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Issues in Long-term Supports and Services: Getting Ready for an Aging America

Issues in Long-term Supports and Services: Getting Ready for an Aging America. Mary Jane Koren, M.D., M.P.H. Vice President The Commonwealth Fund mjk@cmwf.org www.commonwealthfund.org. Long-Term Supports and Services: What are they? For whom? And, where are they provided?.

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Issues in Long-term Supports and Services: Getting Ready for an Aging America

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  1. Issues in Long-term Supports and Services: Getting Ready for an Aging America Mary Jane Koren, M.D., M.P.H. Vice President The Commonwealth Fund mjk@cmwf.org www.commonwealthfund.org

  2. Long-Term Supports and Services: What are they? For whom? And, where are they provided? • Long-term supports and services (LTSS) • Include a range of personal care services, congregate support programs, assistive equipment and environmental modifications • Typically, are expected to be needed for extended periods of time i.e. more than 90 days • LTSS helps elderly persons with physical or cognitive impairments and younger people with disabilities • Sites where services and supports can be provided • In the person’s home, • In the surrounding community, or • In residential settings, e.g. nursing homes or assisted living

  3. State of the states: Findings from the LTSS State Scorecard(www.longtermscorecard.org ) • Wide variation in performance – and even the highest ranking states have things that need improvement • Poverty and high rates of disabilities present challenges • Highest ranking states have enacted policies that result in high performance • Medicaid programs serve more people in need and offer people choices of LTSS beyond just nursing homes • Single point of system entry provides vital information to help consumers make decisions and simplifies access • Support for family caregivers through legal protections and other services to address caregiver needs • LTSS costs are beyond the means of even most middle-income families

  4. Federal policy considerations • While there is no unified approach to the provision of LTSS federal policymakers could take the lead in • Developing common definitions of services • Creating uniform measures for determining states effectiveness in coordinating the delivery of primary, acute and LTSS • Strengthening data collection requirements to monitor quality and assess value received for public expenditures • Federal policies could provide states with incentives and financial assistance to improve their LTSS systems, e.g. shared savings programs

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