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(INDIANAPOLIS) — Indiana plans an overhaul of how senior citizens get longterm health care.

Surveys show most people want to spend their old age at home, but just over half of seniors on Medicaid end up in longterm care. Indiana’s Family and Social Services Administration plans to create a managed-care system to match people with in-home health care. 25 states, including Illinois, Ohio and Michigan, already use that approach.

FSSA Secretary Jennifer Sullivan says the system will encompass not just outside health providers like visiting nurses, but help for family caregivers, from training them on what to do to equipping homes with wheelchair ramps, or advising on how to redo the house to minimize falls.

Sullivan says the new system won’t cost the state any more than it spends now, but would even out eldercare spending between in-home services and nursing care. Until the coronavirus pandemic slammed the brakes on nursing home admissions, she says the state was spending four times as much on long-term care facilities as on in-home care.

FSSA has already taken baby steps this year with a pilot program to speed up the eligibility process for in-home care from six weeks to three days. Chief medical officer Dan Rusyniak says the full transition will take several years. The agency will consult with area councils on aging and other stakeholders to formalize a list of goals for the new system, then decide how to measure whether they’re being met.

Rusyniak says having a central gatekeeper for services will eliminate one current obstacle to in-home services: it’s too hard to find. Rusyniak says there are seven or eight directories and databases of providers and services which aren’t integrated with each other, making it difficult to compare options.