Long-Term Care Demands Face Fiscal Constraints

While the demand for long-term care will only continue to increase as Americans age, states are still battling tight fiscal budgets, according to an AARP report.

A survey by the AARP of long-term services and support (LTSS) systems across 49 states and the District of Columbia found that while more states are participating in Medicaid home- and community-based services, there is an increasing demand for non-Medicaid services.

According to the AARP, the survey results showed that there has been an increase in the caseload for adult protective services (for victims of abuse or exploitation), and, yet, many states haven’t increased funding accordingly for this service.

“It’s increasingly evident that we need to rethink how we address long-term services and supports in this country,” said Susan Reinhard, Senior Vice President for the AARP Public Policy Institute. “Long-term services and supports are critical not only to the population they serve, but also to the family caregivers who support them.”

Other examples of non-Medicaid services are:

• Aging and disability resource centers

• Congregate and home-delivered health

• Family caregiver support

• Transportation

• Case management

However, some states are still recovering from the recession, which is a huge challenge facing LTSS systems. While 34 states project that their 2013 tax revenue will surpass 2007 pre-recession levels, there are 16 that expect collections will still be below 2007 levels.

“The decision by so many states to transform their Medicaid LTSS systems from fee-for-service to managed care ranks as the most significant byproduct of The Great Recession,” observed Martha Roherty, Executive Director of the National Association of States United for Aging and Disabilities. “But our report documents that other vital programs for seniors, reliant entirely on state revenues, still languish six years after the recession began.”

Roherty urges that states with improved economies now look to programs (like Adult Protective Services) that still struggle with issues like reduced funding, hiring freezes and staff reductions.