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RI Must Improve Care for Elderly and Disabled

AARP Rhode Island Releases 

2014 Long Term Services and Supports Scorecard


A follow-up analysis recommends policy steps



PROVIDENCE – AARP Rhode Island today released a state-specific analysis of the 2014 edition of Raising Expectations-2014-AARP-ppi-ltc – commonly known as the LTSS Scorecard.

The 2011 Scorecard was the first multidimensional assessment of state performance of Long-Term Supports and Services (LTSS). The 2014 Scorecard measures how well the nation and each of the states is doing on providing LTSS.

AARP Rhode Island’s subsequent report, “Raising Expectations 2014: A Report Card for Rhode Island Long Term Services and Supports System Performance,” assesses the Scorecard and makes policy recommendations.

“Our analysis provides a closer look at where Rhode Island is keeping pace and where we fall short,” said AARP State Director Kathleen Connell. “The report indicates that, as the state with the highest percentage of persons 85 and older, we face exceptional challenges. It is our hope that the General Assembly and state policymakers find the analysis to be a valuable tool.

The 2014 LTTS Scorecard indicates that Rhode Island:

  • Ranks 4th highest among states in nursing home residents per 1,000 persons age 65 and over
  • Has a high percent of low-care nursing home residents and spends a far higher percent of its LTSS dollars than the national average on nursing home care as opposed to home and community-based services.
  • Has some of the highest long term care cost burdens in the country making private pay long term services unaffordable for the vast majority of older households.
  • Ranked 38th overall, RI had the lowest rank of all New England states.


Rhode Island’s best progress was made in the Legal and System Supports dimension largely due to the 2013 passage of the Temporary Caregiver Insurance program and Caregiver Assessment requirements for Medicaid Home and Community services.

In addition to revisiting the 19 recommendations made following the 2011, the more recent analysis recommends five new major policy actions to improve and transform Rhode Island’s LTSS system:

  • Provide state funds to maintain a robust Aging and Disability Resource Center
  • Develop an online benefits screening tool to assist elders in accessing income-assistance benefits and conduct outreach programs to increase participation.
  • Review the state Nurse Practice Act with the goal of allowing for nurse delegation of certain health maintenance and nursing tasks to be performed by direct care workers.
  • Require hospitals to provide family caregiver education and instruction regarding nursing care needs when a patient is being discharged.
  • Explore using emerging technologies to better serve HCBS clients


“Raising Expectations 2014: A Report Card for Rhode Island Long Term Services and Supports System Performance” includes a total of 16 recommendations.

AARP Rhode Island made 19 recommendations following the 2011 Scorecard’s release. A review shows four have been implemented, most notably those to promote coordination of primary, acute and long term care and to strengthen family caregiver supports.

Six recommendations showing partial implementation include expansion of the home and community co-pay program and authority (but not implementation) under the 1115 Medicaid waiver renewal to provide expedited eligibility for Medicaid HCBS and for a limited increase in the monthly maintenance allowance for persons on Medicaid HCBS who transition out of nursing homes.

Nine recommendations, although still relevant, have not been implemented.

Today, unpaid family caregivers provide the bulk of care for older Rhode Islanders in part because the cost of long-term care remains unaffordable for most middle income families.  In Rhode Island more than 148,00 residents help their 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 totals about $1.9 billion.

“With 131,000 members statewide, AARP Rhode Island is dedicated to improving the state’s LTSS performance,” Connell concluded. “Policy discussions may revolve around data and numbers, but it is people – people’s lives -- we’re really talking about. As the state’s population continues to age, long term care will grow as a critical issue for all Rhode Islanders.  We need to move forward with greater urgency for our citizens to feel supported in their caregiving endeavors and assured affordable resources in place will grow confidence we all will age with proper available care as well as the dignity everyone deserves.”



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