Long term care for impaired younger and older adults has been a major part of the nation’s health care system for several decades, but until now it has not received much attention from the media or policymakers. With the projected doubling of the 70+ population over the next thirty years, however, it is being looked at with renewed interest.
The current publicly (mostly Medicaid) supported long term care (LTC) system is a mix of nursing home, assisted living and in-home supportive services. This mix is slowly but steadily shifting in the direction of community-based services. This shift is largely in response to the proven cost effectiveness of community based alternatives to nursing home care and the overwhelming preference of both older and younger impaired persons for them.
Most paid LTC services are funded by the Medicaid program and, to a much lesser extent, Federal Older Americans Act funds. In most states, these federal funds are administered through the non -profit Aging Network (AN), which consists of over 600 Area Agencies on Aging (AAAs), several thousand mostly non-profit service providers, and many advocates for aging services. As documented by AARP in recent reports, state and local Aging Networks have built an extensive infrastructure of community-based services over the last thirty years and administered them in a comparatively efficient, low-cost manner.
– The Institute for Successful Longevity