LTSS State Scorecard Previous Reports (2011-2023)

Susan Reinhard, Rodney Harrell, Carrie Blakeway Amero, Brendan Flinn, Ari Houser, Paul Lingamfelter, Rita Choula, Selena Caldera, Edem Hado, Julie Alexis, AARP Public Policy Institute

Published September 28, 2023

This page features a collection of Long-Term Services and Supports (LTSS) State Scorecard reports published between 2011 and 2023. Each edition evaluates and compares how U.S. states deliver LTSS to older adults, people with physical disabilities, and family caregivers. The Scorecard focuses on state-level data because the U.S. lacks a single national system to address LTSS needs. Use the links below to view reports from each edition. Use the links below to view reports from each edition.

How the Scorecard Works

The Scorecard uses five categories, called dimensions, to measure state-level long-term services and supports (LTSS) performance. The bullets below represent the dimensions used in the 2023 edition of the Scorecard and how the report defines high performance for each.

Affordability and Access. Consumers can easily find and afford services, with a meaningfully available safety net for those who cannot afford services. Safety net LTSS do not create disparities by income, race/ethnicity, or geography.
Choice of Setting and Provider. A person- and family-centered approach allows for consumer choice and control of services (including self-directed models). A well-trained and adequately paid workforce is available to provide LTSS. Home and community-based services are widely available. Provider choice fosters equity, and consumers across communities have access to a range of culturally competent services and supports.
Safety and Quality. Consumers are treated with respect and preferences are honored whenever possible, with services maximizing positive outcomes—including during and after care transitions. Residential facilities and HCBS settings are adequately staffed and are prepared for emergencies. Policy-, system-, and practice-level efforts reduce and/or prevent disparities in quality and outcomes.
Support for Family Caregivers. Family caregivers are recognized and their needs are assessed and addressed, so they can receive the support they need to continue their essential roles. A robust LTSS workforce limits over-reliance on family caregivers. Family caregiver supports are culturally appropriate and accessible to all communities.
Community Integration. Consumers have access to a range of services and supports that facilitate LTSS, including safe and affordable housing. Communities are age friendly and supported by a state Multisector Plans for Aging. Policy and programming that facilitate livable communities also drive equitable communities.

What Are Long-Term Services and Supports (LTSS)

Long-term services and supports (LTSS) provide help with day-to-day tasks that support people with functional limitations and/or cognitive impairments. These include activities of daily living such as bathing or dressing, instrumental activities of daily living such as managing finances or preparing meals, and medical/nursing tasks such as wound care. LTSS may be provided in the home, in community-based settings like adult day centers and assisted living communities, or in nursing homes. LTSS can also include support for family caregivers such as training and respite care.

Reports

2023

2020

2017

2017 Report: Picking Up the Pace of Change: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers (PDF)

2014

2011

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Suggested citation:
Susan Reinhard, Rodney Harrell, Carrie Blakeway Amero, Brendan Flinn, Ari Houser, Paul Lingamfelter, Rita Choula, Selena Caldera, Edem Hado, and Julie Alexis. Innovation and Opportunity: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers, 2023 Edition. Washington, DC: AARP Public Policy Institute, September, 28, 2023. https://doi.org/10.26419/ppi.00203.001

Long-Term Services and Supports State Scorecard: Reports from 2011-2023