Year of Publication



Martin School of Public Policy and Administration

Date Available


Executive Summary

Long term care for the elderly has been steadily gaining salience in the public policy realm for many years. The federal government has been vigorously studying and exploring solutions, including the Centers for Medicare and Medicaid Services’ (CMS) efforts to expand access to home and community-based services (HCBS) in order to reduce dependence on institutional care. These federal efforts include various incentive programs and policies recently offered under the Affordable Care Act. However, data on the strength of each state’s long term services and supports system has not been easily accessible until recently. The report “Raising Expectations: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers” (Reinhold 2014) measures twenty-six indicators across five dimensions of these supports systems in the states. Using five indicators related to public policy, I explore the relationship between a strong long term services and supports system and the percentage of low-care residents in nursing homes. The indicators used in the analysis have data ranging from 2008 to 2011 (see Research Design).

The results of my analysis reveal that two of the five public policy variables have a statistically significant effect on the dependent variable, the percentage of low-care residents in nursing homes. These two indicators are the Aging and Disability Resource Center Functions and the Percent of Medicaid and state-funded long term services and supports spending going to home and community based services for older people and adults with physical disabilities.



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.