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NCSL Release Report On State Long-Term Care Policy

Friday, July 26, 2002
  Contact: HHS Press Office
(202) 690-6343
NCSL Press Office
(202) 624-8667

Report Highlights State Innovation, Challenges Across the Country


HHS Secretary Tommy G. Thompson today releases a new report analyzing states' long-term care policies and efforts to deal with the rising costs of caring for the elderly, people with disabilities and others requiring long-term care.

The HHS-funded report, prepared by the National Conference of State Legislatures (NCSL), shows many states are adopting innovative approaches to addressing their residents' long-term care needs even as they face tight budgetary situations.

The report also cites a trend in states towards providing individuals greater choice through opportunities for home and community-based care services -- a major goal of President Bush's New Freedom Initiative, which provides a government-wide framework for helping provide people with disabilities with the tools they need to fully access and participate in their communities.

"There are now more choices than ever before for persons who are elderly or have a disability, thanks in large part to the creative approaches that governors and state lawmakers have implemented to help people stay in their homes and communities instead of moving into institutions," Secretary Thompson said. "Helping individuals stay in their own home for as long as possible is generally the best choice for beneficiary and taxpayer alike, and we must -- and will -- do more to expand such opportunities in every state across the nation."

The NCSL report, "State Long-Care: Recent Developments and Policy Directions," takes an in-depth look at long-term care budgets, legislation and planning in the 50 states and the District of Columbia. The report says that tight budget pictures in many states raise new challenges for continuing the trend toward more home and community-based care services.

"Even with the fiscal constraints, several states are using creative approaches to expand the options for frail elders and people with disabilities to enable them to live in their own homes and communities rather than be institutionalized," NCSL Executive Director William Pound said.

For instance, the report highlights a new program in Washington State that will support 300 people under age 65 to transition from nursing homes to the community. It also describes how Colorado created new quality improvement incentives for nursing homes focusing on creating "resident-centered" activity programs.

The report also cites the impact of the National Family Caregiver Support Program, launched by HHS in 2001, which is providing $141.5 million this year to support state and local programs that provide greater choices in home and community-based care.

Other findings from the report include:

  • A slowing economy has increased the number of people turning to public services for help;
  • Shortages of direct care workers have increased pressure on states to provide incentives to attract and retain workers;
  • Court decisions, including the Olmstead Supreme Court ruling, have stimulated many states to increase community-based alternatives to institutionalization; and
  • The aging population means that more frail elderly and people with disabilities need assistance.

Today's study is the first of two reports by NCSL that HHS has funded to provide a thumbnail sketch of long-term care policies in the states. A second report will update the sketch in the future.

NCSL is the bipartisan organization that serves the legislators and staffs of the states, commonwealths and territories and provides research, technical assistance and opportunities for policymakers to exchange ideas on the most pressing state issues.

The study is available at


Note: All HHS press releases, fact sheets and other press materials are available at