Long-Term Care

This publication presents lessons from financing projection models of long-term care (LTC). It describes the methods, conclusions, strengths and weaknesses of several models. It “also explores what such models can and cannot tell us, what research is needed to get better projections, and the key issues that must be addressed by any proposal to deliver and finance care for the baby boomer resident of the future.” This book can be ordered in hard copy or as a pdf via the links.

This analysis examines how U.S. federal laws may be affected if the U.N. Convention on the Rights of Persons with Disabilities (CRPD) is ratified by the country. The authors summarize each CRPD article along with with U.S. laws that either guarantee the same rights or contradict the convention. The authors conclude that better implementation of existing laws or congressional action would bring federal law in line with CRPD.

RE-AIM, a framework for program developers, planners, and evaluators to use to translate research into practices and policies that maintain the health and quality of life of caregivers. This monograph argues that this issue should be a public health policy priority, summarizes RE-AIM, provides policy and program scenarios for using the framework, and list resources and tools. The report is available in six parts here or as one document from the website.

Watch these videos to hear first-hand from direct-care workers about the services they provide. They share their thoughts on why they do this work, how they are viewed by families, friends, and service recipients, and how they deal with challenges such as discrimination and disrespect. They also provide advice on how to improve the field. The videos are available free at this website or can be ordered as a DVD or VHS with a discussion guide included.

Centers for Independent Living (CILs) have been providing important services to individuals with disabilities since the 1970s. State Medicaid programs have contracted with CILs to provide Medicaid-funded services. This paper examines four important home and community-based services (HCBS) provided by CILs and funded by Medicaid: case management/support coordination; personal assistance services; nursing facility transition services; and equipment and home modification.

State leaders are interested in the experience of states that developed adult foster care as part of their service array, trends in provider supply, regulations governing providers, and quality oversight practices. This report is based on the policies and practices in five states – Arizona, Maine, Oregon, Washington and Wisconsin. The states were selected based on their approach to licensing and Medicaid coverage for this residential option. The report focuses on programs for older adults.

In order for Oregon to balance its two-year budget for 2001-03, the Seniors and People with Disabilities Division (SPD) in the Department of Human Services was mandated to reduce LTC spending by nearly 30%. This paper analyzes the 2003 cuts to Oregon’s Medicaid long-term care (LTC) system, the impact of those cuts on a well-developed home and community-based services (HCBS) system, how the state has responded, and lessons that could be learned from its response.

This section of the Family Caregiver Alliance website assists people in locating government, nonprofit, and private long-term care support programs in their respective areas. It includes services for family caregivers, as well as resources for older or disabled adults living at home or in a residential facility. It also includes information on government health and disability programs, legal resources, disease-specific organizations and much more.

This annual report by Genworth Financial provides detailed information on the cost of long-term care (LTC) in the U.S. Current costs and historic trends are identified and organized by state, setting of care, and type of service provider. The website includes interactive state maps and further information on private funding options for LTC.

The prevalence of the practice of transferring patients to sub-acute levels of care has created concerns with hospital discharge planners. Their apprehension arises from the possibility that if they do not quickly transfer patients from an acute care setting to a post-acute level of care, their hospital may be at an economic disadvantage to others with shorter lengths of stay due to differing transfer practices. This paper looks at four factors that mitigate the incentives to transfer patients.