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Results from Recent LTSS Study

Last week, the SCAN Foundation hosted the Summit on Transforming California’s Long-Term Services and Supports (LTSS). Gretchen Alkema, Vice President of Policy and Communications, presented data from the first State LTSS Scorecard sponsored by the AARP Foundation, The Commonwealth Fund and the SCAN Foundation. The purpose of the Scorecard is to help states improve LTSS so that the elderly and disabled can exercise choice and independence.

The Scorecard measures performance across four dimensions:

  1. Affordability and access;
  2. Choice of setting and provider;
  3. Quality of life and quality of care; and
  4. Support for family caregivers

Using this multidimensional approach, California ranked 17th (second quartile) overall, landing in the top quartile for affordability and access (7th) and choice of setting in provider (9th), bottom quartile for quality of life and quality of care (39th), and third quartile (30th) for support for family caregivers. Minnesota grabbed the #1 spot, landing in the top quartile for all four dimensions and Mississippi ranked last, landing in the bottom quartile for the first three dimensions and in the second quartile for family caregiver support.

Above: Data By State (see interactive map)

Some major findings from the study include:

  • Public policy decisions made in leading states result in higher performance systems;
  • Many lagging states are in the South, have the lowest median incomes and highest rates of poverty and disability;
  • In many cases, low performing states have not adopted public policies that increase access or allow choice and control. This leads to wide variation between high performing and low performing states within all dimensions;
  • Consumer choice and affordability are largely affected by Medicaid policies;
  • The cost of services is not “affordable” in any state;
  • High state scores on access, affordability and choice also put an emphasis on caregivers; and
  • Data on these issues are limited.

California ranked in the top five for the following indicators:

  • State rates of consumer direction of services for adults with disabilities – Number of people receiving consumer-directed services per 1,000 adults age 18+ with disabilities (Rank: 1)
  • Reach of Medicaid safety net – Medicaid LTSS participant years per 100 adults age 21+ with ADL disability in nursing home or at/below 250% of poverty in the community (Rank: 2)
  • Measures of Medicaid LTSS balance – Percent of new Medicaid LTSS users first receiving services in the community (Rank: 5)

Read the full report to see California’s rankings in 25 indicators across four dimensions.