AARP Public Policy Institute

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.

The Older Americans Act (OAA) gave rise to important HCBS programs such as the Choices for Independence initiative, ADRCs, and Nursing Home Diversion grants. Here is a concise summary of the legislation, its reauthorization in 2006, and data on the types of support provided under these programs, recipients, and expenditures.

Older Americans speak up on the importance of services and policies that enable them to age in place through the use of home and community-based services (HCBS). Results show that respondents are not only concerned with HCBS as they remain in the home, but also as they move to nursing home alternatives such as assisted living facilities. They identify the availability of long-term care options as one that should be a top priority for AARP's advocacy.

Visitability is a movement that seeks to eliminate certain barriers to aging independently by promoting accessible home design. The authors examine different types of visitability initiatives, challenges to implementation, and opportunities for further acceptance. The design parameters needed for visitability include a zero-step entrance, wide doorways, and at least one half bathroom on the main floor.

Is your area a livable community? You can use this survey and accompanying reports as a model for finding out. AARP defines a livable community as one that allows people to maintain their independence and quality of life as they age and retire. Aspects that make a community livable include mobility, community supports, and affordable housing. Residents age 45 years and older in two OH counties were surveyed to measure whether these things are truly available in their communities.

AARP Bulletin Online has compiled a state-by-state list of local supports to help you quickly access transportation in your community. More than 6,000 transit systems nationwide provide some form of service to older riders, from reduced fares to use of low-floor vehicles to personalized training sessions. This resource puts information about these options in one place.

A survey of AARP members in CO provides insights into how and why seniors use public transport or drive, and how these habits affect their well-being. The survey showed a heavy reliance on cars for transportation and independence, even when public transport is available. People with multiple health and disability problems were most likely to be isolated and have few transportation alternatives. Data reports are available for the entire state and each of the four urban areas surveyed.

This paper examines the extent to which states have balanced the delivery of Medicaid-funded LTC services and supports to people in their homes and in institutions. What is unique about this report is its primary focus on older people and adults with physical disabilities separate from other LTC populations, such as people with developmental disabilities. Explore what has been accomplished under current Medicaid law and review how federal policies impact the ability to balance service delivery.

Find within this resource state-by-state statistics on demographics, Medicaid, Medicare, and health insurance coverage. Of special interest are the data on Medicaid expenditures broken down by recipient type and service environment (HCBS vs. nursing home). Limited data are also given for Puerto Rico and the U.S. Virgin Islands.

This paper outlines the most common barriers to implementing livable communities and outlines cases where these barriers were overcome using planning and zoning tools. Housing, transportation and mobility, land use, cooperation and communication, public involvement in community planning, and leadership are the components of livable communities that are addressed.