Long-Term Services and Supports:
In the States

States are major payers for long-term services through Medicaid and sources of service delivery innovation. This section of our website has information on what’s happening in the states and tools for advocates, including information to help fight cuts to home- and community-based services and to help advocates push for expansion opportunities in health care reform.

Fighting Cuts to State Programs

Five Good Reasons Why States Shouldn't Cut Home- and Community-Based Services in Medicaid outlines why cutting home- and community-based services in Medicaid is a bad idea for states that are facing budget shortfalls. 6 pp. (July 2010)

Managed Long-Term Care

Managed Long-Term Care in Medicaid: What Advocates Need to Know explains potential benefits and drawbacks of managed long-term care in Medicaid. It also describes alternative options for restructuring long-term care and offers advice for managing expectations for savings. (June 2012)

Evaluating Managed Long-Term Care Proposals in Your State: Key Areas for Advocacy provides questions related to consumer input, program structure, plan selection, consumer protections, plan evaluation, and state readiness that advocates should consider as states design their managed long-term care programs. (June 2012)

State Fact Sheets

Cutting Medicaid: Harming Seniors and People with Disabilities Who Need Long-Term Care assesses the human impact of proposed Medicaid cuts on those who need long-term care, as well as their families. It provides state-specific numbers on how many people would be affected by cuts, as well as on how the cuts would hurt families and state workers. | State Reports (May 2011)

Protecting Seniors and People with Disabilities: Why It Is Important to Preserve the Maintenance of Effort Requirement in the Affordable Care Act is a series of state sheets that discuss how stripping the maintenance of effort requirement from the ACA will have negative consequences for the people in each state who depend on Medicaid by allowing states to change eligibility requirements. (Spring 2011) | National Report

Health Reform: New Opportunities for States to Invest in Home- and Community-Based Services is a series of state-specific fact sheets that explore the new options for states to expand home- and community-based services through the health reform law and the reasons why expanding this type of services is a good idea. (Summer 2010)

From the AARP Foundation, the Commonwealth Fund, and the SCAN Foundation: 

Raising Expectations: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Disabilities, and Family Caregivers measures state-level performance of LTSS systems. It includes state-specific scores and rankings for the following dimensions of long-term care: affordability and access, choice of setting and provider, quality of life and quality of care, and support for family caregivers. (September 2011)