Long-Term Care

Policy makers and provider organizations continue to struggle to reduce turnover among direct-care workers in the long-term care field. Unfortunately, data elements used to measure turnover vary widely between programs and make it difficult to understand and counteract this problem. The authors discuss these challenges by drawing on their experience with the turnover tracking system of the Better Jobs Better Care Demonstration.

This graphic shows how information requests from or about people with long-term care needs are handled in Ohio. The illustrated processes include the information request, intake and referral, assessment, and follow-up and evaluation.

Health care experts from diverse fields give their opinions in this survey. The 196 leaders identified the most pressing long-term care (LTC) issues as development of the workforce, improving quality, and securing financing. 76% believe policymakers must urgently deal with the challenge of forming a sufficient supply of home and community-based services. Other themes dealt with include insurance, financial responsibility, a Medicare LTC benefit, and regulatory action.

Prior to this bill mandating improved access to home and community-based long-term care (LTC) services, Tennessee was paying 98% of LTC funds to nursing homes. The act rebalances funding allocation and creates a single point of entry for older adults seeking LTC. It also supports diversion from and transition out of institutions through HCBS counseling and improved needs assessment. It was signed into law 06/17/2008.

AAHSA provides information and resources on legislative, operational, and legal issues and opportunities affecting HCBS providers. The site is geared toward provider agencies and provides breaking news, email listservs, and articles and advice organized by topic.

Thanks to the steadily increasing demand for home care, the second fastest-growing occupation in the country is that of personal and home care aides (PHCAs). Yet PHCA wages - which were low to begin with - are failing to keep up with inflation nationwide. A new publication looks at the decline in inflation-adjusted wages. Based on data from the Bureau of Labor Statistics, it charts the wages received by personal and home care aides in all 50 states and the nation over a seven-year period.

This booklet, through Arkansas’ “Choices in Living” aging and disabilities resource center, profiles the home and community-based long-term care (LTC) options available in the state. Older adults, people with disabilities, families and support workers can determine which of the five profiled programs are best for them based on eligibility criteria and scope of coverage.

This report presents findings from Oct ‘05 – Oct ‘07, which includes the first nine months of strategic planning for the FY05 and FY06 Systems Transformation (ST) Grants and the subsequent initial 15-months of implementation (through Oct ‘07) for the FY05 ST Grants. The report focuses primarily on documenting grantees' experiences during the start-up period and grantees' progress during early implementation and suggests early trends and findings.

Families and government spend $200 billion annually on long-term care (LTC), yet many elderly and disabled people still do not receive needed care. This brief illustrates the flaws of the current LTC finance system and presents three potential solutions and some challenges and advantages of each option. The proposed solutions are: enhance private insurance; base public financing on social insurance rather than welfare; or meld private and public insurance.

This comprehensive report provides data and macro level analyses on public and private residential services. The Executive Summary and Section 3 compare Medicaid utilization and expenditures for home and community-based services with services provided in institutional settings. Data are also presented in state-by-state profiles. Past editions of this annual report dating from 2000 are available at the website provided.