The Importance of Self-Directed Long-Term Services and Supports Programs
Article Publication Date
Summary
The AARP Public Policy Institute recently released a report sharing findings from the 2026 Self-Direction National Inventory, conducted by Applied Self-Direction.
Self-direction is a model of long-term services and supports delivery in which the individual receiving support chooses how, when, and from whom services are delivered. As of 2026, more than 2 million older adults and people with disabilities self-direct their long-term services and supports.
This report shows that self-directed LTSS enrollment trends varied across states, ranging from an increase of more than 1,100 percent in Florida to a decrease of almost 50 percent in Pennsylvania and Arkansas. Additionally, state agencies surveyed generally indicated that self-directed LTSS is cost-effective relative to traditional agency models, with some showing that self-direction costs 20 percent to 30 percent less per person.
Self-direction is a model of long-term services and supports delivery in which the individual receiving support chooses how, when, and from whom services are delivered. As of 2026, more than 2 million older adults and people with disabilities self-direct their long-term services and supports.
This report shows that self-directed LTSS enrollment trends varied across states, ranging from an increase of more than 1,100 percent in Florida to a decrease of almost 50 percent in Pennsylvania and Arkansas. Additionally, state agencies surveyed generally indicated that self-directed LTSS is cost-effective relative to traditional agency models, with some showing that self-direction costs 20 percent to 30 percent less per person.