St. Petersburg, Fla. – America’s grayest state ranks a disappointing fourth from the bottom in the nation in meeting the long-term care needs of older residents and people with disabilities, according to a new, comprehensive state-by-state study.
The Long-Term Services and Supports Scorecard ranked Florida 46th among the 50 states on a detailed list of 23 specific indicators across five key dimensions on the report, issued by AARP with support of the nation’s leading organizations behind quality long-term care, The Commonwealth Fund and SCAN Foundation. The report, Picking Up the Pace of Change: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers, is the third in a continuing series of Scorecard reports. Florida’s performance was ranked on 23 of 25 possible indicators, while data for two more indicators could not be determined.
“We are the grayest, but far from the greatest state in America when it comes to supporting family caregivers and caring for frail older people and the disabled,” said Jack McRay, AARP Florida advocacy manager. “While there are some bright spots in Florida’s long-term care record, it’s clear Florida is falling further behind other states.”
The report lists six areas where Florida has made progress since a 2014 scorecard listed Florida as the seventh-worst state. On one indicator, Florida suffered a significant decline since 2014. However, the 2017 report demonstrates that most other states have progressed more rapidly than Florida over the last three years.
For example, Florida ranked 46th in the nation on six indicators of affordability and access to long-term care services, such as the cost of private nursing-home care as a percentage of annual household income, the number of private long-term care insurance policies in effect and the proportion of people receiving Medicaid-financed in-home care. The state ranked even worse, 49th in the nation, for where and from whom older Floridians can choose long-term-care services. The quality of long-term care, as measured by three indicators, earned Florida a ranking of 10th worst in the nation. Support for family caregivers was ranked fourth-worst in the nation.
However, Florida ranked 21st in the nation on ensuring transitions between hospitals and long-term care in the home or in nursing homes.
In less than 10 years, the massive Boomer generation will begin to turn 80. More than eight in 10 older Floridians tell AARP that they want to remain in their homes and communities as they grow older. AARP has pressed Florida lawmakers to act now to prepare the state for these changes, McRay said. The Long-Term Services and Supports Scorecard is one part of AARP’s research and advocacy on the issue.
Among other indicators, McRay noted, the report showed Florida ranks seventh from the bottom among all 50 states in the percentage of its Medicaid and state-funded long-term care budget that goes to home- and community-based long-term care rather than to more costly nursing-home care. As of 2014, the most recent data studied by the Scorecard, only 22.6 percent of Florida’s long-term care budget went to home- and community-based care. The best states devoted nearly 70 percent of their long-term care spending to home- and community-based care.
Today, unpaid family caregivers provide the bulk of care for older Floridians, in part because the cost of long-term care remains unaffordable for most families. In Florida, nearly 2.7 million residents help aging parents, spouses and other loved ones stay at home by providing assistance with bathing and dressing, transportation, finances, complex medical tasks like wound care and injections, and more. The value of this unpaid care totaled about $29.7 billion in 2013.
Finally, McRay noted that if Congress enacts proposals to deeply cut Medicaid as part of health-coverage now under discussion in the Senate, Florida families, frail older residents and people with disabilities will be in worse shape than the 2017 Scorecard indicates. The U.S. House-passed version of the health-coverage plan would cut $834 billion from Medicaid over 10 years.
Of the 25 Scorecard indicators, many could be improved through state policy changes. Securing those policy changes point to the importance of AARP’s multi-state advocacy campaign, launched in 2014, to help older Americans live independently at home, and to assist the family caregivers that support them.
Long-term care (also called long-term services and supports) is a diverse set of services designed to help older people and those with disabilities. Those services can be provided in a person’s home, in a community setting such as an adult day center, or in a group residential facility, like a nursing home.
The full state Scorecard, along with an interactive map of state rankings and information, is available at www.longtermscorecard.org.