Long-Term Services and Supports: Challenges and Opportunities for States in Difficult Budget Times

An effective system of long-term services and supports (LTSS) is essential to enable older adults and persons with disabilities to live independently in the community.

More than 3 million people in the United States rely on Medicaid for LTSS. For those with extensive needs, Medicaid covers care in nursing homes. For such individuals who prefer to remain in the community, Medicaid can provide personal assistance and attendant care, home health services, homemaker services, adult day health, assistive technologies, respite care, assisted living, case management and many more optional services. In 2009, Medicaid spending on community-based LTSS totaled $51 billion and accounted for 44.8 percent of total LTSS spending. Even though the federal government shares Medicaid costs with the states, the burden on states is substantial and certain to increase.

Long-Term Services and Supports: Challenges and Opportunities for States in Difficult Budget Times discusses the challenges and opportunities that states confront in the current budget climate in expanding their LTSS systems for seniors, adults with physical disabilities and individuals at risk of nursing home placement.

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