Long-Term Care

Learn from 10 years of experience in administering the consumer-directed Cash & Counseling program in Arkansas. The report provides a candid history of the development, implementation, and lessons learned from the program. The author gives details on partnership development and use, changes in agency culture and operations, and data on outcomes, cost neutrality, and participant demographics. Also included are the 2003 and 2008 program budgets.

The majority of NH’s long-term care (LTC) expenditures go to nursing homes, despite the fact that only 2% of surveyed AARP members prefer to receive care in that setting. The AARP surveyed 800 randomly-selected members to set their advocacy agenda in the state. Other opinions gauged deal with ability to pay for LTC, personal sources of LTC financing, volunteerism, and voting practices.

March 2-4, 2009 state program staff, CMS staff, and technical assistance providers met in Baltimore to discuss Money Follows the Person and other strategies for helping people move out of nursing homes. Speakers presented on topics ranging from service integration, housing finance strategies, mentoring, quality, and many others.

Here are demographic, employment, and income characteristics of one of the largest and fastest-growing workforces in the country. Due to this dynamic, understanding the direct care workforce is critical for effective service delivery and policy making in areas from health reform to economic growth. Key figures include job titles and responsibilities, employment status, work setting, wages and benefits.

Program administrators, advocates, and researchers advise the Senate on ways to improve wellbeing and cost outcomes of long-term care by increasing access to HCBS. They speak on national demographics, successful HCBS programs of the past and present, state programs in Wisconsin and Florida, integrating acute and long-term care for dual eligibles, and program finance models. See “Video Contents Index” for time stamps and information on each testimony.

This document outlines a Forum Session which was sponsored by the National Health Policy Forum at George Washington University. The Forum topic focused on different state's approaches to managing overall long-term care spending, offering consumers broader access to home and community-based services, and coordinating long-term care services.

The growing elderly population is a persistent theme in policy deliberations. Gerontologists believe that policy discussions must go beyond population size and take into account socioeconomic characteristics such as living and employment situation, home life, culture, and education. Experts from the fields of economics, political science, and social policy do just that in this forum session, presenting in-depth demographics with a focus on economic security, electoral dynamics, and stereotypes.

Long-term care services for the elderly and for younger populations with disabilities are a significant component of national health care spending. In 2006, long-term care spending was almost $174 billion, most of it paid by the federal-state Medicaid program. This report focuses on concerns about the financing, the already substantial public role, which presages rapid spending increases as the “baby boom” population ages may lead policymakers to revisit these issues.

View the forum session presentations to learn how Arkansas, Texas, and Virginia have created consumer-directed options. They discuss demographics, program details and histories, costs, challenges, and the future. The final presentation goes over Money Follows the Person and Cash and Counseling from the federal level, examining policy, demographics, and outcomes.

The Veterans Health Administration plans to partner with the Aging Network in order to be serving over 109,000 veterans using HCBS by 2011. February 25 and 26, 2009, these organizations met in Boston to develop the partnership, work out next steps, and identify challenges. Presentations provide details on existing infrastructure, Nursing Home Diversion, financial management services, and existing research on HCBS and self-direction.