AARP Publishes New Paper Analyzing High-Performing Long-Term Services and Supports

Earlier this month, AARP published a paper analyzing and revising the framework it uses in ranking states for its Long-Term Services and Supports (LTSS) State Scorecard. In particular, the definition of “high-performing” has been revised for the upcoming 2023 scorecard. The new framework defines a high-performing LTSS system to include metrics that assess affordability and access, choice of setting and provider, quality and safety, support for family caregivers, and community and integration.

The full discussion of the framework can be found in the paper, High-Performance Revisited: Examining Long-Term Services and Supports System Performance. Below is a more detailed description of each revised category:

• Affordability and Access: Consumers can easily find and afford services, with meaningfully available safety net for those who cannot afford services. Safety net LTSS does not create disparities by income, by race/ethnicity, or by geography.
• Choice of Setting and Provider: A person- and family-centered approach allows for consumer choice and control of services (including self-directed models). A well-trained and adequately paid workforce is available to provide LTSS. Home and community-based services (HCBS) are widely available. Provider choice fosters equity, and consumers across communities have access to a range of culturally competent services and supports.
• Quality and Safety: Consumers are treated with respect and preferences are honored when possible, with services maximizing positive outcomes — including during and after care transitions. Residential facilities and HCBS settings are adequately staffed and are prepared for emergencies. Policy-, system-, and practice-level efforts reduce and/or prevent disparities in quality and outcomes.
• Support for Family Caregivers: Family caregivers’ needs are assessed and addressed, so they can receive the support they need to continue their essential roles. A robust LTSS workforce limits over-reliance on family caregivers. Family caregiver supports are culturally appropriate and accessible to all communities.
• Community and Integration: Consumers have access to a range of services and supports that facilitate LTSS, including safe and affordable housing. Communities are age-friendly, supported by state master plans for aging. Policy and programming that facilitates livable communities also drive equitable communities.