AARP Public Policy Institute

To help understand the implications of consumer-directed programs abroad, AARP's Public Policy Institute commissioned a study to describe and analyze consumer-directed programs in the Netherlands, England, and Germany. Researchers completed in-person interviews with key stakeholders and conducted an in-depth literature review.

States increasingly require criminal background checks for home care workers to protect vulnerable adults from harm. While 46 states mandate some type of background check for Medicaid-funded workers, there is no uniform protocol for screening and disqualifying candidates. Developing sound policies and practices is challenging due to costs, database problems & time constraints. The paper offers an up-to-date assessment of practices, policy considerations & research and guidance on moving forward.

Looking for quick talking points on how the expansion of home and community-based long term care services can significantly help address the health care needs of many older adults? A new Fact Sheet provides examples and data on why HCBS is a critical component of Health Reform.

What are the policy options for Medicaid HCBS? This fact sheet suggests: broadening the scope of covered services, enhancing federal Medicaid matches to states to expand HCBS, allowing Medicaid HCBS beneficiaries to retain more assets to pay for home modifications or health services not covered by Medicaid, and allowing Medicaid HCBS waiver programs to serve people with lower levels of functional disability than those required for people in nursing homes.

Nearly every state provides at least some funds for services for low-income older adults or people with disabilities who have too many assets to qualify for Medicaid. AARP reports on how much each state spends on both multiservice and single-service programs. It also compares funding sources, eligibility criteria, services, cost management strategies, consumer direction, and other characteristics.

The authors present evidence in support of states investing in HCBS and nursing home diversion as strategies to deal with declining revenue. They review research reports illustrating how the balance of spending on institutional versus HCBS spending affects future long-term care costs. Using these data and case studies of Washington and Vermont programs, they conclude that HCBS is indeed cost-effective.

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.

This eighth edition of this reference report presents comparable state- and national-level data for more than 140 indicators on long-term services and supports from a wide variety of sources. Published approximately every two years, the series was developed to help inform policy discussions among public and private sector leaders. This publication presents the most up-to-date data available at the time of production, and is displayed in easy-to-use maps, graphics, tables, and state profiles.

AARP offers a list of resources to help plan for long-term care. Especially helpful is the “Staying in Your Home” section. Here you can find tools on preparing homes for aging in place, locating quality home and community-based services, and hiring home care workers.

About 52 million people provided family caregiving worth about $375 billion in 2007. That amount exceeds Medicaid long-term care spending in each state. Caregiving services included in the estimate are personal care, help with everyday tasks, and health-related interventions. The document presents data nationally and by state and concludes with policy recommendations to support and sustain family caregivers.