1. The Future of Community- Based Services and Education Earl K. Darby AET/508 November 9, 2014 Professor Andrea Adins

2. Long Term Care (LTC) Home & Community-Based services: ◦home health care ◦personal care ◦adult day care ◦respite care ◦assisted ◦living facilities

3. Distribution of Medicaid LTC Spending, by Type of Service 1988 $23,800,000,000 ◦SNF 63% ◦ICF-MR 26% ◦Personal Care 6% ◦HCBS Waiver 3% ◦Home Health 2% 2000 $67,700,000,000 ◦SNF 58% ◦ICF-MR 15% ◦Personal Care 6% ◦HCBS 18% ◦Home Health 3%

4. Contemporary Higher Education Challenges:  Enhance its relevance & connection  Pressing issues & problems in local community  Observed separation of universities & community  Aloofness from Real-world problems

5. Contemporary Higher Education: “Future”  Community-Campus Collaboration  Scholarship of Engagement  Search for answer to pressing: Social issues Civic issues Economic issues Moral Problems

6. Community-Based Services & Education: Eliminate Limitations  Manage the Service Introduce wider social considerations Home care less restrictive alternative Post approval training family input Family therapy & group work Develop relevant community based skills

7. Distribution of Medicaid LTC Spending, a 15 Year Projection 2000 $67,700,000,000 ◦SNF 58% ◦ICF-MR 15% ◦Personal Care 6% ◦HCBS 18% ◦Home Health 3% 2029 $88,310,000,000 ◦SNF 50% ◦ICF-MR 18% ◦Personal Care 8% ◦HCBS 20% ◦Home Health 6% See Congressional Budget Office for further details.

8. Aging Demographics Global trend by 2050: Three 60+ per child 4 & younger  Impact health care  Impact income support  Impact age-sensitive systems Historically unprecedented & unanticipated consequences

9. References Campbell, J., Wilson, G., Britton, F., Hamilton, B., Hughes, P., & Manktelow, R. (2001). The management and supervision of Approved Social Workers: Aspects of law, policy, and practice. Journal of Social Welfare and Family Law, 23(2), 155-172. Fujiura, G. T. (2010). Aging Families and the Demographics of Family Financial Support of Adults With Disabilities. Journal of Disability Policy Studies, 20(4), 241-250. doi: 10.1177/1044207309350560 Ishisaka, H. A., Farwell, N., Sohng, S. S. L., & Uehara, E. S. (2004). Partnership For Integrated Community-Based Learning: A Social Work Community-Campus Collaboration. Journal of Social Work Education, 40(2), 321-336. Wiener, J. M., Tilly, J., & and Alecxih, L. M. B. (2002). Home and Community-Based Services in Seven States. Health Care Financing Review, 23(3), 89-114.