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Recently, Oklahoma received the opportunity to join many other states across the nation to improve the balance between community and institutional services for long term care. Currently, Oklahoma relies heavily on nursing homes to provide long term care services which studies have shown is more costly than care provided in the home. Poll after poll has shown that people would prefer to stay in their homes after becoming disabled rather than move to nursing homes. Through a federal grant, Oklahomans can now have a win-win situation. People can live in their home, receive care and at less cost than a nursing facility.

Persons of all ages with disabilities or long-term illnesses who wish to transition from a nursing facility often face significant barriers to community living such as finding accessible housing and having dependable direct care staff. Oklahoma is participating in the Centers for Medicare and Medicaid (CMS) Money Follows the Person nationwide demonstration program. This program is designed to "rebalance" states Medicaid programs serving people with disabilities and long term needs. In Oklahoma this demonstration project has been named "The Living Choice Project". Oklahoma’s Living Choice Project is designed to transform the current long-term care system by promoting community based services instead of institutional services.

The vision of the Living Choice Program is to empower individuals to have choice and control of the services and supports necessary to live in and able part of the community. Community living can become a reality for Oklahoman’s of all ages with disabilities or long-term illnesses. Numerous national polls have shown senior individuals prefer to remain living in their homes rather than move into a nursing facility. There is simply no place like home—living surrounded by favorite photographs and worn furniture, familiar smells and the comforting rhythm of the neighborhood, from the thud of the mail arriving each morning to the whoosh of the school bus passing by each afternoon. Living in one’s home might even help put the brakes on aging. Older people report a better quality of live, more control, more independence and feeling less stigmatized when they live on their own—less old in other words.

Data indicates that over 40 percent of older persons living in nursing facilities do not require significant assistance with activities of daily living such as bathing, meal preparation, (2007 CMS Nursing Home Data Compendium) Targeting these individuals for the Living Choice Program will have an impact on the improving the balance between community and institutional services in the long-term care system in Oklahoma. These persons will be able to access supports and services through community based provider agencies that have not been available through previous Medicaid home and community based waivers.

In order to be eligible for the Living Choice program the person must be at least 19 years of age and must have resided in the nursing facility for at least six months prior to the proposed date of leaving the nursing facility. The person must also be approved for long term care services provided by SoonerCare (Medicaid) for at least one month prior to leaving the nursing facility.

How does a person who lives in a nursing facility connect with the Living Choice Program? In Oklahoma anyone can make a referral to the Oklahoma Health Care Authority (OKHCA); including the individual living in the nursing facility, the family member, the physician or others. The only information that is needed to make a referral is the individual’s name, address and SoonerCare/Medicaid indentification number. You may reach Oklahoma Health Care Authority toll free at (888) 287-2443 to make a referral to the Living Choice Program.

Ability Resources in Tulsa, a Center for Independent Living has been helping Tulsans for years to leave institutions and move back into their homes in their communities.

"Over the past 15 years, Oklahoma has shown that it has the capacity to safely serve individuals who are nursing facility level of care in the community" explains Carla Lawson, Executive Director of Ability Resources. "I encourage nursing facility residents not to be put off by comments from others, however well meaning, that they belong in a nursing facility. Instead, call and find out more about the transition program and the services available in the community to meet their long-term care needs. There is no obligation or pressure to participate in the transition program."

The Living Choice Project represents a giant step forward in the evolution of the delivery of long term care services.

Karen Meason and Patty Casey are System Consultants at LTCA.