Long Term Services and Supports

Governors’ State of the State addresses reveal policy and programmatic trends. This document tracks those comments made in such addresses that indicate wider policy initiatives that impact older adults and people with disabilities. A state-by-state analysis of 43 State addresses and budgets helps to illuminate overall trends in aging and disability policies, such as Medicaid changes and the restructuring of state departments and programs affecting long-term services and supports (LTSS).

The recession continues to affect state programs for older individuals and adults with physical disabilities. Demand for publicly funded services has grown, and resources, including staff, are stretched thin, according to this new 50-state study. 31 states have cut non-Medicaid aging and disability services programs in FY 2010, and 28 states were expecting to cut these programs in FY 2011. Find the research report, brief, video and compiled State profiles.

This document describes the State of Illinois’s plan on aging in accordance to Older Americans Act guidelines. The plan describes the mission, organization, and strategies of Illinois’s Department on Aging to coordinate services for older adults. Amongst some of the goals for FY10-12 is to rebalance long-term care to expand home and community-based services, expand transportation for seniors, promote wellness, and advocate for and protect elder rights.

Background and context for interpretation of the data about Alzheimer's disease and other dementias are contained in the Overview. This information includes definitions of the types of dementia and a summary of current knowledge about Alzheimer’s disease. Other sections address prevalence, mortality, caregiving and use and costs of care and services. There is a focus on the challenges of people with Alzheimer’s disease and other dementias who live alone.

This report provides background on MLTSS to brief the intellectual and developmental disability community, as well as the President and the Secretary of the Department of Health and Human Services, on managed care and changes in LTSS administration so that they may take action and influence outcomes. The report also contains a number of recommendations related to disability stakeholder engagement, choice and self-determination, consumer protections and rights and quality measurement.

Four new papers look at the Money Follows the Person demonstration program, drawing on a 2012 survey of state MFP programs. A total of 46 states have received federal grant money under the program, which was extended through 2016 by the Affordable Care Act. As of August 2012, over 25,000 individuals nationally had been transitioned back to the community since the program’s inception. The survey report describes trends in enrollment, services and per-capita spending in state MFP efforts.

This study examined (1) how intrastate funding formulas take into account older adults with greatest economic and social need, (2) options for modifying OAA title III and VII statutory funding formulas to better target older adults with the greatest economic and social need under generally accepted equity standards, and (3) what effect might these formula modifications have on states' program allotments and what transition measures could be used to ease the implementation of modifications.

Several states are experimenting with solutions to help individuals who need long term services and supports connect with available workers. One approach is a publicly-funded matching service registry (MSR) that facilitates connections between qualified home care workers and individuals who self-direct their in-home services and supports. This document explains how registries can help match supply and demand, what the benefits of MSRs are for states and how to begin creating these registries.

The availability of trained direct service workers is threatened by dramatic increase in population age 65 and older and the growing demand for long-term services and supports. This document explains why states and ADRCs need to focus on building their Direct Service Workforce to meet this growing demand.

This paper aims at testing the relationship between older Americans Act (OAA) program expenditures and the prevalence of low-care residents in nursing homes (NHs). Principal findings indicate that increased spending on home-delivered meals was associated with fewer residents in NHs with low-care needs. States that have invested in their community-based service networks, particularly home-delivered meal programs, have proportionally fewer low-care NH residents.