New Scorecard Shows Where Pennsylvania Needs Improvement to Serve Older Adults and People with Disabilities

Americas, June 15 2017

HARRISBURG, PA.: Pennsylvania ranks 36th among all states when it comes to meeting the long-term care needs of older residents and people with disabilities, according to a new, state-by-state Scorecard produced by AARP with support of the nation’s leading organizations behind quality long-term care, The Commonwealth Fund and SCAN Foundation.

wheelchair userAARP warns that the Scorecard shows much more must be done, at an accelerated pace, to address the need for long-term services and supports in the face of changing demographic demands. Specific areas of concern in Pennsylvania include the affordability and access of long-term care and providing support for the state’s 1.6 million family caregivers.

Picking Up the Pace of Change: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers –the third in a series of reports—ranks each state overall and on 25 specific indicators in 5 key dimensions: affordability and access; choice of setting and provider; quality of life and quality of care; support for family caregivers; and, effective transitions between nursing homes, hospitals and homes.

“The vast majority of older Pennsylvanians want to live independently, at home, as they age—most with the help of unpaid family caregivers,” says Bill Johnston-Walsh, state director of AARP Pennsylvania  which serves more than 1.8 million members age 50 and older in Pennsylvania. “Even facing tight budgets, Pennsylvania is making some progress to help our older residents achieve that goal. However, this Scorecard shows we have more to do, and we need to pick up the pace.”

Today, unpaid family caregivers provide the bulk of care for older Pennsylvanians, in part because the cost of long-term care remains unaffordable for most middle income families. In Pennsylvania, more than 1.6 million residents help their aging parents, spouses and other loved ones stay at home by providing assistance with bathing and dressing, transportation, finances, complex medical tasks like wound care and injections, and more. The value of this unpaid care totals about $19 billion annually.

“When it comes to helping older Pennsylvanians live in the setting of their choice, family caregivers take on big responsibilities,” explains Johnston-Walsh. “Many juggle full-time jobs with their caregiving duties; others provide 24/7 care for their loved ones. With every task they undertake, these family caregivers save the state money by keeping their loved ones out of costly nursing homes – most often paid for by Medicaid. They have earned some basic support.”

The Scorecard shows Pennsylvania ranks 43rd nationally in supporting family caregivers. To help provide additional assistance to caregivers, AARP Pennsylvania is fighting to modernize outdated rules that will broaden the scope of practice for nurse practitioners and allow them to use all their advanced training and skills to care for patients—when and where care is needed. The Association is also fighting to allow nurses in Pennsylvania to delegate basic health maintenance tasks to home aides, giving nurses more time and opportunity to focus on treating patients and supporting family caregivers.

“Pennsylvania has made some progress to improve long-term services and supports for older adults and people with disabilities, as highlighted in this Scorecard. But, proposals in Washington, D.C. to drastically cut federal funding for Pennsylvania’s Medicaid program would threaten these advancements, likely resulting in our most vulnerable citizens losing the lifesaving supports that they count on,” says Johnston-Walsh.

The single strongest predictor of a state’s long-term care system is the reach of its Medicaid safety net. That’s why AARP Pennsylvania is also fighting to expand services provided at home and in the community, by shifting funds away from undesirable and more expensive nursing home care. The Scorecard highlights additional concerns related to institutional care in Pennsylvania, including high costs, the duration of stays and successfully transitioning patients back into the community.

The Scorecard ranks Pennsylvania 30th in the percentage of Medicaid long-term care dollars for older adults and people with physical disabilities that support care provided at home and in the community—the care setting that most older residents prefer. In fact, just 31% of Medicaid and state-funded spending for long term services and supports goes to home and community-based services for older people and adults with physical disabilities.

The Scorecard reveals that in less than 10 years, Boomers will begin to turn 80, placing new expectations and demands on a still imperfect long-term care system. Further, this generation will have far fewer potential family caregivers to provide unpaid help.

Of the 25 indicators measured on the Scorecard, many may be improved through state policy changes, pointing to the importance of AARP’s multi-state advocacy campaign, launched in 2014, to help older Americans live independently, at home, and to support the family caregivers that support them.

“This Scorecard gives us a snapshot of how well Pennsylvania serves our older residents, those with disabilities, and family caregivers—and shows us where we must sharpen our focus to better assist hardworking Pennsylvanians,” concludes Johnston-Walsh. “Now is the time for policymakers to act.”

The full state Scorecard, along with an interactive map of state rankings and information, is available at

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