Long-Term Care

National policymakers and state Medicaid leaders are paying greater attention to better management of long-term supports and services (LTSS). A combination of factors presents state purchasers with significant opportunities to improve care and control costs by better coordinating and managing the full continuum of long-term care services. In this new publication series, states explore and understand emerging options. Review data and options for transforming long-term-care programs.

Most literature focuses on long-term services and support utilization rather than awareness. This Canadian study used a series of 12 vignettes to describe common situations faced by older adults for which community support services (CSSs) might be appropriate. The findings showed that awareness of CSSs is much lower than previously thought, and that the most important sources of information were information and referral sources, the telephone book, doctors’ offices, and word of mouth.

Deficiencies in current LTC financing models are substantial. This article examines what characteristics predispose LTC specialists to weigh one approach, public or private, more than the other. Data are derived from a Web-based survey of 1,147 individuals with known or demonstrable experience with LTC, including consumer advocates, provider representatives, policy experts, and public officials.

Looking for information and resources to help families plan for future long-term care? Explore this web site, developed by the U.S. Department of Health and Human Services, geared toward helping individuals review their options before making decisions. It is primarily intended as a planning resource for individuals who don't yet require long-term care, but includes information on services and financing options that can be helpful to all.

The Long-Term Care Ombudsman Program is a consumer advocacy program established by the Older Americans Act that aims to improve the quality of care for residents in LTC settings by investigating and resolving complaints made by, or on behalf of, such residents. This report provides an overview of the program, including its legislative history, administrative function, and FY2008 funding amounts by source.

In June 2008, Tennessee passed legislation restructuring LTC service delivery, including the expansion of HCBS services by integrating LTC within a managed care environment and providing consumer direction options. In March 2010, the state implemented the CHOICES program, wherein persons enrolled in TennCare that needed LTC services would receive them through a managed care organization. Review a presentation given at the 2010 HCBS conference and the CHOICES website.

Care management has been recognized as a valuable service in supporting family members who care for their older adult relatives. TCARE® is a caregiver assessment and referral protocol designed to assist care managers. The major goal of TCARE® is to provide care managers with a set of steps that are needed to move from the assessment to the implementation of a care plan. Find a presentation on Georgia’s experience with their person-centered initiative and use of the protocol

NJ’s charge to advance a Medicaid LTC system where there would be more options for community care, greater consumer choice and allowance for maximum flexibility between nursing homes and HCBS is “definitely showing positive trend lines” according to this report. The state’s Global Budget Projection model offers a budgetary process for tracking and projecting its LTC expenditures. Explore detailed information about the model’s methodology and findings.

Families have always borne the burden of long-term care, and struggle with feelings of grief, loss, despair, anger and hopelessness. In this powerful first person account, the author points out some of the sad consequences of the American health care system's emphasis on the treatment of acute episodic illness or injury and its relative neglect of chronic illness long-term care. This essay, written for the New England Journal of Medicine’s “Sounding Board” series, is considered a seminal work.

View a four-part series that comprehensively examines the physical, mental, emotional, and lifestyle adjustments associated with caregiving. The show underscores the urgent need for understanding the stressful relationships that can evolve and offers guidance on how to manage expectations, providing insight into what support is already in place.