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Home Care Quality: Emerging State Strategies to Deliver Person-Centered Services

Millions of older Americans receive publicly funded personal care services in their homes to help them with daily activities, such as dressing, bathing, and toileting, that they cannot carry out themselves. The heavy reliance on Medicaid to fund services for persons with disabilities has led federal and state governments to devote increased attention to the quality of care being provided.

Yet, the public agencies funding these services often find it difficult to assess and monitor the home care provided in homes by numerous workers and family caregivers. This AARP Public Policy Institute Issue Paper examines the efforts of three states – South Carolina, Washington and Wisconsin – to improve home care quality by using a more person-centered approach.

  • South Carolina is using information technology to help care managers assist consumers more quickly, to monitor their needs in both everyday situations and emergencies, and to assure that care services are being provided.
  • Washington has developed an intensive monitoring system of assessment and care plan processes to ensure that consumer needs are being correctly addressed by care managers.
  • Wisconsin's Family Care Program has developed 14 “member outcomes” to assess how well care providers address the needs and goals of program participants, and uses a participant feedback system to assess consumer outcomes.

The initiatives described in this report point to the significant ongoing efforts that states are using to ensure quality care and support in the home. The challenge for state officials continues to be the creation of quality assurance systems that place consumer needs and goals for quality of life first. (32 pages)

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