RICHMOND _ Virginia ranks 22nd out of 50 states and the District of Columbia overall when it comes to meeting the long-term care needs of older residents and people with disabilities, but AARP warns more must be done, at an accelerated pace, to meet changing demographic demands.


Virginia ranks next to last in the percent of adults age 21+ who have difficulty performing activities of daily living (such as bathing and dressing)  at or below 250% of poverty receiving Medicaid, and 47 in support for family caregivers. This, according to a new, comprehensive state-by-state Scorecard from AARP with support of the nation’s leading organizations behind quality long-term care, The Commonwealth Fund and SCAN Foundation.


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 –the third in a series of reports—ranks each state overall and on 25 specific indicators in five key dimensions: affordability and access; choice of setting and provider; quality of life and quality of care; support for family caregivers; and, effective transitions between nursing homes, hospitals and homes.


“The vast majority of older Virginians want to live independently, at home, as they age—most with the help of unpaid family caregivers,” says Jim Dau, State Director of AARP Virginia, which has  more than 1 million members age 50 and older in Virginia. “Even facing tight budgets, Virginia is making some progress to help our older residents achieve that goal. However, this Scorecard shows we have more to do, and we need to pick up the pace. Now is the time to build on – not dismantle – Virginia’s critically important long-term care system.”


Overall, Virginia did not decline in any indicators since the last Scorecard, but also improved in only eight indicators.


Today, unpaid family caregivers provide the bulk of care for older Virginians, in part because the cost of long-term care remains unaffordable for most middle income families. In Virginia, more than 1 million 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 $11.8 billion annually in Virginia.


“When it comes to helping older Virginians live in the setting of their choice, family caregivers take on big responsibilities,” explains Dau. “Many juggle full-time jobs with their caregiving duties; others provide 24/7 care for their loved ones. With every task they undertake, these family caregivers save the state money by keeping their loved ones out of costly nursing homes – most often paid for by the state Medicaid program. They have earned some basic support.”


The state ranks 35th in nurse delegation and nurse practitioner scope of practice.  AARP will continue to push for improvements to the scope of practice for nurse practitioners.


“Virginia has made some progress to improve long-term services and supports for older adults and people with disabilities, as highlighted in this Scorecard. But, proposals in Washington, D.C. to drastically cut federal funding for Medicaid would threaten any advancements, likely resulting in our most vulnerable Virginians losing the lifesaving supports that they count on,” Dau said.


The state made big improvements and now ranks 11th on the percent of Medicaid long-term services and support funding for older people and people with physical disabilities going toward home and community based services, instead of institutional care.


The single strongest predictor of a state’s long-term care system is the reach of its Medicaid long-term care safety net. That’s why AARP is also fighting to expand services provided at home and in the community, by shifting funds away from undesirable and more expensive nursing home care. While the inappropriate use of antipsychotic medication in nursing homes has decreased, the Scorecard highlights that the percentage of Virginia nursing home residents with pressure sores has remained the same.


While Virginia does rank 11th in the percentage of Medicaid long-term care dollars for older adults and people with physical disabilities that support care provided at home and in the community—the care setting that most Virginians prefer—the Scorecard spotlights significant areas that call for improvement, especially regarding affordability and access.   Specifically, Virginia ranks 50th in percentage of adults age 21+ with ADL disabilities at or below 250% of poverty receiving Medicaid, and 44th in Medicaid long-term services and support beneficiaries per 100 people who need assistance with activities of daily living.


“This Scorecard gives us a snapshot of how well Virginia serves our older residents, those with disabilities, and family caregivers—and shows us where we must sharpen our focus to better assist hardworking Virginians,” concludes Dau.


Of the 25 Scorecard indicators, many may be improved through state policy changes, pointing to the importance of AARP’s multi-state advocacy campaign, launched in 2014, to help older Americans live independently, at home, and the family caregivers that support them.


The Scorecard reveals that in less than 10 years, Baby Boomers will begin to turn 80, placing new expectations and demands on a still imperfect long-term care system. Further, this generation will have far fewer potential family caregivers to provide unpaid help.


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; 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




About AARP: AARP is the nation’s largest nonprofit, nonpartisan organization dedicated to empowering Americans 50 and older to choose how they live as they age. With nearly 38 million members and offices in every state, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands, AARP works to strengthen communities and advocate for what matters most to families with a focus on health security, financial stability and personal fulfillment. AARP also works for individuals in the marketplace by sparking new solutions and allowing carefully chosen, high-quality products and services to carry the AARP name. As a trusted source for news and information, AARP produces the world’s largest circulation publications, AARP The Magazine and AARP Bulletin. To learn more, visit or follow @AARP and @AARPadvocates on social media.


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