Scorecard Rates States on Services for Older Adults, the Physically Disabled

The quality of long-term services that states provide to older adults and individuals with physical disabilities varies widely, with no single state winning top marks across the board, according to a new report by AARP's Public Policy Institute (PPI).

See also: Caregiver's dilemma.

Called "Raising Expectations: A State Scorecard on Long-Term Services and Supports (LTSS) for Older Adults, People With Physical Disabilities and Family Caregivers," the report offers the first comprehensive look at how all 50 states and the District of Columbia stack up in helping people manage routine activities of daily life such as bathing, eating, preparing meals and shopping for necessities.

Its conclusion: States perform best when they adopt public policies that increase consumers' access to services and allow people to exercise more choice and control over where they receive those services and who provides them.

Quality doesn't have to be expensive

The good news, particularly in these belt-tightening times, is that providing a better level of service doesn't have to be costly. In fact, states can improve support at little or no cost in many ways. These range from making home- and community-based care more accessible — an option encouraged by the new Patient Protection and Affordable Care Act of 2010 and federal grants programs such as Money Follows the Person — to allowing home care workers to perform some of the services often relegated to a registered nurse. "States can take actions that save money and give people what they want," said Enid Kassner, director of Independent Living and Long-Term Services and Supports for PPI.

The scorecard evaluated states' performances in four key areas: affordability of and access to services and supports; opportunities for consumer choice of settings and providers; quality of life and quality of care for people with long-term care needs; and support for family caregivers. The extent to which states' performance vary was striking.

Next: Family caregivers are key. >>