A Better Life for Low-Income Elders in Austin, PRP 188

This report describes a policy research project conducted in the 2015-16 academic year with support from the St. David’s Foundation and Central Health, and government client the Texas Health and Human Services Commission. The study addresses how to care for elderly, vulnerable county residents in the community. As baby boomers approach retirement age nationwide, the share of Austin’s elderly population is growing as well. Austin and Travis County are facing new challenges in providing services to a growing share of frail and disabled older residents. The core objective of this project is to offer options for community-based long- term care in an equitable and cost-effective manner. As part of this objective, the project team examined existing community-based, long-term care and social services programs in Texas and California for dually eligible Medicaid and Medicare enrollees, including Texas’s managed care option, STAR+PLUS, and the Program of All Inclusive Care for the Elderly (PACE). PACE provides comprehensive medical care and social services to persons 55 and older who require nursing home care, but prefer to live in the community. The study examines other community-based long-term care alternatives that could be introduced in Austin and the characteristics of what makes PACE and other alternatives work for dual-eligible older persons. The study includes a cost analysis from the perspectives of the state and program provider, an analysis of participant satisfaction in each program, and an in- depth qualitative analysis of the barriers to success for PACE sites in Texas and California. The study also explores ways of leveraging community resources in Austin.