Mike LaurenceIllinois readies model framework for long-term care of the elderlySPRINGFIELD - The Thompson administration has crafted healthy, new strategies for rescuing the ailingold.The key’s are• Development of “case coordination units* as pivotal participants in sparing thousands from nursing homes through in-home assistance• General backing of the state's plan by Washington, which will contribute about $7 4 million during the next fiscal year.I.NDEED, THE OUTLOOK for thousands of elderly appears much brighter than it did a year ago. which is particularly noteworthy in times when most social services are malnourished“Illinois is being watched by the other states . being considered the mover and shaker for long-term care.” says Peg Blaser. Department on Aging director And her pride seems justified.Last summer, the state s budding in-home program, though heralded, was nipped A federal judge frowned at waiting lists and determined all meeting eligibility standards should be accommodated immediatelyThus, a fiscally feeble governmenthad to tighten the standards, which meant only the poorest and the most impaired could benefit from services such as housecleanmg and cooking, that the first-come, first-served approach had to be scrappedDIRECTOR BLASER was disturbed But the new focus has been dictated by the General Assembly as well as the court, and Mrs Blaser has become comfortable with itShe is comfortable, in part, because Aging has been successfully referring other worthy senior citizens to federally funded area agencies for the elderlyBut she is comfortable, for the most part, because her department has developed a novel mode of handling its own clients and making referrals.Through contracts, Aging has created a statewide network of “case coordination units — already existing private and public outfits capable of evaluating whether a senior qualifies for the state's program, marshaling appropriate services for the chosen and scouting aid for others who are needy but not desperatePREVIOUSLY the department dealt directly with service providers.Yet, the providers were not necessarily aware of every community resource, nor were they inclined to seek a sophisticated mix of assistance for a home-loving senior.By working with operations like county health departments, elderly centers and religiously sponsored organizations adept at casework. Aging has enlisted seasoned soldiers for the front lines of its dignity-preservingbattle ,s ,;.l,Moreover, Aging has won approval to have its “case co-ordination units screen applicants for Medicaid-supported, in-home services. That function is performed by welfare agencies in the vast majority of states, but Mrs. Blaser said the Department of Public Aid has agreed to the plan, and she views that as crucial.Older people generally recoil from dealing with the welfare system, she says She also points out Aging caseworkers will be especially sensitive to seniors. But Scott Umbreit, her deputy director, is perhaps even blunterWELFARE WORKERS he says without intending criticism, have become essentially paper processors “so people get their checks, so thatpeople get their food stamps, so that people get their green (medical treatment) cards.”“A public aid worker in any medium or large-sized county can hardly afford to take the time to talk to any client for a half hour or 45 minutes or an hour or an hour and a half about problems and needs and then call other agencies to try to arrange services ”So in their view, seniors benefit, as do taxpayers.The federal boost will allow the caseload to climb from 11,500, to 15,000. It will permit Aging’s in-home care budget to rise from $23.5 million to $30 5 million without additional state outlay In fact, the state and federal governments, by being humanitarian, can actually save millions of Medicaid dollars through substituting relatively inexpensive services for steep nursing home costs.Even then, hundreds of thousands who could make good use of the program will not qualify because they are not among the most frail and the poorest But an impressive beginning has been made, and the hope here is the Aging effort can be a major artery in a care system that ultimately reaches hundreds of thousands