The SCAN Foundation

Some of the most vulnerable people needing long-term services and supports are the nine million Americans covered by both Medicare – the program for those over 65 and the disabled of all ages - and Medicaid, the health program for income individual. They are “among the “poorest, sickest, and highest cost people covered by both programs,” according to an August, 2009 report by the Kaiser Family Foundation, titled “Health Reform Opportunities: Improving Policy for Dual Eligible.”

Special fiscal relief from the federal government has helped state governments avoid cutting back enrollment in programs serving people who need long-term services and supports. Frequency of visits and reimbursement of providers have been trimmed, but enrollment has not. State budgets, which are already strained, are likely to be trimmed further when the federal stimulus money that has been providing additional support to state Medicaid programs expires in 2011. A November 2009 report, The Economic Crisis And Its Impact On State Aging Programs, from the National Association of State Units on Aging gives some grim figures:

Scientists are discovering that they “need a broader scientific perspective on late-life dementia,” because drug treatments aren’t making significant progress in slowing the disease, according to the December 19, 2009 announcement of an editorial in the Journal of the American Medical Association. This has significant impact for the debate over the best way to provide long-term services and supports for Americans.

Almost three million people are receiving long-term services and supports under Medicaid Home and Community-Based Service (HCBS) programs, according to the most recent data compiled by the Kaiser Family Foundation. Spending totaled $38 billion in 2006, an increase of 8% over the previous year’s figure as stated in the report Medicaid Home and Community-Based Service Programs: Data Update issued on December 18, 2009 by Kaiser.