As the Illinois budget battles get underway, I am reposting a blog first published on October 30, 2011 about the current state of affairs for long term care services and supports in Illinois. Not surprisingly, the cup is half full (or half empty) depending on your point of view. I'll return next week with a fresh blog.
We've come along way....but still have far to go...
Last month, AARP's Public Policy Institute published a fascinating new report "A State Scorecard on Long-Term Services and Supports (LTSS) for Older Adults, People with Physical Disabilities, and Family Caregivers." The scorecard website can be found here.
The Scorecard is designed to help states improve the performance of their LTSS systems so that older adults in all states can maximize their independence and well-being. As loyal readers of this blog can attest, public policy plays an important role in LTSS systems by establishing who is eligible for assistance, what services are provided, how quality is monitored and how family caregivers are supported.
Illinois received an overall ranking of 23, placing the Land of Lincoln firmly in the 2nd quartile overall. The Scorecard examines LTSS system 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 of family caregivers. Each dimension is then subdivided into indicators (there are 25 indicators overall). For example, an indicator of the quality of life and quality of care dimension is: "Nursing home staffing turnover: ratio of employee terminations to average number of active employees." In this indicator, Illinois ranked 2nd in the nation. Hurray for us!
The states in the top tier have public policies designed to:
- improve access to needed services and choice in their delivery by transforming their Medicaid programs to cover more populations in need and offer the alternatives to nursing homes;
- facilitate accces to information and services by developing effective "single point of entry" systems so that people who need services can find help easily; and
- address the needs of family caregivers by offering legal protections as well as support and services.
The leading states generally scored in the top half of all states across all dimensions, but no state scored in the top quartile of all indicators, demonstrating that even the best performing states had room for improvement. Poorer performing states often are among those with the lowest median incomes, and the highest rates of both poverty and disability.
The report also found that the cost of LTSS is unaffordable for middle-income families (no surprise there). The recent demise of the CLASS Act would seem to indicate that in the near future there will be no substantial mechanism to ease the burden to middle-income families.
The Scorecard reveals the wide variation of LTSS systems among the states and opines that the lack of a single LTSS delivery model (although Medicaid is the chief LTSS funder, it is a federal-state partnership and states are provided with substantial flexibility) along with other trends (e.g. median income levels, disability rates, etc.) drives this variation.
Let me know if you would like are more in depth review of the Illinois score!
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