ services for poverty, domestic violence, and other disadvantages’ adequate health care’ and ethnic, social, and religious connections.

Private payment and insurance: Many people pay privately for care at home, in foster homes, assisted living facilities, or nursing homes, but good data is not available about costs or numbers. Long-term care insurance covers only 7% of long-term care expenses nationwide.

Veterans’ programs: Veterans’ services, integrated into some Area Agency on Aging networks, assist qualified veterans and their dependents to obtain VA pensions, providing the veteran with medical care and a higher income, which can be used to meet some long-term care needs.

Older Americans Act (OAA): Information and assistance are provided statewide and nationwide. Services such as home delivered meals and the new Family Caregiver support Program help families care for an older relative, and help frail older people remain at home.

Oregon Project Independence (OPI): The legislature created OPI in 1975, to help seniors and eligible adults with dementia remain safely at home and avoid premature institutionalization. The majority of those served by OPI are quite old. All OPI clients live at home, the majority alone.

Medicaid home & community services: Paid for through the Federal Home and Community Based Service Waiver (Title XIX), all people receiving these services are eligible for care in a nursing home, but choose to live in a less restrictive setting. Many would have to consider moving into a nursing home at a much higher cost if they lost waivered services.

Medicaid nursing facility: Nursing facility care is appropriate for some people-such as when there is no family available to help, the focus is on rehabilitation, or 24-hour nursing needed. Some prefer an institutional setting, and have the right under Medicaid to make this choice.

Medicare and end-of-life care: Federal Medicare covers health care, rehabilitation, and specialized end-of-life care through hospice, which in Oregon is delivered primarily at home.

The Oregon Model of Care for elderly and disabled people saves the taxpayer dollars by:

Allowing people to choose lower-cost alternatives to nursing home care
Helping people to stay safe and healthy in their own homes
Coordinating resources to cost-effectively meet the needs of people receiving care
Helping people with disabilities to work, pay taxes and contribute to the community
Providing support for family caregivers to prevent them from burning out and needing care themselves.

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