Examining The Performance of Long-Term Services and Supports System for Older Adults, People with Physical Disabilities, and Family Caregivers

In November 2022, AARP released the 2020 Long-Term Services and Supports (LTSS) State Scorecard, which measures states' performance and rank. The report defines LTSS as assistance with daily living and its instrumental activities provided to older adults and adults with physical disabilities. They cannot perform these activities independently due to a physical, cognitive, or chronic health condition that is expected to continue for an extended period, typically 90 days or more. The report breaks these activities into five categories:

• Affordability and access
• Choice of setting and provider
• Quality of life and quality of care
• Support for family caregivers
• Effective transitions

The state rankings demonstrate how each state is doing relative to several measures that address how each state has opted to deliver the services required relative to the Medicaid program. An expert panel provided input on the measures to be included in each category and the data sources to be used. The Scorecard can be used as a resource to assess policies and practices in each state.

The results shared in the report are important to the health and well-being of not only older adults or other adults with chronic physical or cognitive disabilities but also to their caregivers, who, in many instances, are family members. Since UPLIFT Florida Network focuses on Florida, it was important for us to look at the performance of Florida relative to the Scorecard. Sadly, Florida is ranked 51st out of 51 (50 states and the District of Columbia) – a decrease from 46th in 2017. This is of critical importance as Florida has the highest percentage of older adults in the nation, and this population is growing at a dynamic rate fueled in part by the many sources that rank Florida and specific areas of Florida as prime retirement options.

The results of the Scorecard analysis provide the information and impetus for the work that needs to be done across the spectrum of service delivery, government policies, and the setting of priorities for the allocation of funding in each state. The slip from 2017 to 2020 means that the states of Tennessee, Mississippi, Alabama, Kentucky, and Indiana improved, and Florida either stayed the same or declined in its performance. It would benefit agencies, organizations, and companies in the provision of services to these populations to study the Scorecard to identify the highest priority and highest impact for the allocation of resources in the coming years.