South Carolina ranked 38 for (LTSS) to older adults and the disabled | Health

A new report released jointly  by AARP’s Public Policy Institute, The Commonwealth Fund and The SCAN Foundation shows that South Carolina lags far behind other states, ranking 38th in the delivery of long-term services and supports (LTSS) to older adults and people with disabilities.

The report, Raising Expectations:  A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers, examines four key dimensions of state LTSS system performance: affordability and access; choice of setting and provider; quality of life and quality of care; and support for family caregivers. It assesses each state’s performance as a whole and on 25 individual indicators, some of which were measured for the first time.

The study demonstrates that South Carolina needs to vastly improve in areas including home care, assisted living, nursing home care, and supports for family caregivers, and more efficiently spend the substantial funds they currently allocate to LTSS. A South Carolina specific fact sheet detailing indicators is attached to this release.  Specifically, the report ranked South Carolina’s LTSS:

• 44th Support for family caregivers
• 35th Choice of setting and provider
• 29th Quality of life and quality of care
• 15th Affordability and access

“This report will help South Carolina make and sustain targeted improvements so that people can live and age with dignity in their own homes and communities,” said Jane Wiley, AARP South Carolina state director. “Achieving a high-performing long-term supports and services system will require a concerted effort from both the public and private sectors.”

If South Carolina reached levels currently achieved by leading states, the study finds the state could realize significant gains in health, better care experiences and potentially lower costs:

• 14,267 more low- or moderate-income (<250% poverty) adults age 21+ with activity of daily living disabilities would be covered by Medicaid.
• 2,429 more new users of Medicaid LTSS would first receive services in home and community based settings instead of nursing homes.
• 863 nursing home residents with low care needs would instead be able to receive LTSS in the community.
• 1,424 unnecessary hospitalizations of people in nursing homes would be avoided.

This Scorecard finds that generally states with the highest level of performance have enacted public policies designed to:

• Improve access to services and choices in their delivery by directing state Medicaid programs to serve more people in need and offer alternatives to nursing homes that most consumers prefer.

• Establish a single point of system entry to help people find needed information and more easily access services.

• Improve support for family caregivers by offering legal protections as well as other services to address caregiver needs.

The report shows all states can do better in areas where performance lags.  Wide variation in performance in specific dimensions makes this clear:

• Percent of LTSS spending going for home- and community-based services—60 percent in the top five states, 13 percent in the bottom five, the average is 37 percent.

• Percentage of Medicaid LTSS coverage of low- and moderate-income people with disabilities—the top five states cover 63 percent, the bottom five cover 20 percent, the national average is 36 percent.

• Percent of Medicaid LTSS recipients receiving home- and community-based services before nursing home placement— 77 percent in top five states, 26 percent in bottom five states, average is 57 percent.

• Rate of Medicaid LTSS recipients receiving self-directed services—143 per 1,000 in the top performing state, fewer than 1 per 1,000 in the bottom 6 states, 22 per 1,000 people national average.

• Hospitalization rates of nursing home residents—10 percent in top five states, 29 percent in bottom five states, median of 19 percent.