Home and Community Based Services Resource Network


Title: State LTC Profiles Report, 1996

Author(s)/Publisher/Date: Ladd, Richard, C., Kane, R. L., & Kane, R. A. (1999). 

Key concepts/Target audiences: This report, an extension of the 1992 State LTC Profiles Report, (November, 1995) updates previous data to 1996 and provides profiles showing state rankings and data regarding the need for long-term care and utilization patterns across States.  The main focus of the analysis is on how States are progressing in the provision of home and community based services.  The data presented is useful to state administrators, policy makers, agency administrators, and program planners.

Summary: Using quantitative data available from published sources or specifically provided by each state, this report is designed to provide a relative measure of how each state is progressing toward a balanced LTC system as compared to one another and the national average.  The premise for states is to spend less dollars on nursing facility care and more on HCBS alternative care. 

Results: Ten states (i.e., Oregon, California, Idaho, Nevada, Texas, Michigan, Virginia, Kentucky, Washington, and Illinois) are highly committed to HCBS and control over the growth of nursing homes as reflected in control of nursing home utilization and expenditures and commitment to HCBS utilization and expenditures.  In the 1992 report, only two states, Oregon and New York, met these criteria.  Twelve additional states have made substantial progress in these areas including Arizona, Florida, Arkansas, Missouri, Maine, South Carolina, Alaska, North Carolina, West Virginia, New Mexico, Oklahoma, and Utah.  In the 1992 report, eight states met similar criteria (i.e., California, Washington, Texas, Delaware, Idaho, Arizona, Arkansas, and North Carolina). 

These overall summary statistics, however, do not reflect what happens after controlling for potential demand for public long-term care.  Twelve states are ranked high or very high in both their commitment to HCBS utilization and control of nursing home utilization and include Idaho, Kentucky, Maine, Alaska, California, Michigan, Nevada, New Mexico, New York, Oregon, Texas, and Washington.  Of these, only 4 have a very high/ high potential demand for public LTC including Kentucky, New Mexico, New York, and Texas.  In terms of commitment to HCBS expenditures and control over nursing home expenditures, 13 states ranked high/ very high including Idaho, Kansas, Mississippi, Oklahoma, West Virginia, Wyoming, California, Illinois, Michigan, Nevada, Oregon, Texas, and Virginia.  Of these, only 5 had high/ very high potential demand for LTC including Mississippi, Missouri, Oklahoma, Texas, and West Virginia.  A total of 15 states (i.e., Kentucky, New York, Texas, Arkansas, North Carolina, Alaska, California, Idaho, Maine, Michigan, Nevada, Oregon, Washington, Colorado, Illinois) were highly committed to HCBS utilization and HCBS expenditures and of these only 3 are ranked high/ very high in demand for public LTC (Kentucky, North Carolina, and Arkansas).

The data indicate that 22 states have made outstanding or substantial progress in balancing LTC systems when compared to the national averages.  In 1992, only 10 states met these criteria.  Overall, this report and the numbers generated suggest that more states are making considerable progress in balancing their LTC systems in 1996 as compared to 1992. 



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