Long-Term Care

Experts were asked about the current state of LTC in the US and potential reforms in the delivery and financing of these services. Eight articles appearing in the August 2010 issue of Medical Care Research and Review explore the survey findings and analysis, revealing opinions on the state of the industry, the nature of its problems, its dissatisfaction with past efforts at repair, and its preferences for future strategies for improvement.

Ten grants were awarded to states to develop a profile of the publicly funded LTC system and to assist CMS to develop national benchmarks that will be used to measure the degree and success of states' efforts to offer community based LTC services. Review Michigan’s report which focuses on the priority population of the elderly and adults with physical disabilities, but also includes systems that serve adults with developmental disabilities, adults with mental illness and children.

Under a Cooperative Agreement with AoA, the Benjamin Rose Institute on Aging convened a panel of experts on strengthening the LTC workforce. The experts were organized to address five areas of concern: supply of DCWs and family caregivers; retention of these helpers; readiness or capacity of these helpers to provide care; quality of care they provide in terms of outcomes for those in their care; and the impact of the ACA, including the CLASS Act, on family caregivers.

The Benjamin Rose Institute on Aging sponsored PPAR’s Winter/Spring 2010 issue. It includes seven articles written by national experts describing recent and notable changes in LTC policy, with its increasing emphasis on HCBS services. An introductory essay provides a 30-year review of the evolutionary process of LTC. Consumer-directed initiatives, caregiver and workforce issues, maturation of the service delivery system, and a review of recent state-level initiatives are discussed.

Health Affairs has published a special issue devoted entirely to long-term care. Review articles on providers, issues related to Medicare and Medicaid, transition and diversion programs, new state strategies to meet LTC needs, quality of care, demographic issues, policy and financing, health spending, caregivers and the workforce, and palliative care and end-of-life.

Find a summary of the CLASS Act developed by the AARP Public Policy Institute. The legislation creates a voluntary national insurance program for long-term services and supports (LTSS) to help address the financial challenges many American households face when confronted with the high cost of LTSS. This fact sheet succinctly answers questions such as who can participate in CLASS, what are the benefit amounts, how are premiums computed and how CLASS interacts with Medicaid.

Examine a snapshot of workforce competencies that have been identified for professionals who work in LTC settings. It focuses on providers who serve long-term care needs of the older population. The paper also examines whether the competencies are the same or different from what is needed to care for the geriatric population in acute and ambulatory care settings.

Find an example of a comprehensive, user-friendly guide to long term care planning. Developed by the District of Columbia, this publication provides a detailed overview of long term care (LTC) options, and includes information on understanding the need for LTC, costs, financing, and service and support options. Easy to understand graphics and data are included. This guide can serve as an example for other organizations looking to develop similar consumer-oriented materials.

Review this series of handouts that discuss key considerations for program planners and managers and staff involved in options counseling. Core competencies identified and detailed are: determining the need for options counseling; assessing needs, values and preferences; understanding and educating about public and private sector resources; facilitating self-direction/self-determination; encouraging future orientation; and following-up. Additional resources are offered for each core competency.

Long-term services and supports (LTSS) for the elderly and younger populations with disabilities are a significant component of national health care spending. In 2008, spending for these services was almost $191.1 billion (almost 10 percent of all U.S. personal health care spending), most of it paid by the federal-state Medicaid program. This publication presents data on LTSS spending by major public and private sources.