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Long-Term Services & Supports, Long-Term Care

ASPE conducts research, analysis, and evaluation of policies related to the long-term care and personal assistance needs of people of all ages with chronic disabilities. ASPE’s work also highlights the financing, delivery, organization, and quality of long-term services and supports, including those supported or financed by private insurers, Medicaid, Medicare, and the Administration for Community Living (ACL). This includes assessing the interaction between health care, post-acute care, chronic care, long-term care, and supportive services needs of persons with disabilities across the age spectrum; determining service use and program participation patterns; and coordinating the development of long-term care data and policies that affect the characteristics, circumstances, and needs of people with long-term care needs, including older adults and people with disabilities. 

Most Older Adults Are Likely to Need and Use Long-Term Services and Supports

More than one-half of older adults, regardless of their lifetime earnings, are projected to experience serious LTSS needs and use some paid LTSS after turning 65. 

Older adults with limited lifetime earnings are more likely to develop serious LTSS needs than those with more earnings. 

However, fifty-six percent of older adults in the top lifetime earnings quintile receive some paid LTSS, and the likelihood of nursing home care does not vary much by lifetime earnings. Learn more.


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Recent Changes in Service Use Patterns of Disabled Medicare Beneficiaries

December 31, 1989
U.S. Department of Health and Human Services

Characteristics of Persons with Developmental Disabilities: Evidence from the Survey of Income and Program Participation

December 31, 1989
In spite of the growth in federal programs affecting the developmentally disabled, there is little comprehensive information about this population. The Survey of Income and Program Participation (SIPP) is one available source of information. SIPP is a nationally representative longitudinal survey of the adult civilian non-institutionalized population in the U.S.

Federal Programs for Persons with Disabilities

December 31, 1989
This report provides an overview of the major federal assistance programs targeted on non-elderly persons with disabilities. Program descriptions include expenditures, trends, the number and characteristics of recipients, eligibility rules, recent program history and legislative changes, and interactions with other federal programs.

Design for Survey of Persons with Mental Retardation and Developmental Disabilities: Summary of Recommendations for Survey Questions and Screening Criteria

November 28, 1989
This document contains brief summaries of recommendations for survey items to be included in the Survey of Persons with Mental Retardation and Developmental Disabilities. The domains covered by these recommendations are based on the core set identified in consultation with the Technical Advisory Group and HHS. [49 PDF pages]

Use of Functional Criteria in Allocating Long-Term Care Benefits: What Are the Policy Implications?

October 31, 1989
This paper discusses the policy implications of allocating long-term care benefits to the elderly on the basis of objective functional criteria, particularly functioning in the activities of daily living (ADLs).

Caregiver Burden and Institutionalization, Hospital Use, and Stability of Care: Final Report

October 31, 1989
U.S. Department of Health and Human Services

The Activities of Daily Living, National Surveys and Long-Term Care Cost Estimates: Two Current Initiatives

October 31, 1989
This paper was presented at the 42nd Annual Meeting of the Gerontological Society of America, November 17-21, 1989. It focuses on several problems associated with making estimates using activities of daily living and highlights some of the methodological work carried out or sponsored by HHS to overcome these problems. [14 PDF pages]

Population Profile of Disability

September 30, 1989
U.S. Department of Health and Human Services

Measuring the Activities of Daily Living Among the Elderly: A Guide to National Surveys

September 30, 1989
U.S. Department of Health and Human Services

A Pilot Study fo the Adequacy of Post-Hospital Community Care for the Elderly: Final Report

September 12, 1989
U.S. Department of Health and Human Services