Between 2012 and 2013, a majority of states increased their spending on home- and community-based care, while spending on institutional long-term care settings decreased as nursing home populations declined or remained flat, according to the AARP Public Policy Institute’s 2013 report on long-term services and supports.
“[M]ost states continue to expand Medicaid home and community-based services (HCBS) waiver recipients and expenditures. Over 2012 and 2013, 80 percent of the  responding states indicated that HCBS waiver census has or will increase,” says AARP in At the Crossroads: Providing Long-Term Services and Supports at a Time of High Demand and Fiscal Constraint.
At least 34 states, including the District of Columbia, saw their spending on HCBS increase from 2012 to 2013, of the states that responded to the survey.
Six states—Arizona, Florida, Illinois, Maine, North Carolina, and West Virginia—did not provide any data regarding expenditure changes for HCBS from 2011 to 2012, and then 2012 to 2013.
Three more—Connecticut, Delaware, and Pennsylvania—did not give exact percentages, but indicated that expenditures had increased during those timeframes. Only two states, Missouri and New York, indicated their HCBS spending decreased from 2012 to 2013, both down by 5% or less.
Tennessee and Mississippi are the only two states where spending rose 15% or more last year, while the majority of states reported spending increases between 8-15% or less than 5%.
Several states reported plans to add personal care and assisted living options to Medicaid-funded waivers, including Indiana, North Dakota and South Carolina, while others such as Alabama and Massachusetts are expanding services for the Money Follows the Person program.
Almost three-fourths of responding states reported a continued decline or no change in the number of Medicaid nursing facility residents, but the remainder said they had “slight” increases in their Medicaid nursing home populations in 2012, says AARP.
View the entire AARP report on long-term services and supports.
Written by Alyssa Gerace