Growth in Public LTC Expenditures for Persons 60+ by Category between 1990 and 1996–97 in NC
Notes:
While the most striking trend shown in this chart is the rise in all long-term care expenditures, it also shows a trend toward home and community care. Institutional care (primarily nursing home, but also including residential mental health) receives a majority of the public funding, but the rate of growth was highest for home and community care.
Some of the reasons for the growth in home and community care include:
- Steady growth in the Medicaid Community Alternatives Program, from about $57 million in SFY 1994–95 to more than 92.5 million in 1996–97. This program, designed to serve people in their homes who would otherwise require care in a skilled nursing facility, is now available in all counties.
- The Medicaid in-home personal care program (outside of CAP) has also grown during this period—-in SFY 1991-92 it totaled $18.5 million—in 1996–97, nearly $53 million.
- The General Assembly’s appropriation of additional state funding in fiscal years 1996–97 and 1997–98 is further supporting this shift toward home and community services. This appropriation targets those with low income who are not Medicaid eligible—a group that has had great difficulty finding the resources for long-term care.
One reason for the growth of expenditures for adult care homes is the start-up in SFY 1995–96 of Medicaid-funded personal care for eligible residents.
Notes on the slide categories:
“Institutional” includes: nursing homes, state inpatient psychiatric care, and other mental health care.
Actual expenditures 1990: Institutional=$370,776,306 (76.2%); Home & Community Care =$78,071,822 (16.0%); Adult Care Home=$37,690,782 (7.8%)
Actual expenditures 1996-97-- Institutional=$868,950,427 (72.6%); Home & Community Care =$225,931,368 (18.9%); Adult Care Home=$101,718,828 (8.5%)