Warning (2): include(/var/www/vhosts/vcc_staging/app/Resource/aarp2_master.head.html): failed to open stream: No such file or directory [APP/View/Layouts/aarp_2023.ctp, line 53]Code Context<?php // if (!$nowrapper) (Globals::$language == 'es') ? include(APP . "/Resource/aarpe_global_js_es.html") : include(APP . "/Resource/aarpe_global_js.html"); ?>
<?php if (!$nowrapper): // MLW - Spanish wrappers TBD
include (APP . "Resource/aarp2_master.head.html");
$viewFile = '/var/www/vhosts/vcc_staging/app/View/Layouts/aarp_2023.ctp' $dataForView = array( 'content_for_layout' => '<div class="row twoColumnLayout"> <div class="col-md-8 left-rail"><div class="module clearfix"><div class="ar-basic-box"> <div> <div class="module-spacer"> <header><h1 class="article-headline">How Mid-Atlantic States Are Expanding Home Care</h1></header> <div class="posted-on"> Posted on 12/03/23 by <b>Ann Hardie</b> </div> </div> <div class="module-spacer"> <span class="blog-content"><p><div class="RichTextArticleBody"> <div class="RichTextArticleBody-body"><p>John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The 55-year-old from Dover, Delaware, goes to work every day, helps his 8-year-old son with basketball drills and watches his beloved Philadelphia Eagles with friends at Buffalo Wild Wings.<br><br>McNeal does so with the assistance of direct-care workers who help him get dressed in the morning, fix his meals and drive him where he needs to go.<br><br>“My life is unique in that I have a significant disability,” says McNeal, director of Delaware’s State Council for Persons with Disabilities. But, he says, it’s “a productive life that is every bit as normal as anybody else’s.”<br><br>Across the country, states such as Delaware are spending a growing percentage of long-term care funding to keep people in their homes and communities instead of institutional settings. That’s according to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023" target="_blank" rel="noopener noreferrer">AARP’s most recent Long-Term Services and Supports State Scorecard</a></span></span>, which uses 50 spending, quality and access indicators to rank each state’s long-term care system.<br><br>The new data shows that for the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid’s long-term care dollars nationally for older people and adults with physical disabilities went to home- and community-based services instead of nursing homes or other facilities.<br></p><p class="cms-textAlign-center"><b>EXPLORE: </b><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/" target="_blank" rel="noopener noreferrer"><b>AARP Long-Term Care Scorecard</b></a></span></span></p><p>“This is a big deal. We are seeing a breaking point,” says Susan Reinhard, senior vice president of the AARP Public Policy Institute, which published the Scorecard in September.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/da/c2/a471a2d346088edaf8c38a8b7a46/midalantic.png" alt="midalantic.png" width="6900" height="5761"/> <figcaption class="Figure-caption">Nicolas Rapp</figcaption> </figure> </div> </div><p>The shift to home- and community-based services comes as demand for such care has increased, fueled in part by a pandemic that took a horrific toll on nursing home residents. Polls have consistently shown that most older Americans want to age in place. A 2021 AARP survey found that more than three-quarters of adults 50-plus say they want to remain in their homes as they grow older.<br><br>But with America’s population of older adults growing, the chasm between the availability of HCBS and access to such services is poised to widen. <br><br>“We’re going to see a dramatic increase in the 80-plus and 85-plus population” as the boomer generation gets older, says Robert Applebaum, a senior research scholar at Miami University’s Scripps Gerontology Center in Ohio. “So the demand for long-term services ... is going to be tremendous.”<br><br><b><u>A person-centered approach</u></b><br><br>In the Mid-Atlantic region, Delaware, the District of Columbia, Maryland, New Jersey and West Virginia have all increased the percentage of their Medicaid dollars going to HCBS for older people and adults with physical disabilities in recent years, the Scorecard shows. One way they are doing that: giving more older adults the power to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">direct their own care</a></span></span>, funded through Medicaid initiatives. (Medicaid, a joint federal-state program for low-income Americans, includes coverage for nursing homes and other long-term care.) <br><br>Enrollment in these <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">“self-directed” care </a></span></span>programs increased by 10 percent or more across 34 states and the District of Columbia in recent years, the Scorecard shows. Such programs give people a greater say over how to spend government dollars on their own care.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/25/1e/2926ddba4cd09d7af135e7604561/1140-inset1-de-john-mcneal.jpg" alt="John McNeal, Director of the State Council for Persons with Disabilities for the State of Delaware, photographed at his office in Dover DE for AARP Bulletin, 7 December 2023. Photo by Mike Morgan." width="655" height="1140" style="height: auto; max-width: 380px;"/> <figcaption class="Figure-caption">John McNeal exits his car. Photo by Mike Morgan.</figcaption> </figure> </div> </div><p>“It’s like the ultimate person-centered approach,” says Lisa Alecxih, who researches long-term care for The Lewin Group, a health care and human services consulting firm. She notes that such programs often have the added benefit of allowing participants to hire family members as caregivers. That’s crucial because there’s a national shortage of direct-care workers.<br><br>Applebaum says his research on self-directed programs has also shown the satisfaction levels were “beyond anything I’ve ever seen as an evaluator.”<br><br>McNeal, the Delaware disability advocate, says that’s certainly true for him. “This is probably the most important program that has come into my life,” he says. “It has allowed me the opportunity to have everything that anybody else in the community has.”<br><br><b><u>Growing demand, workforce crunch</u></b><br><br>Self-directed services are one of many state-level innovations highlighted in the Scorecard as a way states can meet the growing demand for home- and community-based care. In the Mid-Atlantic region, D.C., Virginia and New Jersey posted the highest numbers of people enrolled in self-directed programs relative to their disabled populations.<br><br>Pennsylvania is the only state in the region that did not see an increase, but that could change as Jason Kavulich—who became Pennsylvania’s Secretary of Aging in January 2023—leads the state’s effort to develop a 10-year master plan for aging. “It is our top-most priority to make sure that people can age in place, how they choose, and to make sure that the services that we have really are responsive,” Kavulich says.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/90/ca/722b3834468a82b147701fcee20d/midatlanticranks.png" alt="midatlanticranks.png" width="3166" height="6717" style="height: auto; max-width: 350px;"/> </figure> </div> </div><p>One of the biggest challenges states face in expanding HCBS is the <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">shortage of</a></span></span> <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">direct-care workers</a></span></span> to fill those jobs. The work can be emotionally and physically taxing and usually comes with low pay, poor benefits and limited support and training.<br><br>The Scorecard shows that across the U.S., wages for direct-care workers are lower than in jobs with similar or lower entry requirements. Their median income is about $30,000 a year—approximately $5,000 less than workers in comparable jobs are paid in most states. D.C. has the highest wage gap in the country, with direct-care workers earning $5.03 less per hour than their counterparts in other sectors.<br><br>“I’m in competition with fast-food places. It’s as simple as that,” says 63-year-old Keith Williams of Clarks Green, Pennsylvania, outside Scranton. He was born with arthrogryposis, a combination of conditions that causes joint contractures and weak muscles.<br><br>Through a self-directed program, he hires care workers to help him with everything from showering to eating. He recruits through word of mouth and online postings. When that fails, he hires his sister-in-law.<br><br>It’s not easy, says Williams, the manager of independent living services for the Northeast Pennsylvania Center for Independent Living, a community-based organization staffed in part by people with disabilities. But the control he has over his care has allowed him to have a meaningful life.<br><br>“It’s meant that I’ve been able to live life on my own terms,” he says.<br><br><i>Ann Hardie spent a decade covering aging issues for The Atlanta Journal-Constitution. She has written for the Bulletin for 15 years.</i><br><br><b>More on Home Care</b><br></p><ul><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2023/rise-of-companion-care.html" target="_blank" rel="noopener noreferrer">Care Companions: A Watchful Eye and Willing Ear for Older Adults</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2019/home-health-aides.html" target="_blank" rel="noopener noreferrer">Find the Right Home Aide for Your Loved One</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://press.aarp.org/2021-11-18-AARP-Survey-Shows-8-in-10-Older-Adults-Want-to-Age-in-Their-Homes-While-Number-and-Needs-of-Households-Headed-Older-Adults-Grow-Dramatically" target="_blank" rel="noopener noreferrer">AARP Survey: 8 in 10 Older Adults Want to Age at Home</a></span></span></li></ul><div class="Enhancement" > <div class="Enhancement-item"><span class="VideoEnhancement" data-video-disable-history data-embeddedvideo-container> <div class="VideoEnhancement-player"><bsp-brightcoveplayer data-video-player class="BrightcoveVideoPlayer" data-account="3772599298001" data-player="KM9xJAJa4" data-video-id="5754403576001" data-video-title="How In-Home Care Helps — AARP" > <video class="video-js" id="BrightcoveVideoPlayer-5754403576001" data-video-id="5754403576001" data-account="" data-player="KM9xJAJa4" data-embed="default" controls ></video> </bsp-brightcoveplayer> </div> <div class="VideoEnhancement-title">How In-Home Care Helps — AARP</div> </span> </div> </div><p></p></div> </div> </p></span> </div> </div> </div> </div><div class="module clearfix"><script src="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.c85a242a55150cd195e494cd6e5b9c77.gz.js" async=""></script> <link rel="stylesheet" media="all" href="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.bfe6eb5a8301841feef3af4e9bd1e26d.gz.css"> <!-- bypass --> <style> a:focus, a:hover { text-decoration: underline; } h1.article-headline { margin: 0 0 1rem; } </style> <!-- <style> .Enhancement-item .Figure { margin-bottom: 24px; } .RichTextArticleBody-body ul { margin-bottom: 24px; } .RichTextArticleBody-body p{ margin: 12px 0; } .RichTextModule-items { clear: both; display: table; width: 100%; margin-bottom: 12px; } .VideoEnhancement>* { color: var(--primaryTextColor); font-size: 13px; font-weight: 400; line-height: 1.4; font-style: italic; background: #f0efed } @media only screen and (min-width: 768px) { .VideoEnhancement>* { font-size:14px; font-weight: 400; line-height: 1.47 } } .VideoEnhancement-title { padding: 20px } @media only screen and (min-width: 768px) { .VideoEnhancement-title { padding:30px } } .VideoEnhancement-player>* { position: relative; width: 100%; height: 0; padding-bottom: 56.25% } .VideoEnhancement iframe { border: 0; position: absolute; top: 0; left: 0; width: 100%; height: 100% } [data-video-player] { display: block; padding-bottom: 56.25%; height: 0; margin: 0 auto; } [data-video-player][data-aspect-ratio="4x3"] { padding-bottom: 56.25%; } [data-video-player][data-aspect-ratio="16x9"] { padding-bottom: 56.25% } </style> --></div><div class="module clearfix"><div class="module-spacer tout-homefit-750"> <a data-formelementid="CSN-LOCAL-HC-NEWSSK-02272024" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-HC-NEWSSK-02272024"><img class="img-responsive" alt="Explore the free AARP HomeFit Guide" title="Explore the free AARP HomeFit Guide" src="https://cdn-aarp.americantowns.com/img/touts/HomeFit_750x150.png"></a> </div></div></div> <div class="col-md-4 right-rail thin-rhs"><div class="module clearfix"><!--default--> <!-- module_RHS - AARP Events --> <div class="ar-basic-box module-spacer"> <header> <div class="pull-right"> <a href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS"> <img style="width:30px;" src="https://cdn-aarp.americantowns.com/img/template/icons/aarp_event_icon.png" alt="Upcoming AARP Events" /> </a> </div> <h2 class="visible-lg">AARP Events for Washington</h2> <h2 class="hidden-lg">AARP Events for Washington</h2> </header> <div class="wrap"> <div class="ar-listing snippet"> <ul class="list"> <li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-co-virtual-functional-fitness-online-99-10142024-sgnszx3wwws.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-FUNCTIONAL-FITNESS-WITH-BASIC-BODY-MOVEMENTS">Functional Fitness with Basic Body Movements</a></h2> <p class="time">Monday, Oct 7, 2024 at 9:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-nm-tai-ji-quan-moving-for-better-balance-albuquerque-nm-100724-j7nhvzxdkxd.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TAI-JI-QUAN-MOVING-FOR-BETTER-BALANCE">Tai Ji Quan: Moving for Better Balance</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/virtual-aarp-tx-mobility-mondays-houston-tx-100724-f5n2bjqhntc.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TRY-A-LOWIMPACT-WORKOUT-TO-IMPROVE-MOBILITY">Try A Low-Impact Workout to Improve Mobility</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom and Facebook</p> <p class="loc">Online Event</p> </li> </ul> <p><a class="link-red" href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS">View All AARP Events<i class="ml-1 fas fa-chevron-right"></i></a></p> </div> </div> </div> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_53475" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_53475', size:'300x250'}); } </script> </div> </div> <div class="card-tout card-dark membership-tout" style="margin:0 0 30px 0;"> <img class="img-responsive image" title="image of two AARP membership cards" alt="image of two AARP membership cards" src="https://cdn-aarp.americantowns.com/img/tout-two-cards.png"> <div class="title">Only $12 your first year with Automatic Renewal</div> <ul class="list"> <li>Immediate access to your <a href="https://www.aarp.org/benefits-discounts/">member benefits</a></li> <li>Discounts on travel and everyday savings</li> <li>Subscription to AARP The Magazine</li> <li>FREE second membership</li> </ul> <div class="action"> <a class="btn" href="https://appsec.aarp.org/mem/join?campaignid=UAJFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Join AARP</a> <div class="body">Already a member? <a href="https://appsec.aarp.org/mem/renew?campaignid= UARFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Renew</a> or <a href="https://www.aarp.org/benefits-discounts/my-membership/print-your-card/">Print Card</a></div> </div> </div> <style> .membership-tout {padding:16px 20px;} .membership-tout .list li { margin: 0; } </style> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_93505" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_93505', size:'300x250'}); } </script> </div> </div> <div class="module-spacer text-center"> <div class="fb-page" alt="Image of AARP District of Columbia Facebook Page" title="Image of AARP District of Columbia Facebook Page" data-href="https://www.facebook.com/aarpdc" data-tabs="timeline" width="320" height="" data-small-header="false" data-adapt-container-width="true" data-hide-cover="false" data-show-facepile="true" lazy="true"> <blockquote cite="https://www.facebook.com/aarpdc" class="fb-xfbml-parse-ignore"><a href="https://www.facebook.com/aarpdc">Facebook</a></blockquote> </div> </div> <div class="ar-basic-box module-spacer"> <header> <h2>Contact AARP<br />District of Columbia</h2> </header> <div class="wrap"> <div class="ar-quick-list module-spacer"> <ul class="list-unstyled"> <li><i class="list-icon fa fa-envelope" alt="Email icon" title="Email icon" aria-hidden="true"></i><a href="mailto:DCAARP@aarp.org " target="_blank" rel="noopener">DCAARP@aarp.org </a></li> <li><i class="list-icon fa fa-globe" alt="Globe icon" title="Globe icon" aria-hidden="true"></i><a href="https://states.aarp.org/region/washington-dc/" target="_blank" rel="noopener">AARP Washington, DC</a></li> <li><i class="list-icon fa fa-map-marker" alt="Map Marker icon" title="Map Marker icon" aria-hidden="true"></i><a href="https://states.aarp.org/aarp-district-of-columbia-state-office/?intcmp=SNG-LNK-AARPLOCAL-CONTACT-20140101-WASHINGTON-DC" target="_blank" rel="noopener">Contact Us</a></li> </ul> </div> <a href="https://www.facebook.com/aarpdc" target="_blank" rel="noopener" aria-label="Open Facebook"><img alt="Facebook icon" title="Facebook icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/facebook-dreamstale25.png"></a> <a href="https://twitter.com/AARPDC" target="_blank" rel="noopener" aria-label="Open Twitter"><img alt="Twitter icon" title="Twitter icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/x-logo-black.png"></a> </div> </div> </div></div> <div class="col-md-8 left-rail left-bot"></div> <div class="col-md-4 right-rail right-bot thin-rhs"></div> </div> <div class="row oneColumnLayout"> </div> <div class="row oneColumnLayout"> <div class="col-md-12"><!-- script to activate navbar --> <script type="text/javascript"> jQuery(".channelBarMain ul.left li a").click(function() { window.location = jQuery(this).attr('href'); }); </script> </div> </div> ', 'scripts_for_layout' => '<title>How Mid-Atlantic States Are Expanding Home Care</title> <meta name="page_title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="robots" content="noindex, nofollow"/> <meta content="John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The" name="description"/> <meta content="How, Mid, Atlantic, States, Expanding, Home, Care" name="keywords"/> <link rel="canonical" href="https://states.aarp.org/ltss-in-the-mid-atlantic" /> <meta property="og:url" content="https://vccstaging.local.aarp.org/news/how-midatlantic-states-are-expanding-home-care-2023-12-03.html"/> <meta name="twitter:card" content="summary_large_image"/> <meta name="twitter:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="twitter:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta name="twitter:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> <meta property="og:type" content="article"/> <meta property="og:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta property="og:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta property="og:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }', 'title_for_layout' => '{local_city_c}, {local_state} Happenings - AARP' ) $content_for_layout = '<div class="row twoColumnLayout"> <div class="col-md-8 left-rail"><div class="module clearfix"><div class="ar-basic-box"> <div> <div class="module-spacer"> <header><h1 class="article-headline">How Mid-Atlantic States Are Expanding Home Care</h1></header> <div class="posted-on"> Posted on 12/03/23 by <b>Ann Hardie</b> </div> </div> <div class="module-spacer"> <span class="blog-content"><p><div class="RichTextArticleBody"> <div class="RichTextArticleBody-body"><p>John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The 55-year-old from Dover, Delaware, goes to work every day, helps his 8-year-old son with basketball drills and watches his beloved Philadelphia Eagles with friends at Buffalo Wild Wings.<br><br>McNeal does so with the assistance of direct-care workers who help him get dressed in the morning, fix his meals and drive him where he needs to go.<br><br>“My life is unique in that I have a significant disability,” says McNeal, director of Delaware’s State Council for Persons with Disabilities. But, he says, it’s “a productive life that is every bit as normal as anybody else’s.”<br><br>Across the country, states such as Delaware are spending a growing percentage of long-term care funding to keep people in their homes and communities instead of institutional settings. That’s according to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023" target="_blank" rel="noopener noreferrer">AARP’s most recent Long-Term Services and Supports State Scorecard</a></span></span>, which uses 50 spending, quality and access indicators to rank each state’s long-term care system.<br><br>The new data shows that for the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid’s long-term care dollars nationally for older people and adults with physical disabilities went to home- and community-based services instead of nursing homes or other facilities.<br></p><p class="cms-textAlign-center"><b>EXPLORE: </b><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/" target="_blank" rel="noopener noreferrer"><b>AARP Long-Term Care Scorecard</b></a></span></span></p><p>“This is a big deal. We are seeing a breaking point,” says Susan Reinhard, senior vice president of the AARP Public Policy Institute, which published the Scorecard in September.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/da/c2/a471a2d346088edaf8c38a8b7a46/midalantic.png" alt="midalantic.png" width="6900" height="5761"/> <figcaption class="Figure-caption">Nicolas Rapp</figcaption> </figure> </div> </div><p>The shift to home- and community-based services comes as demand for such care has increased, fueled in part by a pandemic that took a horrific toll on nursing home residents. Polls have consistently shown that most older Americans want to age in place. A 2021 AARP survey found that more than three-quarters of adults 50-plus say they want to remain in their homes as they grow older.<br><br>But with America’s population of older adults growing, the chasm between the availability of HCBS and access to such services is poised to widen. <br><br>“We’re going to see a dramatic increase in the 80-plus and 85-plus population” as the boomer generation gets older, says Robert Applebaum, a senior research scholar at Miami University’s Scripps Gerontology Center in Ohio. “So the demand for long-term services ... is going to be tremendous.”<br><br><b><u>A person-centered approach</u></b><br><br>In the Mid-Atlantic region, Delaware, the District of Columbia, Maryland, New Jersey and West Virginia have all increased the percentage of their Medicaid dollars going to HCBS for older people and adults with physical disabilities in recent years, the Scorecard shows. One way they are doing that: giving more older adults the power to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">direct their own care</a></span></span>, funded through Medicaid initiatives. (Medicaid, a joint federal-state program for low-income Americans, includes coverage for nursing homes and other long-term care.) <br><br>Enrollment in these <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">“self-directed” care </a></span></span>programs increased by 10 percent or more across 34 states and the District of Columbia in recent years, the Scorecard shows. Such programs give people a greater say over how to spend government dollars on their own care.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/25/1e/2926ddba4cd09d7af135e7604561/1140-inset1-de-john-mcneal.jpg" alt="John McNeal, Director of the State Council for Persons with Disabilities for the State of Delaware, photographed at his office in Dover DE for AARP Bulletin, 7 December 2023. Photo by Mike Morgan." width="655" height="1140" style="height: auto; max-width: 380px;"/> <figcaption class="Figure-caption">John McNeal exits his car. Photo by Mike Morgan.</figcaption> </figure> </div> </div><p>“It’s like the ultimate person-centered approach,” says Lisa Alecxih, who researches long-term care for The Lewin Group, a health care and human services consulting firm. She notes that such programs often have the added benefit of allowing participants to hire family members as caregivers. That’s crucial because there’s a national shortage of direct-care workers.<br><br>Applebaum says his research on self-directed programs has also shown the satisfaction levels were “beyond anything I’ve ever seen as an evaluator.”<br><br>McNeal, the Delaware disability advocate, says that’s certainly true for him. “This is probably the most important program that has come into my life,” he says. “It has allowed me the opportunity to have everything that anybody else in the community has.”<br><br><b><u>Growing demand, workforce crunch</u></b><br><br>Self-directed services are one of many state-level innovations highlighted in the Scorecard as a way states can meet the growing demand for home- and community-based care. In the Mid-Atlantic region, D.C., Virginia and New Jersey posted the highest numbers of people enrolled in self-directed programs relative to their disabled populations.<br><br>Pennsylvania is the only state in the region that did not see an increase, but that could change as Jason Kavulich—who became Pennsylvania’s Secretary of Aging in January 2023—leads the state’s effort to develop a 10-year master plan for aging. “It is our top-most priority to make sure that people can age in place, how they choose, and to make sure that the services that we have really are responsive,” Kavulich says.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/90/ca/722b3834468a82b147701fcee20d/midatlanticranks.png" alt="midatlanticranks.png" width="3166" height="6717" style="height: auto; max-width: 350px;"/> </figure> </div> </div><p>One of the biggest challenges states face in expanding HCBS is the <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">shortage of</a></span></span> <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">direct-care workers</a></span></span> to fill those jobs. The work can be emotionally and physically taxing and usually comes with low pay, poor benefits and limited support and training.<br><br>The Scorecard shows that across the U.S., wages for direct-care workers are lower than in jobs with similar or lower entry requirements. Their median income is about $30,000 a year—approximately $5,000 less than workers in comparable jobs are paid in most states. D.C. has the highest wage gap in the country, with direct-care workers earning $5.03 less per hour than their counterparts in other sectors.<br><br>“I’m in competition with fast-food places. It’s as simple as that,” says 63-year-old Keith Williams of Clarks Green, Pennsylvania, outside Scranton. He was born with arthrogryposis, a combination of conditions that causes joint contractures and weak muscles.<br><br>Through a self-directed program, he hires care workers to help him with everything from showering to eating. He recruits through word of mouth and online postings. When that fails, he hires his sister-in-law.<br><br>It’s not easy, says Williams, the manager of independent living services for the Northeast Pennsylvania Center for Independent Living, a community-based organization staffed in part by people with disabilities. But the control he has over his care has allowed him to have a meaningful life.<br><br>“It’s meant that I’ve been able to live life on my own terms,” he says.<br><br><i>Ann Hardie spent a decade covering aging issues for The Atlanta Journal-Constitution. She has written for the Bulletin for 15 years.</i><br><br><b>More on Home Care</b><br></p><ul><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2023/rise-of-companion-care.html" target="_blank" rel="noopener noreferrer">Care Companions: A Watchful Eye and Willing Ear for Older Adults</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2019/home-health-aides.html" target="_blank" rel="noopener noreferrer">Find the Right Home Aide for Your Loved One</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://press.aarp.org/2021-11-18-AARP-Survey-Shows-8-in-10-Older-Adults-Want-to-Age-in-Their-Homes-While-Number-and-Needs-of-Households-Headed-Older-Adults-Grow-Dramatically" target="_blank" rel="noopener noreferrer">AARP Survey: 8 in 10 Older Adults Want to Age at Home</a></span></span></li></ul><div class="Enhancement" > <div class="Enhancement-item"><span class="VideoEnhancement" data-video-disable-history data-embeddedvideo-container> <div class="VideoEnhancement-player"><bsp-brightcoveplayer data-video-player class="BrightcoveVideoPlayer" data-account="3772599298001" data-player="KM9xJAJa4" data-video-id="5754403576001" data-video-title="How In-Home Care Helps — AARP" > <video class="video-js" id="BrightcoveVideoPlayer-5754403576001" data-video-id="5754403576001" data-account="" data-player="KM9xJAJa4" data-embed="default" controls ></video> </bsp-brightcoveplayer> </div> <div class="VideoEnhancement-title">How In-Home Care Helps — AARP</div> </span> </div> </div><p></p></div> </div> </p></span> </div> </div> </div> </div><div class="module clearfix"><script src="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.c85a242a55150cd195e494cd6e5b9c77.gz.js" async=""></script> <link rel="stylesheet" media="all" href="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.bfe6eb5a8301841feef3af4e9bd1e26d.gz.css"> <!-- bypass --> <style> a:focus, a:hover { text-decoration: underline; } h1.article-headline { margin: 0 0 1rem; } </style> <!-- <style> .Enhancement-item .Figure { margin-bottom: 24px; } .RichTextArticleBody-body ul { margin-bottom: 24px; } .RichTextArticleBody-body p{ margin: 12px 0; } .RichTextModule-items { clear: both; display: table; width: 100%; margin-bottom: 12px; } .VideoEnhancement>* { color: var(--primaryTextColor); font-size: 13px; font-weight: 400; line-height: 1.4; font-style: italic; background: #f0efed } @media only screen and (min-width: 768px) { .VideoEnhancement>* { font-size:14px; font-weight: 400; line-height: 1.47 } } .VideoEnhancement-title { padding: 20px } @media only screen and (min-width: 768px) { .VideoEnhancement-title { padding:30px } } .VideoEnhancement-player>* { position: relative; width: 100%; height: 0; padding-bottom: 56.25% } .VideoEnhancement iframe { border: 0; position: absolute; top: 0; left: 0; width: 100%; height: 100% } [data-video-player] { display: block; padding-bottom: 56.25%; height: 0; margin: 0 auto; } [data-video-player][data-aspect-ratio="4x3"] { padding-bottom: 56.25%; } [data-video-player][data-aspect-ratio="16x9"] { padding-bottom: 56.25% } </style> --></div><div class="module clearfix"><div class="module-spacer tout-homefit-750"> <a data-formelementid="CSN-LOCAL-HC-NEWSSK-02272024" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-HC-NEWSSK-02272024"><img class="img-responsive" alt="Explore the free AARP HomeFit Guide" title="Explore the free AARP HomeFit Guide" src="https://cdn-aarp.americantowns.com/img/touts/HomeFit_750x150.png"></a> </div></div></div> <div class="col-md-4 right-rail thin-rhs"><div class="module clearfix"><!--default--> <!-- module_RHS - AARP Events --> <div class="ar-basic-box module-spacer"> <header> <div class="pull-right"> <a href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS"> <img style="width:30px;" src="https://cdn-aarp.americantowns.com/img/template/icons/aarp_event_icon.png" alt="Upcoming AARP Events" /> </a> </div> <h2 class="visible-lg">AARP Events for Washington</h2> <h2 class="hidden-lg">AARP Events for Washington</h2> </header> <div class="wrap"> <div class="ar-listing snippet"> <ul class="list"> <li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-co-virtual-functional-fitness-online-99-10142024-sgnszx3wwws.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-FUNCTIONAL-FITNESS-WITH-BASIC-BODY-MOVEMENTS">Functional Fitness with Basic Body Movements</a></h2> <p class="time">Monday, Oct 7, 2024 at 9:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-nm-tai-ji-quan-moving-for-better-balance-albuquerque-nm-100724-j7nhvzxdkxd.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TAI-JI-QUAN-MOVING-FOR-BETTER-BALANCE">Tai Ji Quan: Moving for Better Balance</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/virtual-aarp-tx-mobility-mondays-houston-tx-100724-f5n2bjqhntc.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TRY-A-LOWIMPACT-WORKOUT-TO-IMPROVE-MOBILITY">Try A Low-Impact Workout to Improve Mobility</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom and Facebook</p> <p class="loc">Online Event</p> </li> </ul> <p><a class="link-red" href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS">View All AARP Events<i class="ml-1 fas fa-chevron-right"></i></a></p> </div> </div> </div> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_53475" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_53475', size:'300x250'}); } </script> </div> </div> <div class="card-tout card-dark membership-tout" style="margin:0 0 30px 0;"> <img class="img-responsive image" title="image of two AARP membership cards" alt="image of two AARP membership cards" src="https://cdn-aarp.americantowns.com/img/tout-two-cards.png"> <div class="title">Only $12 your first year with Automatic Renewal</div> <ul class="list"> <li>Immediate access to your <a href="https://www.aarp.org/benefits-discounts/">member benefits</a></li> <li>Discounts on travel and everyday savings</li> <li>Subscription to AARP The Magazine</li> <li>FREE second membership</li> </ul> <div class="action"> <a class="btn" href="https://appsec.aarp.org/mem/join?campaignid=UAJFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Join AARP</a> <div class="body">Already a member? <a href="https://appsec.aarp.org/mem/renew?campaignid= UARFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Renew</a> or <a href="https://www.aarp.org/benefits-discounts/my-membership/print-your-card/">Print Card</a></div> </div> </div> <style> .membership-tout {padding:16px 20px;} .membership-tout .list li { margin: 0; } </style> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_93505" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_93505', size:'300x250'}); } </script> </div> </div> <div class="module-spacer text-center"> <div class="fb-page" alt="Image of AARP District of Columbia Facebook Page" title="Image of AARP District of Columbia Facebook Page" data-href="https://www.facebook.com/aarpdc" data-tabs="timeline" width="320" height="" data-small-header="false" data-adapt-container-width="true" data-hide-cover="false" data-show-facepile="true" lazy="true"> <blockquote cite="https://www.facebook.com/aarpdc" class="fb-xfbml-parse-ignore"><a href="https://www.facebook.com/aarpdc">Facebook</a></blockquote> </div> </div> <div class="ar-basic-box module-spacer"> <header> <h2>Contact AARP<br />District of Columbia</h2> </header> <div class="wrap"> <div class="ar-quick-list module-spacer"> <ul class="list-unstyled"> <li><i class="list-icon fa fa-envelope" alt="Email icon" title="Email icon" aria-hidden="true"></i><a href="mailto:DCAARP@aarp.org " target="_blank" rel="noopener">DCAARP@aarp.org </a></li> <li><i class="list-icon fa fa-globe" alt="Globe icon" title="Globe icon" aria-hidden="true"></i><a href="https://states.aarp.org/region/washington-dc/" target="_blank" rel="noopener">AARP Washington, DC</a></li> <li><i class="list-icon fa fa-map-marker" alt="Map Marker icon" title="Map Marker icon" aria-hidden="true"></i><a href="https://states.aarp.org/aarp-district-of-columbia-state-office/?intcmp=SNG-LNK-AARPLOCAL-CONTACT-20140101-WASHINGTON-DC" target="_blank" rel="noopener">Contact Us</a></li> </ul> </div> <a href="https://www.facebook.com/aarpdc" target="_blank" rel="noopener" aria-label="Open Facebook"><img alt="Facebook icon" title="Facebook icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/facebook-dreamstale25.png"></a> <a href="https://twitter.com/AARPDC" target="_blank" rel="noopener" aria-label="Open Twitter"><img alt="Twitter icon" title="Twitter icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/x-logo-black.png"></a> </div> </div> </div></div> <div class="col-md-8 left-rail left-bot"></div> <div class="col-md-4 right-rail right-bot thin-rhs"></div> </div> <div class="row oneColumnLayout"> </div> <div class="row oneColumnLayout"> <div class="col-md-12"><!-- script to activate navbar --> <script type="text/javascript"> jQuery(".channelBarMain ul.left li a").click(function() { window.location = jQuery(this).attr('href'); }); </script> </div> </div> ' $scripts_for_layout = '<title>How Mid-Atlantic States Are Expanding Home Care</title> <meta name="page_title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="robots" content="noindex, nofollow"/> <meta content="John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The" name="description"/> <meta content="How, Mid, Atlantic, States, Expanding, Home, Care" name="keywords"/> <link rel="canonical" href="https://states.aarp.org/ltss-in-the-mid-atlantic" /> <meta property="og:url" content="https://vccstaging.local.aarp.org/news/how-midatlantic-states-are-expanding-home-care-2023-12-03.html"/> <meta name="twitter:card" content="summary_large_image"/> <meta name="twitter:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="twitter:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta name="twitter:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> <meta property="og:type" content="article"/> <meta property="og:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta property="og:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta property="og:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }' $title_for_layout = '{local_city_c}, {local_state} Happenings - AARP' $asset_version = '230831' $min = true $nowrapper = false $css = ' :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }'include - APP/View/Layouts/aarp_2023.ctp, line 53 include - APP/View/Layouts/aarp_2023.ctp, line 53 View::_evaluate() - CORE/Cake/View/View.php, line 971 View::_render() - CORE/Cake/View/View.php, line 933 View::renderLayout() - CORE/Cake/View/View.php, line 546 View::render() - CORE/Cake/View/View.php, line 481 Controller::render() - CORE/Cake/Controller/Controller.php, line 963 AppController::renderPage() - APP/Controller/AppController.php, line 136 BlogsController::display() - APP/Controller/BlogsController.php, line 81 ReflectionMethod::invokeArgs() - [internal], line ?? Controller::invokeAction() - CORE/Cake/Controller/Controller.php, line 491 Dispatcher::_invoke() - CORE/Cake/Routing/Dispatcher.php, line 193 Dispatcher::dispatch() - CORE/Cake/Routing/Dispatcher.php, line 167 [main] - APP/webroot/index.php, line 118
Warning (2): include() [<a href='http://php.net/function.include'>function.include</a>]: Failed opening '/var/www/vhosts/vcc_staging/app/Resource/aarp2_master.head.html' for inclusion (include_path='/var/www/vhosts/vcc_staging/lib:.:/usr/share/pear:/usr/share/php') [APP/View/Layouts/aarp_2023.ctp, line 53]Code Context<?php // if (!$nowrapper) (Globals::$language == 'es') ? include(APP . "/Resource/aarpe_global_js_es.html") : include(APP . "/Resource/aarpe_global_js.html"); ?>
<?php if (!$nowrapper): // MLW - Spanish wrappers TBD
include (APP . "Resource/aarp2_master.head.html");
$viewFile = '/var/www/vhosts/vcc_staging/app/View/Layouts/aarp_2023.ctp' $dataForView = array( 'content_for_layout' => '<div class="row twoColumnLayout"> <div class="col-md-8 left-rail"><div class="module clearfix"><div class="ar-basic-box"> <div> <div class="module-spacer"> <header><h1 class="article-headline">How Mid-Atlantic States Are Expanding Home Care</h1></header> <div class="posted-on"> Posted on 12/03/23 by <b>Ann Hardie</b> </div> </div> <div class="module-spacer"> <span class="blog-content"><p><div class="RichTextArticleBody"> <div class="RichTextArticleBody-body"><p>John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The 55-year-old from Dover, Delaware, goes to work every day, helps his 8-year-old son with basketball drills and watches his beloved Philadelphia Eagles with friends at Buffalo Wild Wings.<br><br>McNeal does so with the assistance of direct-care workers who help him get dressed in the morning, fix his meals and drive him where he needs to go.<br><br>“My life is unique in that I have a significant disability,” says McNeal, director of Delaware’s State Council for Persons with Disabilities. But, he says, it’s “a productive life that is every bit as normal as anybody else’s.”<br><br>Across the country, states such as Delaware are spending a growing percentage of long-term care funding to keep people in their homes and communities instead of institutional settings. That’s according to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023" target="_blank" rel="noopener noreferrer">AARP’s most recent Long-Term Services and Supports State Scorecard</a></span></span>, which uses 50 spending, quality and access indicators to rank each state’s long-term care system.<br><br>The new data shows that for the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid’s long-term care dollars nationally for older people and adults with physical disabilities went to home- and community-based services instead of nursing homes or other facilities.<br></p><p class="cms-textAlign-center"><b>EXPLORE: </b><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/" target="_blank" rel="noopener noreferrer"><b>AARP Long-Term Care Scorecard</b></a></span></span></p><p>“This is a big deal. We are seeing a breaking point,” says Susan Reinhard, senior vice president of the AARP Public Policy Institute, which published the Scorecard in September.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/da/c2/a471a2d346088edaf8c38a8b7a46/midalantic.png" alt="midalantic.png" width="6900" height="5761"/> <figcaption class="Figure-caption">Nicolas Rapp</figcaption> </figure> </div> </div><p>The shift to home- and community-based services comes as demand for such care has increased, fueled in part by a pandemic that took a horrific toll on nursing home residents. Polls have consistently shown that most older Americans want to age in place. A 2021 AARP survey found that more than three-quarters of adults 50-plus say they want to remain in their homes as they grow older.<br><br>But with America’s population of older adults growing, the chasm between the availability of HCBS and access to such services is poised to widen. <br><br>“We’re going to see a dramatic increase in the 80-plus and 85-plus population” as the boomer generation gets older, says Robert Applebaum, a senior research scholar at Miami University’s Scripps Gerontology Center in Ohio. “So the demand for long-term services ... is going to be tremendous.”<br><br><b><u>A person-centered approach</u></b><br><br>In the Mid-Atlantic region, Delaware, the District of Columbia, Maryland, New Jersey and West Virginia have all increased the percentage of their Medicaid dollars going to HCBS for older people and adults with physical disabilities in recent years, the Scorecard shows. One way they are doing that: giving more older adults the power to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">direct their own care</a></span></span>, funded through Medicaid initiatives. (Medicaid, a joint federal-state program for low-income Americans, includes coverage for nursing homes and other long-term care.) <br><br>Enrollment in these <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">“self-directed” care </a></span></span>programs increased by 10 percent or more across 34 states and the District of Columbia in recent years, the Scorecard shows. Such programs give people a greater say over how to spend government dollars on their own care.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/25/1e/2926ddba4cd09d7af135e7604561/1140-inset1-de-john-mcneal.jpg" alt="John McNeal, Director of the State Council for Persons with Disabilities for the State of Delaware, photographed at his office in Dover DE for AARP Bulletin, 7 December 2023. Photo by Mike Morgan." width="655" height="1140" style="height: auto; max-width: 380px;"/> <figcaption class="Figure-caption">John McNeal exits his car. Photo by Mike Morgan.</figcaption> </figure> </div> </div><p>“It’s like the ultimate person-centered approach,” says Lisa Alecxih, who researches long-term care for The Lewin Group, a health care and human services consulting firm. She notes that such programs often have the added benefit of allowing participants to hire family members as caregivers. That’s crucial because there’s a national shortage of direct-care workers.<br><br>Applebaum says his research on self-directed programs has also shown the satisfaction levels were “beyond anything I’ve ever seen as an evaluator.”<br><br>McNeal, the Delaware disability advocate, says that’s certainly true for him. “This is probably the most important program that has come into my life,” he says. “It has allowed me the opportunity to have everything that anybody else in the community has.”<br><br><b><u>Growing demand, workforce crunch</u></b><br><br>Self-directed services are one of many state-level innovations highlighted in the Scorecard as a way states can meet the growing demand for home- and community-based care. In the Mid-Atlantic region, D.C., Virginia and New Jersey posted the highest numbers of people enrolled in self-directed programs relative to their disabled populations.<br><br>Pennsylvania is the only state in the region that did not see an increase, but that could change as Jason Kavulich—who became Pennsylvania’s Secretary of Aging in January 2023—leads the state’s effort to develop a 10-year master plan for aging. “It is our top-most priority to make sure that people can age in place, how they choose, and to make sure that the services that we have really are responsive,” Kavulich says.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/90/ca/722b3834468a82b147701fcee20d/midatlanticranks.png" alt="midatlanticranks.png" width="3166" height="6717" style="height: auto; max-width: 350px;"/> </figure> </div> </div><p>One of the biggest challenges states face in expanding HCBS is the <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">shortage of</a></span></span> <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">direct-care workers</a></span></span> to fill those jobs. The work can be emotionally and physically taxing and usually comes with low pay, poor benefits and limited support and training.<br><br>The Scorecard shows that across the U.S., wages for direct-care workers are lower than in jobs with similar or lower entry requirements. Their median income is about $30,000 a year—approximately $5,000 less than workers in comparable jobs are paid in most states. D.C. has the highest wage gap in the country, with direct-care workers earning $5.03 less per hour than their counterparts in other sectors.<br><br>“I’m in competition with fast-food places. It’s as simple as that,” says 63-year-old Keith Williams of Clarks Green, Pennsylvania, outside Scranton. He was born with arthrogryposis, a combination of conditions that causes joint contractures and weak muscles.<br><br>Through a self-directed program, he hires care workers to help him with everything from showering to eating. He recruits through word of mouth and online postings. When that fails, he hires his sister-in-law.<br><br>It’s not easy, says Williams, the manager of independent living services for the Northeast Pennsylvania Center for Independent Living, a community-based organization staffed in part by people with disabilities. But the control he has over his care has allowed him to have a meaningful life.<br><br>“It’s meant that I’ve been able to live life on my own terms,” he says.<br><br><i>Ann Hardie spent a decade covering aging issues for The Atlanta Journal-Constitution. She has written for the Bulletin for 15 years.</i><br><br><b>More on Home Care</b><br></p><ul><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2023/rise-of-companion-care.html" target="_blank" rel="noopener noreferrer">Care Companions: A Watchful Eye and Willing Ear for Older Adults</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2019/home-health-aides.html" target="_blank" rel="noopener noreferrer">Find the Right Home Aide for Your Loved One</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://press.aarp.org/2021-11-18-AARP-Survey-Shows-8-in-10-Older-Adults-Want-to-Age-in-Their-Homes-While-Number-and-Needs-of-Households-Headed-Older-Adults-Grow-Dramatically" target="_blank" rel="noopener noreferrer">AARP Survey: 8 in 10 Older Adults Want to Age at Home</a></span></span></li></ul><div class="Enhancement" > <div class="Enhancement-item"><span class="VideoEnhancement" data-video-disable-history data-embeddedvideo-container> <div class="VideoEnhancement-player"><bsp-brightcoveplayer data-video-player class="BrightcoveVideoPlayer" data-account="3772599298001" data-player="KM9xJAJa4" data-video-id="5754403576001" data-video-title="How In-Home Care Helps — AARP" > <video class="video-js" id="BrightcoveVideoPlayer-5754403576001" data-video-id="5754403576001" data-account="" data-player="KM9xJAJa4" data-embed="default" controls ></video> </bsp-brightcoveplayer> </div> <div class="VideoEnhancement-title">How In-Home Care Helps — AARP</div> </span> </div> </div><p></p></div> </div> </p></span> </div> </div> </div> </div><div class="module clearfix"><script src="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.c85a242a55150cd195e494cd6e5b9c77.gz.js" async=""></script> <link rel="stylesheet" media="all" href="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.bfe6eb5a8301841feef3af4e9bd1e26d.gz.css"> <!-- bypass --> <style> a:focus, a:hover { text-decoration: underline; } h1.article-headline { margin: 0 0 1rem; } </style> <!-- <style> .Enhancement-item .Figure { margin-bottom: 24px; } .RichTextArticleBody-body ul { margin-bottom: 24px; } .RichTextArticleBody-body p{ margin: 12px 0; } .RichTextModule-items { clear: both; display: table; width: 100%; margin-bottom: 12px; } .VideoEnhancement>* { color: var(--primaryTextColor); font-size: 13px; font-weight: 400; line-height: 1.4; font-style: italic; background: #f0efed } @media only screen and (min-width: 768px) { .VideoEnhancement>* { font-size:14px; font-weight: 400; line-height: 1.47 } } .VideoEnhancement-title { padding: 20px } @media only screen and (min-width: 768px) { .VideoEnhancement-title { padding:30px } } .VideoEnhancement-player>* { position: relative; width: 100%; height: 0; padding-bottom: 56.25% } .VideoEnhancement iframe { border: 0; position: absolute; top: 0; left: 0; width: 100%; height: 100% } [data-video-player] { display: block; padding-bottom: 56.25%; height: 0; margin: 0 auto; } [data-video-player][data-aspect-ratio="4x3"] { padding-bottom: 56.25%; } [data-video-player][data-aspect-ratio="16x9"] { padding-bottom: 56.25% } </style> --></div><div class="module clearfix"><div class="module-spacer tout-homefit-750"> <a data-formelementid="CSN-LOCAL-HC-NEWSSK-02272024" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-HC-NEWSSK-02272024"><img class="img-responsive" alt="Explore the free AARP HomeFit Guide" title="Explore the free AARP HomeFit Guide" src="https://cdn-aarp.americantowns.com/img/touts/HomeFit_750x150.png"></a> </div></div></div> <div class="col-md-4 right-rail thin-rhs"><div class="module clearfix"><!--default--> <!-- module_RHS - AARP Events --> <div class="ar-basic-box module-spacer"> <header> <div class="pull-right"> <a href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS"> <img style="width:30px;" src="https://cdn-aarp.americantowns.com/img/template/icons/aarp_event_icon.png" alt="Upcoming AARP Events" /> </a> </div> <h2 class="visible-lg">AARP Events for Washington</h2> <h2 class="hidden-lg">AARP Events for Washington</h2> </header> <div class="wrap"> <div class="ar-listing snippet"> <ul class="list"> <li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-co-virtual-functional-fitness-online-99-10142024-sgnszx3wwws.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-FUNCTIONAL-FITNESS-WITH-BASIC-BODY-MOVEMENTS">Functional Fitness with Basic Body Movements</a></h2> <p class="time">Monday, Oct 7, 2024 at 9:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-nm-tai-ji-quan-moving-for-better-balance-albuquerque-nm-100724-j7nhvzxdkxd.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TAI-JI-QUAN-MOVING-FOR-BETTER-BALANCE">Tai Ji Quan: Moving for Better Balance</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/virtual-aarp-tx-mobility-mondays-houston-tx-100724-f5n2bjqhntc.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TRY-A-LOWIMPACT-WORKOUT-TO-IMPROVE-MOBILITY">Try A Low-Impact Workout to Improve Mobility</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom and Facebook</p> <p class="loc">Online Event</p> </li> </ul> <p><a class="link-red" href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS">View All AARP Events<i class="ml-1 fas fa-chevron-right"></i></a></p> </div> </div> </div> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_53475" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_53475', size:'300x250'}); } </script> </div> </div> <div class="card-tout card-dark membership-tout" style="margin:0 0 30px 0;"> <img class="img-responsive image" title="image of two AARP membership cards" alt="image of two AARP membership cards" src="https://cdn-aarp.americantowns.com/img/tout-two-cards.png"> <div class="title">Only $12 your first year with Automatic Renewal</div> <ul class="list"> <li>Immediate access to your <a href="https://www.aarp.org/benefits-discounts/">member benefits</a></li> <li>Discounts on travel and everyday savings</li> <li>Subscription to AARP The Magazine</li> <li>FREE second membership</li> </ul> <div class="action"> <a class="btn" href="https://appsec.aarp.org/mem/join?campaignid=UAJFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Join AARP</a> <div class="body">Already a member? <a href="https://appsec.aarp.org/mem/renew?campaignid= UARFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Renew</a> or <a href="https://www.aarp.org/benefits-discounts/my-membership/print-your-card/">Print Card</a></div> </div> </div> <style> .membership-tout {padding:16px 20px;} .membership-tout .list li { margin: 0; } </style> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_93505" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_93505', size:'300x250'}); } </script> </div> </div> <div class="module-spacer text-center"> <div class="fb-page" alt="Image of AARP District of Columbia Facebook Page" title="Image of AARP District of Columbia Facebook Page" data-href="https://www.facebook.com/aarpdc" data-tabs="timeline" width="320" height="" data-small-header="false" data-adapt-container-width="true" data-hide-cover="false" data-show-facepile="true" lazy="true"> <blockquote cite="https://www.facebook.com/aarpdc" class="fb-xfbml-parse-ignore"><a href="https://www.facebook.com/aarpdc">Facebook</a></blockquote> </div> </div> <div class="ar-basic-box module-spacer"> <header> <h2>Contact AARP<br />District of Columbia</h2> </header> <div class="wrap"> <div class="ar-quick-list module-spacer"> <ul class="list-unstyled"> <li><i class="list-icon fa fa-envelope" alt="Email icon" title="Email icon" aria-hidden="true"></i><a href="mailto:DCAARP@aarp.org " target="_blank" rel="noopener">DCAARP@aarp.org </a></li> <li><i class="list-icon fa fa-globe" alt="Globe icon" title="Globe icon" aria-hidden="true"></i><a href="https://states.aarp.org/region/washington-dc/" target="_blank" rel="noopener">AARP Washington, DC</a></li> <li><i class="list-icon fa fa-map-marker" alt="Map Marker icon" title="Map Marker icon" aria-hidden="true"></i><a href="https://states.aarp.org/aarp-district-of-columbia-state-office/?intcmp=SNG-LNK-AARPLOCAL-CONTACT-20140101-WASHINGTON-DC" target="_blank" rel="noopener">Contact Us</a></li> </ul> </div> <a href="https://www.facebook.com/aarpdc" target="_blank" rel="noopener" aria-label="Open Facebook"><img alt="Facebook icon" title="Facebook icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/facebook-dreamstale25.png"></a> <a href="https://twitter.com/AARPDC" target="_blank" rel="noopener" aria-label="Open Twitter"><img alt="Twitter icon" title="Twitter icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/x-logo-black.png"></a> </div> </div> </div></div> <div class="col-md-8 left-rail left-bot"></div> <div class="col-md-4 right-rail right-bot thin-rhs"></div> </div> <div class="row oneColumnLayout"> </div> <div class="row oneColumnLayout"> <div class="col-md-12"><!-- script to activate navbar --> <script type="text/javascript"> jQuery(".channelBarMain ul.left li a").click(function() { window.location = jQuery(this).attr('href'); }); </script> </div> </div> ', 'scripts_for_layout' => '<title>How Mid-Atlantic States Are Expanding Home Care</title> <meta name="page_title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="robots" content="noindex, nofollow"/> <meta content="John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The" name="description"/> <meta content="How, Mid, Atlantic, States, Expanding, Home, Care" name="keywords"/> <link rel="canonical" href="https://states.aarp.org/ltss-in-the-mid-atlantic" /> <meta property="og:url" content="https://vccstaging.local.aarp.org/news/how-midatlantic-states-are-expanding-home-care-2023-12-03.html"/> <meta name="twitter:card" content="summary_large_image"/> <meta name="twitter:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="twitter:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta name="twitter:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> <meta property="og:type" content="article"/> <meta property="og:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta property="og:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta property="og:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }', 'title_for_layout' => '{local_city_c}, {local_state} Happenings - AARP' ) $content_for_layout = '<div class="row twoColumnLayout"> <div class="col-md-8 left-rail"><div class="module clearfix"><div class="ar-basic-box"> <div> <div class="module-spacer"> <header><h1 class="article-headline">How Mid-Atlantic States Are Expanding Home Care</h1></header> <div class="posted-on"> Posted on 12/03/23 by <b>Ann Hardie</b> </div> </div> <div class="module-spacer"> <span class="blog-content"><p><div class="RichTextArticleBody"> <div class="RichTextArticleBody-body"><p>John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The 55-year-old from Dover, Delaware, goes to work every day, helps his 8-year-old son with basketball drills and watches his beloved Philadelphia Eagles with friends at Buffalo Wild Wings.<br><br>McNeal does so with the assistance of direct-care workers who help him get dressed in the morning, fix his meals and drive him where he needs to go.<br><br>“My life is unique in that I have a significant disability,” says McNeal, director of Delaware’s State Council for Persons with Disabilities. But, he says, it’s “a productive life that is every bit as normal as anybody else’s.”<br><br>Across the country, states such as Delaware are spending a growing percentage of long-term care funding to keep people in their homes and communities instead of institutional settings. That’s according to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023" target="_blank" rel="noopener noreferrer">AARP’s most recent Long-Term Services and Supports State Scorecard</a></span></span>, which uses 50 spending, quality and access indicators to rank each state’s long-term care system.<br><br>The new data shows that for the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid’s long-term care dollars nationally for older people and adults with physical disabilities went to home- and community-based services instead of nursing homes or other facilities.<br></p><p class="cms-textAlign-center"><b>EXPLORE: </b><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/" target="_blank" rel="noopener noreferrer"><b>AARP Long-Term Care Scorecard</b></a></span></span></p><p>“This is a big deal. We are seeing a breaking point,” says Susan Reinhard, senior vice president of the AARP Public Policy Institute, which published the Scorecard in September.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/da/c2/a471a2d346088edaf8c38a8b7a46/midalantic.png" alt="midalantic.png" width="6900" height="5761"/> <figcaption class="Figure-caption">Nicolas Rapp</figcaption> </figure> </div> </div><p>The shift to home- and community-based services comes as demand for such care has increased, fueled in part by a pandemic that took a horrific toll on nursing home residents. Polls have consistently shown that most older Americans want to age in place. A 2021 AARP survey found that more than three-quarters of adults 50-plus say they want to remain in their homes as they grow older.<br><br>But with America’s population of older adults growing, the chasm between the availability of HCBS and access to such services is poised to widen. <br><br>“We’re going to see a dramatic increase in the 80-plus and 85-plus population” as the boomer generation gets older, says Robert Applebaum, a senior research scholar at Miami University’s Scripps Gerontology Center in Ohio. “So the demand for long-term services ... is going to be tremendous.”<br><br><b><u>A person-centered approach</u></b><br><br>In the Mid-Atlantic region, Delaware, the District of Columbia, Maryland, New Jersey and West Virginia have all increased the percentage of their Medicaid dollars going to HCBS for older people and adults with physical disabilities in recent years, the Scorecard shows. One way they are doing that: giving more older adults the power to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">direct their own care</a></span></span>, funded through Medicaid initiatives. (Medicaid, a joint federal-state program for low-income Americans, includes coverage for nursing homes and other long-term care.) <br><br>Enrollment in these <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">“self-directed” care </a></span></span>programs increased by 10 percent or more across 34 states and the District of Columbia in recent years, the Scorecard shows. Such programs give people a greater say over how to spend government dollars on their own care.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/25/1e/2926ddba4cd09d7af135e7604561/1140-inset1-de-john-mcneal.jpg" alt="John McNeal, Director of the State Council for Persons with Disabilities for the State of Delaware, photographed at his office in Dover DE for AARP Bulletin, 7 December 2023. Photo by Mike Morgan." width="655" height="1140" style="height: auto; max-width: 380px;"/> <figcaption class="Figure-caption">John McNeal exits his car. Photo by Mike Morgan.</figcaption> </figure> </div> </div><p>“It’s like the ultimate person-centered approach,” says Lisa Alecxih, who researches long-term care for The Lewin Group, a health care and human services consulting firm. She notes that such programs often have the added benefit of allowing participants to hire family members as caregivers. That’s crucial because there’s a national shortage of direct-care workers.<br><br>Applebaum says his research on self-directed programs has also shown the satisfaction levels were “beyond anything I’ve ever seen as an evaluator.”<br><br>McNeal, the Delaware disability advocate, says that’s certainly true for him. “This is probably the most important program that has come into my life,” he says. “It has allowed me the opportunity to have everything that anybody else in the community has.”<br><br><b><u>Growing demand, workforce crunch</u></b><br><br>Self-directed services are one of many state-level innovations highlighted in the Scorecard as a way states can meet the growing demand for home- and community-based care. In the Mid-Atlantic region, D.C., Virginia and New Jersey posted the highest numbers of people enrolled in self-directed programs relative to their disabled populations.<br><br>Pennsylvania is the only state in the region that did not see an increase, but that could change as Jason Kavulich—who became Pennsylvania’s Secretary of Aging in January 2023—leads the state’s effort to develop a 10-year master plan for aging. “It is our top-most priority to make sure that people can age in place, how they choose, and to make sure that the services that we have really are responsive,” Kavulich says.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/90/ca/722b3834468a82b147701fcee20d/midatlanticranks.png" alt="midatlanticranks.png" width="3166" height="6717" style="height: auto; max-width: 350px;"/> </figure> </div> </div><p>One of the biggest challenges states face in expanding HCBS is the <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">shortage of</a></span></span> <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">direct-care workers</a></span></span> to fill those jobs. The work can be emotionally and physically taxing and usually comes with low pay, poor benefits and limited support and training.<br><br>The Scorecard shows that across the U.S., wages for direct-care workers are lower than in jobs with similar or lower entry requirements. Their median income is about $30,000 a year—approximately $5,000 less than workers in comparable jobs are paid in most states. D.C. has the highest wage gap in the country, with direct-care workers earning $5.03 less per hour than their counterparts in other sectors.<br><br>“I’m in competition with fast-food places. It’s as simple as that,” says 63-year-old Keith Williams of Clarks Green, Pennsylvania, outside Scranton. He was born with arthrogryposis, a combination of conditions that causes joint contractures and weak muscles.<br><br>Through a self-directed program, he hires care workers to help him with everything from showering to eating. He recruits through word of mouth and online postings. When that fails, he hires his sister-in-law.<br><br>It’s not easy, says Williams, the manager of independent living services for the Northeast Pennsylvania Center for Independent Living, a community-based organization staffed in part by people with disabilities. But the control he has over his care has allowed him to have a meaningful life.<br><br>“It’s meant that I’ve been able to live life on my own terms,” he says.<br><br><i>Ann Hardie spent a decade covering aging issues for The Atlanta Journal-Constitution. She has written for the Bulletin for 15 years.</i><br><br><b>More on Home Care</b><br></p><ul><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2023/rise-of-companion-care.html" target="_blank" rel="noopener noreferrer">Care Companions: A Watchful Eye and Willing Ear for Older Adults</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2019/home-health-aides.html" target="_blank" rel="noopener noreferrer">Find the Right Home Aide for Your Loved One</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://press.aarp.org/2021-11-18-AARP-Survey-Shows-8-in-10-Older-Adults-Want-to-Age-in-Their-Homes-While-Number-and-Needs-of-Households-Headed-Older-Adults-Grow-Dramatically" target="_blank" rel="noopener noreferrer">AARP Survey: 8 in 10 Older Adults Want to Age at Home</a></span></span></li></ul><div class="Enhancement" > <div class="Enhancement-item"><span class="VideoEnhancement" data-video-disable-history data-embeddedvideo-container> <div class="VideoEnhancement-player"><bsp-brightcoveplayer data-video-player class="BrightcoveVideoPlayer" data-account="3772599298001" data-player="KM9xJAJa4" data-video-id="5754403576001" data-video-title="How In-Home Care Helps — AARP" > <video class="video-js" id="BrightcoveVideoPlayer-5754403576001" data-video-id="5754403576001" data-account="" data-player="KM9xJAJa4" data-embed="default" controls ></video> </bsp-brightcoveplayer> </div> <div class="VideoEnhancement-title">How In-Home Care Helps — AARP</div> </span> </div> </div><p></p></div> </div> </p></span> </div> </div> </div> </div><div class="module clearfix"><script src="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.c85a242a55150cd195e494cd6e5b9c77.gz.js" async=""></script> <link rel="stylesheet" media="all" href="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.bfe6eb5a8301841feef3af4e9bd1e26d.gz.css"> <!-- bypass --> <style> a:focus, a:hover { text-decoration: underline; } h1.article-headline { margin: 0 0 1rem; } </style> <!-- <style> .Enhancement-item .Figure { margin-bottom: 24px; } .RichTextArticleBody-body ul { margin-bottom: 24px; } .RichTextArticleBody-body p{ margin: 12px 0; } .RichTextModule-items { clear: both; display: table; width: 100%; margin-bottom: 12px; } .VideoEnhancement>* { color: var(--primaryTextColor); font-size: 13px; font-weight: 400; line-height: 1.4; font-style: italic; background: #f0efed } @media only screen and (min-width: 768px) { .VideoEnhancement>* { font-size:14px; font-weight: 400; line-height: 1.47 } } .VideoEnhancement-title { padding: 20px } @media only screen and (min-width: 768px) { .VideoEnhancement-title { padding:30px } } .VideoEnhancement-player>* { position: relative; width: 100%; height: 0; padding-bottom: 56.25% } .VideoEnhancement iframe { border: 0; position: absolute; top: 0; left: 0; width: 100%; height: 100% } [data-video-player] { display: block; padding-bottom: 56.25%; height: 0; margin: 0 auto; } [data-video-player][data-aspect-ratio="4x3"] { padding-bottom: 56.25%; } [data-video-player][data-aspect-ratio="16x9"] { padding-bottom: 56.25% } </style> --></div><div class="module clearfix"><div class="module-spacer tout-homefit-750"> <a data-formelementid="CSN-LOCAL-HC-NEWSSK-02272024" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-HC-NEWSSK-02272024"><img class="img-responsive" alt="Explore the free AARP HomeFit Guide" title="Explore the free AARP HomeFit Guide" src="https://cdn-aarp.americantowns.com/img/touts/HomeFit_750x150.png"></a> </div></div></div> <div class="col-md-4 right-rail thin-rhs"><div class="module clearfix"><!--default--> <!-- module_RHS - AARP Events --> <div class="ar-basic-box module-spacer"> <header> <div class="pull-right"> <a href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS"> <img style="width:30px;" src="https://cdn-aarp.americantowns.com/img/template/icons/aarp_event_icon.png" alt="Upcoming AARP Events" /> </a> </div> <h2 class="visible-lg">AARP Events for Washington</h2> <h2 class="hidden-lg">AARP Events for Washington</h2> </header> <div class="wrap"> <div class="ar-listing snippet"> <ul class="list"> <li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-co-virtual-functional-fitness-online-99-10142024-sgnszx3wwws.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-FUNCTIONAL-FITNESS-WITH-BASIC-BODY-MOVEMENTS">Functional Fitness with Basic Body Movements</a></h2> <p class="time">Monday, Oct 7, 2024 at 9:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-nm-tai-ji-quan-moving-for-better-balance-albuquerque-nm-100724-j7nhvzxdkxd.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TAI-JI-QUAN-MOVING-FOR-BETTER-BALANCE">Tai Ji Quan: Moving for Better Balance</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/virtual-aarp-tx-mobility-mondays-houston-tx-100724-f5n2bjqhntc.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TRY-A-LOWIMPACT-WORKOUT-TO-IMPROVE-MOBILITY">Try A Low-Impact Workout to Improve Mobility</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom and Facebook</p> <p class="loc">Online Event</p> </li> </ul> <p><a class="link-red" href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS">View All AARP Events<i class="ml-1 fas fa-chevron-right"></i></a></p> </div> </div> </div> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_53475" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_53475', size:'300x250'}); } </script> </div> </div> <div class="card-tout card-dark membership-tout" style="margin:0 0 30px 0;"> <img class="img-responsive image" title="image of two AARP membership cards" alt="image of two AARP membership cards" src="https://cdn-aarp.americantowns.com/img/tout-two-cards.png"> <div class="title">Only $12 your first year with Automatic Renewal</div> <ul class="list"> <li>Immediate access to your <a href="https://www.aarp.org/benefits-discounts/">member benefits</a></li> <li>Discounts on travel and everyday savings</li> <li>Subscription to AARP The Magazine</li> <li>FREE second membership</li> </ul> <div class="action"> <a class="btn" href="https://appsec.aarp.org/mem/join?campaignid=UAJFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Join AARP</a> <div class="body">Already a member? <a href="https://appsec.aarp.org/mem/renew?campaignid= UARFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Renew</a> or <a href="https://www.aarp.org/benefits-discounts/my-membership/print-your-card/">Print Card</a></div> </div> </div> <style> .membership-tout {padding:16px 20px;} .membership-tout .list li { margin: 0; } </style> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_93505" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_93505', size:'300x250'}); } </script> </div> </div> <div class="module-spacer text-center"> <div class="fb-page" alt="Image of AARP District of Columbia Facebook Page" title="Image of AARP District of Columbia Facebook Page" data-href="https://www.facebook.com/aarpdc" data-tabs="timeline" width="320" height="" data-small-header="false" data-adapt-container-width="true" data-hide-cover="false" data-show-facepile="true" lazy="true"> <blockquote cite="https://www.facebook.com/aarpdc" class="fb-xfbml-parse-ignore"><a href="https://www.facebook.com/aarpdc">Facebook</a></blockquote> </div> </div> <div class="ar-basic-box module-spacer"> <header> <h2>Contact AARP<br />District of Columbia</h2> </header> <div class="wrap"> <div class="ar-quick-list module-spacer"> <ul class="list-unstyled"> <li><i class="list-icon fa fa-envelope" alt="Email icon" title="Email icon" aria-hidden="true"></i><a href="mailto:DCAARP@aarp.org " target="_blank" rel="noopener">DCAARP@aarp.org </a></li> <li><i class="list-icon fa fa-globe" alt="Globe icon" title="Globe icon" aria-hidden="true"></i><a href="https://states.aarp.org/region/washington-dc/" target="_blank" rel="noopener">AARP Washington, DC</a></li> <li><i class="list-icon fa fa-map-marker" alt="Map Marker icon" title="Map Marker icon" aria-hidden="true"></i><a href="https://states.aarp.org/aarp-district-of-columbia-state-office/?intcmp=SNG-LNK-AARPLOCAL-CONTACT-20140101-WASHINGTON-DC" target="_blank" rel="noopener">Contact Us</a></li> </ul> </div> <a href="https://www.facebook.com/aarpdc" target="_blank" rel="noopener" aria-label="Open Facebook"><img alt="Facebook icon" title="Facebook icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/facebook-dreamstale25.png"></a> <a href="https://twitter.com/AARPDC" target="_blank" rel="noopener" aria-label="Open Twitter"><img alt="Twitter icon" title="Twitter icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/x-logo-black.png"></a> </div> </div> </div></div> <div class="col-md-8 left-rail left-bot"></div> <div class="col-md-4 right-rail right-bot thin-rhs"></div> </div> <div class="row oneColumnLayout"> </div> <div class="row oneColumnLayout"> <div class="col-md-12"><!-- script to activate navbar --> <script type="text/javascript"> jQuery(".channelBarMain ul.left li a").click(function() { window.location = jQuery(this).attr('href'); }); </script> </div> </div> ' $scripts_for_layout = '<title>How Mid-Atlantic States Are Expanding Home Care</title> <meta name="page_title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="robots" content="noindex, nofollow"/> <meta content="John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The" name="description"/> <meta content="How, Mid, Atlantic, States, Expanding, Home, Care" name="keywords"/> <link rel="canonical" href="https://states.aarp.org/ltss-in-the-mid-atlantic" /> <meta property="og:url" content="https://vccstaging.local.aarp.org/news/how-midatlantic-states-are-expanding-home-care-2023-12-03.html"/> <meta name="twitter:card" content="summary_large_image"/> <meta name="twitter:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="twitter:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta name="twitter:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> <meta property="og:type" content="article"/> <meta property="og:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta property="og:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta property="og:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }' $title_for_layout = '{local_city_c}, {local_state} Happenings - AARP' $asset_version = '230831' $min = true $nowrapper = false $css = ' :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }'include - APP/View/Layouts/aarp_2023.ctp, line 53 include - APP/View/Layouts/aarp_2023.ctp, line 53 View::_evaluate() - CORE/Cake/View/View.php, line 971 View::_render() - CORE/Cake/View/View.php, line 933 View::renderLayout() - CORE/Cake/View/View.php, line 546 View::render() - CORE/Cake/View/View.php, line 481 Controller::render() - CORE/Cake/Controller/Controller.php, line 963 AppController::renderPage() - APP/Controller/AppController.php, line 136 BlogsController::display() - APP/Controller/BlogsController.php, line 81 ReflectionMethod::invokeArgs() - [internal], line ?? Controller::invokeAction() - CORE/Cake/Controller/Controller.php, line 491 Dispatcher::_invoke() - CORE/Cake/Routing/Dispatcher.php, line 193 Dispatcher::dispatch() - CORE/Cake/Routing/Dispatcher.php, line 167 [main] - APP/webroot/index.php, line 118
Warning (2): include(/var/www/vhosts/vcc_staging/app/Resource/aarp2_master.resource.root.html) [<a href='http://php.net/function.include'>function.include</a>]: failed to open stream: No such file or directory [APP/View/Layouts/aarp_2023.ctp, line 54]Code Context<?php if (!$nowrapper): // MLW - Spanish wrappers TBD
include (APP . "Resource/aarp2_master.head.html");
include (APP . "Resource/aarp2_master.resource.root.html");
$viewFile = '/var/www/vhosts/vcc_staging/app/View/Layouts/aarp_2023.ctp' $dataForView = array( 'content_for_layout' => '<div class="row twoColumnLayout"> <div class="col-md-8 left-rail"><div class="module clearfix"><div class="ar-basic-box"> <div> <div class="module-spacer"> <header><h1 class="article-headline">How Mid-Atlantic States Are Expanding Home Care</h1></header> <div class="posted-on"> Posted on 12/03/23 by <b>Ann Hardie</b> </div> </div> <div class="module-spacer"> <span class="blog-content"><p><div class="RichTextArticleBody"> <div class="RichTextArticleBody-body"><p>John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The 55-year-old from Dover, Delaware, goes to work every day, helps his 8-year-old son with basketball drills and watches his beloved Philadelphia Eagles with friends at Buffalo Wild Wings.<br><br>McNeal does so with the assistance of direct-care workers who help him get dressed in the morning, fix his meals and drive him where he needs to go.<br><br>“My life is unique in that I have a significant disability,” says McNeal, director of Delaware’s State Council for Persons with Disabilities. But, he says, it’s “a productive life that is every bit as normal as anybody else’s.”<br><br>Across the country, states such as Delaware are spending a growing percentage of long-term care funding to keep people in their homes and communities instead of institutional settings. That’s according to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023" target="_blank" rel="noopener noreferrer">AARP’s most recent Long-Term Services and Supports State Scorecard</a></span></span>, which uses 50 spending, quality and access indicators to rank each state’s long-term care system.<br><br>The new data shows that for the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid’s long-term care dollars nationally for older people and adults with physical disabilities went to home- and community-based services instead of nursing homes or other facilities.<br></p><p class="cms-textAlign-center"><b>EXPLORE: </b><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/" target="_blank" rel="noopener noreferrer"><b>AARP Long-Term Care Scorecard</b></a></span></span></p><p>“This is a big deal. We are seeing a breaking point,” says Susan Reinhard, senior vice president of the AARP Public Policy Institute, which published the Scorecard in September.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/da/c2/a471a2d346088edaf8c38a8b7a46/midalantic.png" alt="midalantic.png" width="6900" height="5761"/> <figcaption class="Figure-caption">Nicolas Rapp</figcaption> </figure> </div> </div><p>The shift to home- and community-based services comes as demand for such care has increased, fueled in part by a pandemic that took a horrific toll on nursing home residents. Polls have consistently shown that most older Americans want to age in place. A 2021 AARP survey found that more than three-quarters of adults 50-plus say they want to remain in their homes as they grow older.<br><br>But with America’s population of older adults growing, the chasm between the availability of HCBS and access to such services is poised to widen. <br><br>“We’re going to see a dramatic increase in the 80-plus and 85-plus population” as the boomer generation gets older, says Robert Applebaum, a senior research scholar at Miami University’s Scripps Gerontology Center in Ohio. “So the demand for long-term services ... is going to be tremendous.”<br><br><b><u>A person-centered approach</u></b><br><br>In the Mid-Atlantic region, Delaware, the District of Columbia, Maryland, New Jersey and West Virginia have all increased the percentage of their Medicaid dollars going to HCBS for older people and adults with physical disabilities in recent years, the Scorecard shows. One way they are doing that: giving more older adults the power to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">direct their own care</a></span></span>, funded through Medicaid initiatives. (Medicaid, a joint federal-state program for low-income Americans, includes coverage for nursing homes and other long-term care.) <br><br>Enrollment in these <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">“self-directed” care </a></span></span>programs increased by 10 percent or more across 34 states and the District of Columbia in recent years, the Scorecard shows. Such programs give people a greater say over how to spend government dollars on their own care.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/25/1e/2926ddba4cd09d7af135e7604561/1140-inset1-de-john-mcneal.jpg" alt="John McNeal, Director of the State Council for Persons with Disabilities for the State of Delaware, photographed at his office in Dover DE for AARP Bulletin, 7 December 2023. Photo by Mike Morgan." width="655" height="1140" style="height: auto; max-width: 380px;"/> <figcaption class="Figure-caption">John McNeal exits his car. Photo by Mike Morgan.</figcaption> </figure> </div> </div><p>“It’s like the ultimate person-centered approach,” says Lisa Alecxih, who researches long-term care for The Lewin Group, a health care and human services consulting firm. She notes that such programs often have the added benefit of allowing participants to hire family members as caregivers. That’s crucial because there’s a national shortage of direct-care workers.<br><br>Applebaum says his research on self-directed programs has also shown the satisfaction levels were “beyond anything I’ve ever seen as an evaluator.”<br><br>McNeal, the Delaware disability advocate, says that’s certainly true for him. “This is probably the most important program that has come into my life,” he says. “It has allowed me the opportunity to have everything that anybody else in the community has.”<br><br><b><u>Growing demand, workforce crunch</u></b><br><br>Self-directed services are one of many state-level innovations highlighted in the Scorecard as a way states can meet the growing demand for home- and community-based care. In the Mid-Atlantic region, D.C., Virginia and New Jersey posted the highest numbers of people enrolled in self-directed programs relative to their disabled populations.<br><br>Pennsylvania is the only state in the region that did not see an increase, but that could change as Jason Kavulich—who became Pennsylvania’s Secretary of Aging in January 2023—leads the state’s effort to develop a 10-year master plan for aging. “It is our top-most priority to make sure that people can age in place, how they choose, and to make sure that the services that we have really are responsive,” Kavulich says.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/90/ca/722b3834468a82b147701fcee20d/midatlanticranks.png" alt="midatlanticranks.png" width="3166" height="6717" style="height: auto; max-width: 350px;"/> </figure> </div> </div><p>One of the biggest challenges states face in expanding HCBS is the <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">shortage of</a></span></span> <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">direct-care workers</a></span></span> to fill those jobs. The work can be emotionally and physically taxing and usually comes with low pay, poor benefits and limited support and training.<br><br>The Scorecard shows that across the U.S., wages for direct-care workers are lower than in jobs with similar or lower entry requirements. Their median income is about $30,000 a year—approximately $5,000 less than workers in comparable jobs are paid in most states. D.C. has the highest wage gap in the country, with direct-care workers earning $5.03 less per hour than their counterparts in other sectors.<br><br>“I’m in competition with fast-food places. It’s as simple as that,” says 63-year-old Keith Williams of Clarks Green, Pennsylvania, outside Scranton. He was born with arthrogryposis, a combination of conditions that causes joint contractures and weak muscles.<br><br>Through a self-directed program, he hires care workers to help him with everything from showering to eating. He recruits through word of mouth and online postings. When that fails, he hires his sister-in-law.<br><br>It’s not easy, says Williams, the manager of independent living services for the Northeast Pennsylvania Center for Independent Living, a community-based organization staffed in part by people with disabilities. But the control he has over his care has allowed him to have a meaningful life.<br><br>“It’s meant that I’ve been able to live life on my own terms,” he says.<br><br><i>Ann Hardie spent a decade covering aging issues for The Atlanta Journal-Constitution. She has written for the Bulletin for 15 years.</i><br><br><b>More on Home Care</b><br></p><ul><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2023/rise-of-companion-care.html" target="_blank" rel="noopener noreferrer">Care Companions: A Watchful Eye and Willing Ear for Older Adults</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2019/home-health-aides.html" target="_blank" rel="noopener noreferrer">Find the Right Home Aide for Your Loved One</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://press.aarp.org/2021-11-18-AARP-Survey-Shows-8-in-10-Older-Adults-Want-to-Age-in-Their-Homes-While-Number-and-Needs-of-Households-Headed-Older-Adults-Grow-Dramatically" target="_blank" rel="noopener noreferrer">AARP Survey: 8 in 10 Older Adults Want to Age at Home</a></span></span></li></ul><div class="Enhancement" > <div class="Enhancement-item"><span class="VideoEnhancement" data-video-disable-history data-embeddedvideo-container> <div class="VideoEnhancement-player"><bsp-brightcoveplayer data-video-player class="BrightcoveVideoPlayer" data-account="3772599298001" data-player="KM9xJAJa4" data-video-id="5754403576001" data-video-title="How In-Home Care Helps — AARP" > <video class="video-js" id="BrightcoveVideoPlayer-5754403576001" data-video-id="5754403576001" data-account="" data-player="KM9xJAJa4" data-embed="default" controls ></video> </bsp-brightcoveplayer> </div> <div class="VideoEnhancement-title">How In-Home Care Helps — AARP</div> </span> </div> </div><p></p></div> </div> </p></span> </div> </div> </div> </div><div class="module clearfix"><script src="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.c85a242a55150cd195e494cd6e5b9c77.gz.js" async=""></script> <link rel="stylesheet" media="all" href="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.bfe6eb5a8301841feef3af4e9bd1e26d.gz.css"> <!-- bypass --> <style> a:focus, a:hover { text-decoration: underline; } h1.article-headline { margin: 0 0 1rem; } </style> <!-- <style> .Enhancement-item .Figure { margin-bottom: 24px; } .RichTextArticleBody-body ul { margin-bottom: 24px; } .RichTextArticleBody-body p{ margin: 12px 0; } .RichTextModule-items { clear: both; display: table; width: 100%; margin-bottom: 12px; } .VideoEnhancement>* { color: var(--primaryTextColor); font-size: 13px; font-weight: 400; line-height: 1.4; font-style: italic; background: #f0efed } @media only screen and (min-width: 768px) { .VideoEnhancement>* { font-size:14px; font-weight: 400; line-height: 1.47 } } .VideoEnhancement-title { padding: 20px } @media only screen and (min-width: 768px) { .VideoEnhancement-title { padding:30px } } .VideoEnhancement-player>* { position: relative; width: 100%; height: 0; padding-bottom: 56.25% } .VideoEnhancement iframe { border: 0; position: absolute; top: 0; left: 0; width: 100%; height: 100% } [data-video-player] { display: block; padding-bottom: 56.25%; height: 0; margin: 0 auto; } [data-video-player][data-aspect-ratio="4x3"] { padding-bottom: 56.25%; } [data-video-player][data-aspect-ratio="16x9"] { padding-bottom: 56.25% } </style> --></div><div class="module clearfix"><div class="module-spacer tout-homefit-750"> <a data-formelementid="CSN-LOCAL-HC-NEWSSK-02272024" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-HC-NEWSSK-02272024"><img class="img-responsive" alt="Explore the free AARP HomeFit Guide" title="Explore the free AARP HomeFit Guide" src="https://cdn-aarp.americantowns.com/img/touts/HomeFit_750x150.png"></a> </div></div></div> <div class="col-md-4 right-rail thin-rhs"><div class="module clearfix"><!--default--> <!-- module_RHS - AARP Events --> <div class="ar-basic-box module-spacer"> <header> <div class="pull-right"> <a href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS"> <img style="width:30px;" src="https://cdn-aarp.americantowns.com/img/template/icons/aarp_event_icon.png" alt="Upcoming AARP Events" /> </a> </div> <h2 class="visible-lg">AARP Events for Washington</h2> <h2 class="hidden-lg">AARP Events for Washington</h2> </header> <div class="wrap"> <div class="ar-listing snippet"> <ul class="list"> <li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-co-virtual-functional-fitness-online-99-10142024-sgnszx3wwws.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-FUNCTIONAL-FITNESS-WITH-BASIC-BODY-MOVEMENTS">Functional Fitness with Basic Body Movements</a></h2> <p class="time">Monday, Oct 7, 2024 at 9:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-nm-tai-ji-quan-moving-for-better-balance-albuquerque-nm-100724-j7nhvzxdkxd.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TAI-JI-QUAN-MOVING-FOR-BETTER-BALANCE">Tai Ji Quan: Moving for Better Balance</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/virtual-aarp-tx-mobility-mondays-houston-tx-100724-f5n2bjqhntc.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TRY-A-LOWIMPACT-WORKOUT-TO-IMPROVE-MOBILITY">Try A Low-Impact Workout to Improve Mobility</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom and Facebook</p> <p class="loc">Online Event</p> </li> </ul> <p><a class="link-red" href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS">View All AARP Events<i class="ml-1 fas fa-chevron-right"></i></a></p> </div> </div> </div> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_53475" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_53475', size:'300x250'}); } </script> </div> </div> <div class="card-tout card-dark membership-tout" style="margin:0 0 30px 0;"> <img class="img-responsive image" title="image of two AARP membership cards" alt="image of two AARP membership cards" src="https://cdn-aarp.americantowns.com/img/tout-two-cards.png"> <div class="title">Only $12 your first year with Automatic Renewal</div> <ul class="list"> <li>Immediate access to your <a href="https://www.aarp.org/benefits-discounts/">member benefits</a></li> <li>Discounts on travel and everyday savings</li> <li>Subscription to AARP The Magazine</li> <li>FREE second membership</li> </ul> <div class="action"> <a class="btn" href="https://appsec.aarp.org/mem/join?campaignid=UAJFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Join AARP</a> <div class="body">Already a member? <a href="https://appsec.aarp.org/mem/renew?campaignid= UARFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Renew</a> or <a href="https://www.aarp.org/benefits-discounts/my-membership/print-your-card/">Print Card</a></div> </div> </div> <style> .membership-tout {padding:16px 20px;} .membership-tout .list li { margin: 0; } </style> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_93505" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_93505', size:'300x250'}); } </script> </div> </div> <div class="module-spacer text-center"> <div class="fb-page" alt="Image of AARP District of Columbia Facebook Page" title="Image of AARP District of Columbia Facebook Page" data-href="https://www.facebook.com/aarpdc" data-tabs="timeline" width="320" height="" data-small-header="false" data-adapt-container-width="true" data-hide-cover="false" data-show-facepile="true" lazy="true"> <blockquote cite="https://www.facebook.com/aarpdc" class="fb-xfbml-parse-ignore"><a href="https://www.facebook.com/aarpdc">Facebook</a></blockquote> </div> </div> <div class="ar-basic-box module-spacer"> <header> <h2>Contact AARP<br />District of Columbia</h2> </header> <div class="wrap"> <div class="ar-quick-list module-spacer"> <ul class="list-unstyled"> <li><i class="list-icon fa fa-envelope" alt="Email icon" title="Email icon" aria-hidden="true"></i><a href="mailto:DCAARP@aarp.org " target="_blank" rel="noopener">DCAARP@aarp.org </a></li> <li><i class="list-icon fa fa-globe" alt="Globe icon" title="Globe icon" aria-hidden="true"></i><a href="https://states.aarp.org/region/washington-dc/" target="_blank" rel="noopener">AARP Washington, DC</a></li> <li><i class="list-icon fa fa-map-marker" alt="Map Marker icon" title="Map Marker icon" aria-hidden="true"></i><a href="https://states.aarp.org/aarp-district-of-columbia-state-office/?intcmp=SNG-LNK-AARPLOCAL-CONTACT-20140101-WASHINGTON-DC" target="_blank" rel="noopener">Contact Us</a></li> </ul> </div> <a href="https://www.facebook.com/aarpdc" target="_blank" rel="noopener" aria-label="Open Facebook"><img alt="Facebook icon" title="Facebook icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/facebook-dreamstale25.png"></a> <a href="https://twitter.com/AARPDC" target="_blank" rel="noopener" aria-label="Open Twitter"><img alt="Twitter icon" title="Twitter icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/x-logo-black.png"></a> </div> </div> </div></div> <div class="col-md-8 left-rail left-bot"></div> <div class="col-md-4 right-rail right-bot thin-rhs"></div> </div> <div class="row oneColumnLayout"> </div> <div class="row oneColumnLayout"> <div class="col-md-12"><!-- script to activate navbar --> <script type="text/javascript"> jQuery(".channelBarMain ul.left li a").click(function() { window.location = jQuery(this).attr('href'); }); </script> </div> </div> ', 'scripts_for_layout' => '<title>How Mid-Atlantic States Are Expanding Home Care</title> <meta name="page_title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="robots" content="noindex, nofollow"/> <meta content="John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The" name="description"/> <meta content="How, Mid, Atlantic, States, Expanding, Home, Care" name="keywords"/> <link rel="canonical" href="https://states.aarp.org/ltss-in-the-mid-atlantic" /> <meta property="og:url" content="https://vccstaging.local.aarp.org/news/how-midatlantic-states-are-expanding-home-care-2023-12-03.html"/> <meta name="twitter:card" content="summary_large_image"/> <meta name="twitter:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="twitter:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta name="twitter:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> <meta property="og:type" content="article"/> <meta property="og:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta property="og:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta property="og:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }', 'title_for_layout' => '{local_city_c}, {local_state} Happenings - AARP' ) $content_for_layout = '<div class="row twoColumnLayout"> <div class="col-md-8 left-rail"><div class="module clearfix"><div class="ar-basic-box"> <div> <div class="module-spacer"> <header><h1 class="article-headline">How Mid-Atlantic States Are Expanding Home Care</h1></header> <div class="posted-on"> Posted on 12/03/23 by <b>Ann Hardie</b> </div> </div> <div class="module-spacer"> <span class="blog-content"><p><div class="RichTextArticleBody"> <div class="RichTextArticleBody-body"><p>John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The 55-year-old from Dover, Delaware, goes to work every day, helps his 8-year-old son with basketball drills and watches his beloved Philadelphia Eagles with friends at Buffalo Wild Wings.<br><br>McNeal does so with the assistance of direct-care workers who help him get dressed in the morning, fix his meals and drive him where he needs to go.<br><br>“My life is unique in that I have a significant disability,” says McNeal, director of Delaware’s State Council for Persons with Disabilities. But, he says, it’s “a productive life that is every bit as normal as anybody else’s.”<br><br>Across the country, states such as Delaware are spending a growing percentage of long-term care funding to keep people in their homes and communities instead of institutional settings. That’s according to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023" target="_blank" rel="noopener noreferrer">AARP’s most recent Long-Term Services and Supports State Scorecard</a></span></span>, which uses 50 spending, quality and access indicators to rank each state’s long-term care system.<br><br>The new data shows that for the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid’s long-term care dollars nationally for older people and adults with physical disabilities went to home- and community-based services instead of nursing homes or other facilities.<br></p><p class="cms-textAlign-center"><b>EXPLORE: </b><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/" target="_blank" rel="noopener noreferrer"><b>AARP Long-Term Care Scorecard</b></a></span></span></p><p>“This is a big deal. We are seeing a breaking point,” says Susan Reinhard, senior vice president of the AARP Public Policy Institute, which published the Scorecard in September.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/da/c2/a471a2d346088edaf8c38a8b7a46/midalantic.png" alt="midalantic.png" width="6900" height="5761"/> <figcaption class="Figure-caption">Nicolas Rapp</figcaption> </figure> </div> </div><p>The shift to home- and community-based services comes as demand for such care has increased, fueled in part by a pandemic that took a horrific toll on nursing home residents. Polls have consistently shown that most older Americans want to age in place. A 2021 AARP survey found that more than three-quarters of adults 50-plus say they want to remain in their homes as they grow older.<br><br>But with America’s population of older adults growing, the chasm between the availability of HCBS and access to such services is poised to widen. <br><br>“We’re going to see a dramatic increase in the 80-plus and 85-plus population” as the boomer generation gets older, says Robert Applebaum, a senior research scholar at Miami University’s Scripps Gerontology Center in Ohio. “So the demand for long-term services ... is going to be tremendous.”<br><br><b><u>A person-centered approach</u></b><br><br>In the Mid-Atlantic region, Delaware, the District of Columbia, Maryland, New Jersey and West Virginia have all increased the percentage of their Medicaid dollars going to HCBS for older people and adults with physical disabilities in recent years, the Scorecard shows. One way they are doing that: giving more older adults the power to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">direct their own care</a></span></span>, funded through Medicaid initiatives. (Medicaid, a joint federal-state program for low-income Americans, includes coverage for nursing homes and other long-term care.) <br><br>Enrollment in these <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">“self-directed” care </a></span></span>programs increased by 10 percent or more across 34 states and the District of Columbia in recent years, the Scorecard shows. Such programs give people a greater say over how to spend government dollars on their own care.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/25/1e/2926ddba4cd09d7af135e7604561/1140-inset1-de-john-mcneal.jpg" alt="John McNeal, Director of the State Council for Persons with Disabilities for the State of Delaware, photographed at his office in Dover DE for AARP Bulletin, 7 December 2023. Photo by Mike Morgan." width="655" height="1140" style="height: auto; max-width: 380px;"/> <figcaption class="Figure-caption">John McNeal exits his car. Photo by Mike Morgan.</figcaption> </figure> </div> </div><p>“It’s like the ultimate person-centered approach,” says Lisa Alecxih, who researches long-term care for The Lewin Group, a health care and human services consulting firm. She notes that such programs often have the added benefit of allowing participants to hire family members as caregivers. That’s crucial because there’s a national shortage of direct-care workers.<br><br>Applebaum says his research on self-directed programs has also shown the satisfaction levels were “beyond anything I’ve ever seen as an evaluator.”<br><br>McNeal, the Delaware disability advocate, says that’s certainly true for him. “This is probably the most important program that has come into my life,” he says. “It has allowed me the opportunity to have everything that anybody else in the community has.”<br><br><b><u>Growing demand, workforce crunch</u></b><br><br>Self-directed services are one of many state-level innovations highlighted in the Scorecard as a way states can meet the growing demand for home- and community-based care. In the Mid-Atlantic region, D.C., Virginia and New Jersey posted the highest numbers of people enrolled in self-directed programs relative to their disabled populations.<br><br>Pennsylvania is the only state in the region that did not see an increase, but that could change as Jason Kavulich—who became Pennsylvania’s Secretary of Aging in January 2023—leads the state’s effort to develop a 10-year master plan for aging. “It is our top-most priority to make sure that people can age in place, how they choose, and to make sure that the services that we have really are responsive,” Kavulich says.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/90/ca/722b3834468a82b147701fcee20d/midatlanticranks.png" alt="midatlanticranks.png" width="3166" height="6717" style="height: auto; max-width: 350px;"/> </figure> </div> </div><p>One of the biggest challenges states face in expanding HCBS is the <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">shortage of</a></span></span> <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">direct-care workers</a></span></span> to fill those jobs. The work can be emotionally and physically taxing and usually comes with low pay, poor benefits and limited support and training.<br><br>The Scorecard shows that across the U.S., wages for direct-care workers are lower than in jobs with similar or lower entry requirements. Their median income is about $30,000 a year—approximately $5,000 less than workers in comparable jobs are paid in most states. D.C. has the highest wage gap in the country, with direct-care workers earning $5.03 less per hour than their counterparts in other sectors.<br><br>“I’m in competition with fast-food places. It’s as simple as that,” says 63-year-old Keith Williams of Clarks Green, Pennsylvania, outside Scranton. He was born with arthrogryposis, a combination of conditions that causes joint contractures and weak muscles.<br><br>Through a self-directed program, he hires care workers to help him with everything from showering to eating. He recruits through word of mouth and online postings. When that fails, he hires his sister-in-law.<br><br>It’s not easy, says Williams, the manager of independent living services for the Northeast Pennsylvania Center for Independent Living, a community-based organization staffed in part by people with disabilities. But the control he has over his care has allowed him to have a meaningful life.<br><br>“It’s meant that I’ve been able to live life on my own terms,” he says.<br><br><i>Ann Hardie spent a decade covering aging issues for The Atlanta Journal-Constitution. She has written for the Bulletin for 15 years.</i><br><br><b>More on Home Care</b><br></p><ul><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2023/rise-of-companion-care.html" target="_blank" rel="noopener noreferrer">Care Companions: A Watchful Eye and Willing Ear for Older Adults</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2019/home-health-aides.html" target="_blank" rel="noopener noreferrer">Find the Right Home Aide for Your Loved One</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://press.aarp.org/2021-11-18-AARP-Survey-Shows-8-in-10-Older-Adults-Want-to-Age-in-Their-Homes-While-Number-and-Needs-of-Households-Headed-Older-Adults-Grow-Dramatically" target="_blank" rel="noopener noreferrer">AARP Survey: 8 in 10 Older Adults Want to Age at Home</a></span></span></li></ul><div class="Enhancement" > <div class="Enhancement-item"><span class="VideoEnhancement" data-video-disable-history data-embeddedvideo-container> <div class="VideoEnhancement-player"><bsp-brightcoveplayer data-video-player class="BrightcoveVideoPlayer" data-account="3772599298001" data-player="KM9xJAJa4" data-video-id="5754403576001" data-video-title="How In-Home Care Helps — AARP" > <video class="video-js" id="BrightcoveVideoPlayer-5754403576001" data-video-id="5754403576001" data-account="" data-player="KM9xJAJa4" data-embed="default" controls ></video> </bsp-brightcoveplayer> </div> <div class="VideoEnhancement-title">How In-Home Care Helps — AARP</div> </span> </div> </div><p></p></div> </div> </p></span> </div> </div> </div> </div><div class="module clearfix"><script src="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.c85a242a55150cd195e494cd6e5b9c77.gz.js" async=""></script> <link rel="stylesheet" media="all" href="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.bfe6eb5a8301841feef3af4e9bd1e26d.gz.css"> <!-- bypass --> <style> a:focus, a:hover { text-decoration: underline; } h1.article-headline { margin: 0 0 1rem; } </style> <!-- <style> .Enhancement-item .Figure { margin-bottom: 24px; } .RichTextArticleBody-body ul { margin-bottom: 24px; } .RichTextArticleBody-body p{ margin: 12px 0; } .RichTextModule-items { clear: both; display: table; width: 100%; margin-bottom: 12px; } .VideoEnhancement>* { color: var(--primaryTextColor); font-size: 13px; font-weight: 400; line-height: 1.4; font-style: italic; background: #f0efed } @media only screen and (min-width: 768px) { .VideoEnhancement>* { font-size:14px; font-weight: 400; line-height: 1.47 } } .VideoEnhancement-title { padding: 20px } @media only screen and (min-width: 768px) { .VideoEnhancement-title { padding:30px } } .VideoEnhancement-player>* { position: relative; width: 100%; height: 0; padding-bottom: 56.25% } .VideoEnhancement iframe { border: 0; position: absolute; top: 0; left: 0; width: 100%; height: 100% } [data-video-player] { display: block; padding-bottom: 56.25%; height: 0; margin: 0 auto; } [data-video-player][data-aspect-ratio="4x3"] { padding-bottom: 56.25%; } [data-video-player][data-aspect-ratio="16x9"] { padding-bottom: 56.25% } </style> --></div><div class="module clearfix"><div class="module-spacer tout-homefit-750"> <a data-formelementid="CSN-LOCAL-HC-NEWSSK-02272024" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-HC-NEWSSK-02272024"><img class="img-responsive" alt="Explore the free AARP HomeFit Guide" title="Explore the free AARP HomeFit Guide" src="https://cdn-aarp.americantowns.com/img/touts/HomeFit_750x150.png"></a> </div></div></div> <div class="col-md-4 right-rail thin-rhs"><div class="module clearfix"><!--default--> <!-- module_RHS - AARP Events --> <div class="ar-basic-box module-spacer"> <header> <div class="pull-right"> <a href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS"> <img style="width:30px;" src="https://cdn-aarp.americantowns.com/img/template/icons/aarp_event_icon.png" alt="Upcoming AARP Events" /> </a> </div> <h2 class="visible-lg">AARP Events for Washington</h2> <h2 class="hidden-lg">AARP Events for Washington</h2> </header> <div class="wrap"> <div class="ar-listing snippet"> <ul class="list"> <li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-co-virtual-functional-fitness-online-99-10142024-sgnszx3wwws.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-FUNCTIONAL-FITNESS-WITH-BASIC-BODY-MOVEMENTS">Functional Fitness with Basic Body Movements</a></h2> <p class="time">Monday, Oct 7, 2024 at 9:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-nm-tai-ji-quan-moving-for-better-balance-albuquerque-nm-100724-j7nhvzxdkxd.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TAI-JI-QUAN-MOVING-FOR-BETTER-BALANCE">Tai Ji Quan: Moving for Better Balance</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/virtual-aarp-tx-mobility-mondays-houston-tx-100724-f5n2bjqhntc.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TRY-A-LOWIMPACT-WORKOUT-TO-IMPROVE-MOBILITY">Try A Low-Impact Workout to Improve Mobility</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom and Facebook</p> <p class="loc">Online Event</p> </li> </ul> <p><a class="link-red" href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS">View All AARP Events<i class="ml-1 fas fa-chevron-right"></i></a></p> </div> </div> </div> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_53475" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_53475', size:'300x250'}); } </script> </div> </div> <div class="card-tout card-dark membership-tout" style="margin:0 0 30px 0;"> <img class="img-responsive image" title="image of two AARP membership cards" alt="image of two AARP membership cards" src="https://cdn-aarp.americantowns.com/img/tout-two-cards.png"> <div class="title">Only $12 your first year with Automatic Renewal</div> <ul class="list"> <li>Immediate access to your <a href="https://www.aarp.org/benefits-discounts/">member benefits</a></li> <li>Discounts on travel and everyday savings</li> <li>Subscription to AARP The Magazine</li> <li>FREE second membership</li> </ul> <div class="action"> <a class="btn" href="https://appsec.aarp.org/mem/join?campaignid=UAJFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Join AARP</a> <div class="body">Already a member? <a href="https://appsec.aarp.org/mem/renew?campaignid= UARFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Renew</a> or <a href="https://www.aarp.org/benefits-discounts/my-membership/print-your-card/">Print Card</a></div> </div> </div> <style> .membership-tout {padding:16px 20px;} .membership-tout .list li { margin: 0; } </style> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_93505" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_93505', size:'300x250'}); } </script> </div> </div> <div class="module-spacer text-center"> <div class="fb-page" alt="Image of AARP District of Columbia Facebook Page" title="Image of AARP District of Columbia Facebook Page" data-href="https://www.facebook.com/aarpdc" data-tabs="timeline" width="320" height="" data-small-header="false" data-adapt-container-width="true" data-hide-cover="false" data-show-facepile="true" lazy="true"> <blockquote cite="https://www.facebook.com/aarpdc" class="fb-xfbml-parse-ignore"><a href="https://www.facebook.com/aarpdc">Facebook</a></blockquote> </div> </div> <div class="ar-basic-box module-spacer"> <header> <h2>Contact AARP<br />District of Columbia</h2> </header> <div class="wrap"> <div class="ar-quick-list module-spacer"> <ul class="list-unstyled"> <li><i class="list-icon fa fa-envelope" alt="Email icon" title="Email icon" aria-hidden="true"></i><a href="mailto:DCAARP@aarp.org " target="_blank" rel="noopener">DCAARP@aarp.org </a></li> <li><i class="list-icon fa fa-globe" alt="Globe icon" title="Globe icon" aria-hidden="true"></i><a href="https://states.aarp.org/region/washington-dc/" target="_blank" rel="noopener">AARP Washington, DC</a></li> <li><i class="list-icon fa fa-map-marker" alt="Map Marker icon" title="Map Marker icon" aria-hidden="true"></i><a href="https://states.aarp.org/aarp-district-of-columbia-state-office/?intcmp=SNG-LNK-AARPLOCAL-CONTACT-20140101-WASHINGTON-DC" target="_blank" rel="noopener">Contact Us</a></li> </ul> </div> <a href="https://www.facebook.com/aarpdc" target="_blank" rel="noopener" aria-label="Open Facebook"><img alt="Facebook icon" title="Facebook icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/facebook-dreamstale25.png"></a> <a href="https://twitter.com/AARPDC" target="_blank" rel="noopener" aria-label="Open Twitter"><img alt="Twitter icon" title="Twitter icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/x-logo-black.png"></a> </div> </div> </div></div> <div class="col-md-8 left-rail left-bot"></div> <div class="col-md-4 right-rail right-bot thin-rhs"></div> </div> <div class="row oneColumnLayout"> </div> <div class="row oneColumnLayout"> <div class="col-md-12"><!-- script to activate navbar --> <script type="text/javascript"> jQuery(".channelBarMain ul.left li a").click(function() { window.location = jQuery(this).attr('href'); }); </script> </div> </div> ' $scripts_for_layout = '<title>How Mid-Atlantic States Are Expanding Home Care</title> <meta name="page_title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="robots" content="noindex, nofollow"/> <meta content="John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The" name="description"/> <meta content="How, Mid, Atlantic, States, Expanding, Home, Care" name="keywords"/> <link rel="canonical" href="https://states.aarp.org/ltss-in-the-mid-atlantic" /> <meta property="og:url" content="https://vccstaging.local.aarp.org/news/how-midatlantic-states-are-expanding-home-care-2023-12-03.html"/> <meta name="twitter:card" content="summary_large_image"/> <meta name="twitter:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="twitter:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta name="twitter:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> <meta property="og:type" content="article"/> <meta property="og:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta property="og:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta property="og:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }' $title_for_layout = '{local_city_c}, {local_state} Happenings - AARP' $asset_version = '230831' $min = true $nowrapper = false $css = ' :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }'include - APP/View/Layouts/aarp_2023.ctp, line 54 include - APP/View/Layouts/aarp_2023.ctp, line 54 View::_evaluate() - CORE/Cake/View/View.php, line 971 View::_render() - CORE/Cake/View/View.php, line 933 View::renderLayout() - CORE/Cake/View/View.php, line 546 View::render() - CORE/Cake/View/View.php, line 481 Controller::render() - CORE/Cake/Controller/Controller.php, line 963 AppController::renderPage() - APP/Controller/AppController.php, line 136 BlogsController::display() - APP/Controller/BlogsController.php, line 81 ReflectionMethod::invokeArgs() - [internal], line ?? Controller::invokeAction() - CORE/Cake/Controller/Controller.php, line 491 Dispatcher::_invoke() - CORE/Cake/Routing/Dispatcher.php, line 193 Dispatcher::dispatch() - CORE/Cake/Routing/Dispatcher.php, line 167 [main] - APP/webroot/index.php, line 118
Warning (2): include() [<a href='http://php.net/function.include'>function.include</a>]: Failed opening '/var/www/vhosts/vcc_staging/app/Resource/aarp2_master.resource.root.html' for inclusion (include_path='/var/www/vhosts/vcc_staging/lib:.:/usr/share/pear:/usr/share/php') [APP/View/Layouts/aarp_2023.ctp, line 54]Code Context<?php if (!$nowrapper): // MLW - Spanish wrappers TBD
include (APP . "Resource/aarp2_master.head.html");
include (APP . "Resource/aarp2_master.resource.root.html");
$viewFile = '/var/www/vhosts/vcc_staging/app/View/Layouts/aarp_2023.ctp' $dataForView = array( 'content_for_layout' => '<div class="row twoColumnLayout"> <div class="col-md-8 left-rail"><div class="module clearfix"><div class="ar-basic-box"> <div> <div class="module-spacer"> <header><h1 class="article-headline">How Mid-Atlantic States Are Expanding Home Care</h1></header> <div class="posted-on"> Posted on 12/03/23 by <b>Ann Hardie</b> </div> </div> <div class="module-spacer"> <span class="blog-content"><p><div class="RichTextArticleBody"> <div class="RichTextArticleBody-body"><p>John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The 55-year-old from Dover, Delaware, goes to work every day, helps his 8-year-old son with basketball drills and watches his beloved Philadelphia Eagles with friends at Buffalo Wild Wings.<br><br>McNeal does so with the assistance of direct-care workers who help him get dressed in the morning, fix his meals and drive him where he needs to go.<br><br>“My life is unique in that I have a significant disability,” says McNeal, director of Delaware’s State Council for Persons with Disabilities. But, he says, it’s “a productive life that is every bit as normal as anybody else’s.”<br><br>Across the country, states such as Delaware are spending a growing percentage of long-term care funding to keep people in their homes and communities instead of institutional settings. That’s according to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023" target="_blank" rel="noopener noreferrer">AARP’s most recent Long-Term Services and Supports State Scorecard</a></span></span>, which uses 50 spending, quality and access indicators to rank each state’s long-term care system.<br><br>The new data shows that for the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid’s long-term care dollars nationally for older people and adults with physical disabilities went to home- and community-based services instead of nursing homes or other facilities.<br></p><p class="cms-textAlign-center"><b>EXPLORE: </b><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/" target="_blank" rel="noopener noreferrer"><b>AARP Long-Term Care Scorecard</b></a></span></span></p><p>“This is a big deal. We are seeing a breaking point,” says Susan Reinhard, senior vice president of the AARP Public Policy Institute, which published the Scorecard in September.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/da/c2/a471a2d346088edaf8c38a8b7a46/midalantic.png" alt="midalantic.png" width="6900" height="5761"/> <figcaption class="Figure-caption">Nicolas Rapp</figcaption> </figure> </div> </div><p>The shift to home- and community-based services comes as demand for such care has increased, fueled in part by a pandemic that took a horrific toll on nursing home residents. Polls have consistently shown that most older Americans want to age in place. A 2021 AARP survey found that more than three-quarters of adults 50-plus say they want to remain in their homes as they grow older.<br><br>But with America’s population of older adults growing, the chasm between the availability of HCBS and access to such services is poised to widen. <br><br>“We’re going to see a dramatic increase in the 80-plus and 85-plus population” as the boomer generation gets older, says Robert Applebaum, a senior research scholar at Miami University’s Scripps Gerontology Center in Ohio. “So the demand for long-term services ... is going to be tremendous.”<br><br><b><u>A person-centered approach</u></b><br><br>In the Mid-Atlantic region, Delaware, the District of Columbia, Maryland, New Jersey and West Virginia have all increased the percentage of their Medicaid dollars going to HCBS for older people and adults with physical disabilities in recent years, the Scorecard shows. One way they are doing that: giving more older adults the power to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">direct their own care</a></span></span>, funded through Medicaid initiatives. (Medicaid, a joint federal-state program for low-income Americans, includes coverage for nursing homes and other long-term care.) <br><br>Enrollment in these <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">“self-directed” care </a></span></span>programs increased by 10 percent or more across 34 states and the District of Columbia in recent years, the Scorecard shows. Such programs give people a greater say over how to spend government dollars on their own care.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/25/1e/2926ddba4cd09d7af135e7604561/1140-inset1-de-john-mcneal.jpg" alt="John McNeal, Director of the State Council for Persons with Disabilities for the State of Delaware, photographed at his office in Dover DE for AARP Bulletin, 7 December 2023. Photo by Mike Morgan." width="655" height="1140" style="height: auto; max-width: 380px;"/> <figcaption class="Figure-caption">John McNeal exits his car. Photo by Mike Morgan.</figcaption> </figure> </div> </div><p>“It’s like the ultimate person-centered approach,” says Lisa Alecxih, who researches long-term care for The Lewin Group, a health care and human services consulting firm. She notes that such programs often have the added benefit of allowing participants to hire family members as caregivers. That’s crucial because there’s a national shortage of direct-care workers.<br><br>Applebaum says his research on self-directed programs has also shown the satisfaction levels were “beyond anything I’ve ever seen as an evaluator.”<br><br>McNeal, the Delaware disability advocate, says that’s certainly true for him. “This is probably the most important program that has come into my life,” he says. “It has allowed me the opportunity to have everything that anybody else in the community has.”<br><br><b><u>Growing demand, workforce crunch</u></b><br><br>Self-directed services are one of many state-level innovations highlighted in the Scorecard as a way states can meet the growing demand for home- and community-based care. In the Mid-Atlantic region, D.C., Virginia and New Jersey posted the highest numbers of people enrolled in self-directed programs relative to their disabled populations.<br><br>Pennsylvania is the only state in the region that did not see an increase, but that could change as Jason Kavulich—who became Pennsylvania’s Secretary of Aging in January 2023—leads the state’s effort to develop a 10-year master plan for aging. “It is our top-most priority to make sure that people can age in place, how they choose, and to make sure that the services that we have really are responsive,” Kavulich says.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/90/ca/722b3834468a82b147701fcee20d/midatlanticranks.png" alt="midatlanticranks.png" width="3166" height="6717" style="height: auto; max-width: 350px;"/> </figure> </div> </div><p>One of the biggest challenges states face in expanding HCBS is the <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">shortage of</a></span></span> <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">direct-care workers</a></span></span> to fill those jobs. The work can be emotionally and physically taxing and usually comes with low pay, poor benefits and limited support and training.<br><br>The Scorecard shows that across the U.S., wages for direct-care workers are lower than in jobs with similar or lower entry requirements. Their median income is about $30,000 a year—approximately $5,000 less than workers in comparable jobs are paid in most states. D.C. has the highest wage gap in the country, with direct-care workers earning $5.03 less per hour than their counterparts in other sectors.<br><br>“I’m in competition with fast-food places. It’s as simple as that,” says 63-year-old Keith Williams of Clarks Green, Pennsylvania, outside Scranton. He was born with arthrogryposis, a combination of conditions that causes joint contractures and weak muscles.<br><br>Through a self-directed program, he hires care workers to help him with everything from showering to eating. He recruits through word of mouth and online postings. When that fails, he hires his sister-in-law.<br><br>It’s not easy, says Williams, the manager of independent living services for the Northeast Pennsylvania Center for Independent Living, a community-based organization staffed in part by people with disabilities. But the control he has over his care has allowed him to have a meaningful life.<br><br>“It’s meant that I’ve been able to live life on my own terms,” he says.<br><br><i>Ann Hardie spent a decade covering aging issues for The Atlanta Journal-Constitution. She has written for the Bulletin for 15 years.</i><br><br><b>More on Home Care</b><br></p><ul><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2023/rise-of-companion-care.html" target="_blank" rel="noopener noreferrer">Care Companions: A Watchful Eye and Willing Ear for Older Adults</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2019/home-health-aides.html" target="_blank" rel="noopener noreferrer">Find the Right Home Aide for Your Loved One</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://press.aarp.org/2021-11-18-AARP-Survey-Shows-8-in-10-Older-Adults-Want-to-Age-in-Their-Homes-While-Number-and-Needs-of-Households-Headed-Older-Adults-Grow-Dramatically" target="_blank" rel="noopener noreferrer">AARP Survey: 8 in 10 Older Adults Want to Age at Home</a></span></span></li></ul><div class="Enhancement" > <div class="Enhancement-item"><span class="VideoEnhancement" data-video-disable-history data-embeddedvideo-container> <div class="VideoEnhancement-player"><bsp-brightcoveplayer data-video-player class="BrightcoveVideoPlayer" data-account="3772599298001" data-player="KM9xJAJa4" data-video-id="5754403576001" data-video-title="How In-Home Care Helps — AARP" > <video class="video-js" id="BrightcoveVideoPlayer-5754403576001" data-video-id="5754403576001" data-account="" data-player="KM9xJAJa4" data-embed="default" controls ></video> </bsp-brightcoveplayer> </div> <div class="VideoEnhancement-title">How In-Home Care Helps — AARP</div> </span> </div> </div><p></p></div> </div> </p></span> </div> </div> </div> </div><div class="module clearfix"><script src="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.c85a242a55150cd195e494cd6e5b9c77.gz.js" async=""></script> <link rel="stylesheet" media="all" href="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.bfe6eb5a8301841feef3af4e9bd1e26d.gz.css"> <!-- bypass --> <style> a:focus, a:hover { text-decoration: underline; } h1.article-headline { margin: 0 0 1rem; } </style> <!-- <style> .Enhancement-item .Figure { margin-bottom: 24px; } .RichTextArticleBody-body ul { margin-bottom: 24px; } .RichTextArticleBody-body p{ margin: 12px 0; } .RichTextModule-items { clear: both; display: table; width: 100%; margin-bottom: 12px; } .VideoEnhancement>* { color: var(--primaryTextColor); font-size: 13px; font-weight: 400; line-height: 1.4; font-style: italic; background: #f0efed } @media only screen and (min-width: 768px) { .VideoEnhancement>* { font-size:14px; font-weight: 400; line-height: 1.47 } } .VideoEnhancement-title { padding: 20px } @media only screen and (min-width: 768px) { .VideoEnhancement-title { padding:30px } } .VideoEnhancement-player>* { position: relative; width: 100%; height: 0; padding-bottom: 56.25% } .VideoEnhancement iframe { border: 0; position: absolute; top: 0; left: 0; width: 100%; height: 100% } [data-video-player] { display: block; padding-bottom: 56.25%; height: 0; margin: 0 auto; } [data-video-player][data-aspect-ratio="4x3"] { padding-bottom: 56.25%; } [data-video-player][data-aspect-ratio="16x9"] { padding-bottom: 56.25% } </style> --></div><div class="module clearfix"><div class="module-spacer tout-homefit-750"> <a data-formelementid="CSN-LOCAL-HC-NEWSSK-02272024" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-HC-NEWSSK-02272024"><img class="img-responsive" alt="Explore the free AARP HomeFit Guide" title="Explore the free AARP HomeFit Guide" src="https://cdn-aarp.americantowns.com/img/touts/HomeFit_750x150.png"></a> </div></div></div> <div class="col-md-4 right-rail thin-rhs"><div class="module clearfix"><!--default--> <!-- module_RHS - AARP Events --> <div class="ar-basic-box module-spacer"> <header> <div class="pull-right"> <a href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS"> <img style="width:30px;" src="https://cdn-aarp.americantowns.com/img/template/icons/aarp_event_icon.png" alt="Upcoming AARP Events" /> </a> </div> <h2 class="visible-lg">AARP Events for Washington</h2> <h2 class="hidden-lg">AARP Events for Washington</h2> </header> <div class="wrap"> <div class="ar-listing snippet"> <ul class="list"> <li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-co-virtual-functional-fitness-online-99-10142024-sgnszx3wwws.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-FUNCTIONAL-FITNESS-WITH-BASIC-BODY-MOVEMENTS">Functional Fitness with Basic Body Movements</a></h2> <p class="time">Monday, Oct 7, 2024 at 9:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-nm-tai-ji-quan-moving-for-better-balance-albuquerque-nm-100724-j7nhvzxdkxd.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TAI-JI-QUAN-MOVING-FOR-BETTER-BALANCE">Tai Ji Quan: Moving for Better Balance</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/virtual-aarp-tx-mobility-mondays-houston-tx-100724-f5n2bjqhntc.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TRY-A-LOWIMPACT-WORKOUT-TO-IMPROVE-MOBILITY">Try A Low-Impact Workout to Improve Mobility</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom and Facebook</p> <p class="loc">Online Event</p> </li> </ul> <p><a class="link-red" href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS">View All AARP Events<i class="ml-1 fas fa-chevron-right"></i></a></p> </div> </div> </div> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_53475" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_53475', size:'300x250'}); } </script> </div> </div> <div class="card-tout card-dark membership-tout" style="margin:0 0 30px 0;"> <img class="img-responsive image" title="image of two AARP membership cards" alt="image of two AARP membership cards" src="https://cdn-aarp.americantowns.com/img/tout-two-cards.png"> <div class="title">Only $12 your first year with Automatic Renewal</div> <ul class="list"> <li>Immediate access to your <a href="https://www.aarp.org/benefits-discounts/">member benefits</a></li> <li>Discounts on travel and everyday savings</li> <li>Subscription to AARP The Magazine</li> <li>FREE second membership</li> </ul> <div class="action"> <a class="btn" href="https://appsec.aarp.org/mem/join?campaignid=UAJFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Join AARP</a> <div class="body">Already a member? <a href="https://appsec.aarp.org/mem/renew?campaignid= UARFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Renew</a> or <a href="https://www.aarp.org/benefits-discounts/my-membership/print-your-card/">Print Card</a></div> </div> </div> <style> .membership-tout {padding:16px 20px;} .membership-tout .list li { margin: 0; } </style> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_93505" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_93505', size:'300x250'}); } </script> </div> </div> <div class="module-spacer text-center"> <div class="fb-page" alt="Image of AARP District of Columbia Facebook Page" title="Image of AARP District of Columbia Facebook Page" data-href="https://www.facebook.com/aarpdc" data-tabs="timeline" width="320" height="" data-small-header="false" data-adapt-container-width="true" data-hide-cover="false" data-show-facepile="true" lazy="true"> <blockquote cite="https://www.facebook.com/aarpdc" class="fb-xfbml-parse-ignore"><a href="https://www.facebook.com/aarpdc">Facebook</a></blockquote> </div> </div> <div class="ar-basic-box module-spacer"> <header> <h2>Contact AARP<br />District of Columbia</h2> </header> <div class="wrap"> <div class="ar-quick-list module-spacer"> <ul class="list-unstyled"> <li><i class="list-icon fa fa-envelope" alt="Email icon" title="Email icon" aria-hidden="true"></i><a href="mailto:DCAARP@aarp.org " target="_blank" rel="noopener">DCAARP@aarp.org </a></li> <li><i class="list-icon fa fa-globe" alt="Globe icon" title="Globe icon" aria-hidden="true"></i><a href="https://states.aarp.org/region/washington-dc/" target="_blank" rel="noopener">AARP Washington, DC</a></li> <li><i class="list-icon fa fa-map-marker" alt="Map Marker icon" title="Map Marker icon" aria-hidden="true"></i><a href="https://states.aarp.org/aarp-district-of-columbia-state-office/?intcmp=SNG-LNK-AARPLOCAL-CONTACT-20140101-WASHINGTON-DC" target="_blank" rel="noopener">Contact Us</a></li> </ul> </div> <a href="https://www.facebook.com/aarpdc" target="_blank" rel="noopener" aria-label="Open Facebook"><img alt="Facebook icon" title="Facebook icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/facebook-dreamstale25.png"></a> <a href="https://twitter.com/AARPDC" target="_blank" rel="noopener" aria-label="Open Twitter"><img alt="Twitter icon" title="Twitter icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/x-logo-black.png"></a> </div> </div> </div></div> <div class="col-md-8 left-rail left-bot"></div> <div class="col-md-4 right-rail right-bot thin-rhs"></div> </div> <div class="row oneColumnLayout"> </div> <div class="row oneColumnLayout"> <div class="col-md-12"><!-- script to activate navbar --> <script type="text/javascript"> jQuery(".channelBarMain ul.left li a").click(function() { window.location = jQuery(this).attr('href'); }); </script> </div> </div> ', 'scripts_for_layout' => '<title>How Mid-Atlantic States Are Expanding Home Care</title> <meta name="page_title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="robots" content="noindex, nofollow"/> <meta content="John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The" name="description"/> <meta content="How, Mid, Atlantic, States, Expanding, Home, Care" name="keywords"/> <link rel="canonical" href="https://states.aarp.org/ltss-in-the-mid-atlantic" /> <meta property="og:url" content="https://vccstaging.local.aarp.org/news/how-midatlantic-states-are-expanding-home-care-2023-12-03.html"/> <meta name="twitter:card" content="summary_large_image"/> <meta name="twitter:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="twitter:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta name="twitter:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> <meta property="og:type" content="article"/> <meta property="og:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta property="og:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta property="og:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }', 'title_for_layout' => '{local_city_c}, {local_state} Happenings - AARP' ) $content_for_layout = '<div class="row twoColumnLayout"> <div class="col-md-8 left-rail"><div class="module clearfix"><div class="ar-basic-box"> <div> <div class="module-spacer"> <header><h1 class="article-headline">How Mid-Atlantic States Are Expanding Home Care</h1></header> <div class="posted-on"> Posted on 12/03/23 by <b>Ann Hardie</b> </div> </div> <div class="module-spacer"> <span class="blog-content"><p><div class="RichTextArticleBody"> <div class="RichTextArticleBody-body"><p>John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The 55-year-old from Dover, Delaware, goes to work every day, helps his 8-year-old son with basketball drills and watches his beloved Philadelphia Eagles with friends at Buffalo Wild Wings.<br><br>McNeal does so with the assistance of direct-care workers who help him get dressed in the morning, fix his meals and drive him where he needs to go.<br><br>“My life is unique in that I have a significant disability,” says McNeal, director of Delaware’s State Council for Persons with Disabilities. But, he says, it’s “a productive life that is every bit as normal as anybody else’s.”<br><br>Across the country, states such as Delaware are spending a growing percentage of long-term care funding to keep people in their homes and communities instead of institutional settings. That’s according to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023" target="_blank" rel="noopener noreferrer">AARP’s most recent Long-Term Services and Supports State Scorecard</a></span></span>, which uses 50 spending, quality and access indicators to rank each state’s long-term care system.<br><br>The new data shows that for the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid’s long-term care dollars nationally for older people and adults with physical disabilities went to home- and community-based services instead of nursing homes or other facilities.<br></p><p class="cms-textAlign-center"><b>EXPLORE: </b><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/" target="_blank" rel="noopener noreferrer"><b>AARP Long-Term Care Scorecard</b></a></span></span></p><p>“This is a big deal. We are seeing a breaking point,” says Susan Reinhard, senior vice president of the AARP Public Policy Institute, which published the Scorecard in September.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/da/c2/a471a2d346088edaf8c38a8b7a46/midalantic.png" alt="midalantic.png" width="6900" height="5761"/> <figcaption class="Figure-caption">Nicolas Rapp</figcaption> </figure> </div> </div><p>The shift to home- and community-based services comes as demand for such care has increased, fueled in part by a pandemic that took a horrific toll on nursing home residents. Polls have consistently shown that most older Americans want to age in place. A 2021 AARP survey found that more than three-quarters of adults 50-plus say they want to remain in their homes as they grow older.<br><br>But with America’s population of older adults growing, the chasm between the availability of HCBS and access to such services is poised to widen. <br><br>“We’re going to see a dramatic increase in the 80-plus and 85-plus population” as the boomer generation gets older, says Robert Applebaum, a senior research scholar at Miami University’s Scripps Gerontology Center in Ohio. “So the demand for long-term services ... is going to be tremendous.”<br><br><b><u>A person-centered approach</u></b><br><br>In the Mid-Atlantic region, Delaware, the District of Columbia, Maryland, New Jersey and West Virginia have all increased the percentage of their Medicaid dollars going to HCBS for older people and adults with physical disabilities in recent years, the Scorecard shows. One way they are doing that: giving more older adults the power to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">direct their own care</a></span></span>, funded through Medicaid initiatives. (Medicaid, a joint federal-state program for low-income Americans, includes coverage for nursing homes and other long-term care.) <br><br>Enrollment in these <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">“self-directed” care </a></span></span>programs increased by 10 percent or more across 34 states and the District of Columbia in recent years, the Scorecard shows. Such programs give people a greater say over how to spend government dollars on their own care.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/25/1e/2926ddba4cd09d7af135e7604561/1140-inset1-de-john-mcneal.jpg" alt="John McNeal, Director of the State Council for Persons with Disabilities for the State of Delaware, photographed at his office in Dover DE for AARP Bulletin, 7 December 2023. Photo by Mike Morgan." width="655" height="1140" style="height: auto; max-width: 380px;"/> <figcaption class="Figure-caption">John McNeal exits his car. Photo by Mike Morgan.</figcaption> </figure> </div> </div><p>“It’s like the ultimate person-centered approach,” says Lisa Alecxih, who researches long-term care for The Lewin Group, a health care and human services consulting firm. She notes that such programs often have the added benefit of allowing participants to hire family members as caregivers. That’s crucial because there’s a national shortage of direct-care workers.<br><br>Applebaum says his research on self-directed programs has also shown the satisfaction levels were “beyond anything I’ve ever seen as an evaluator.”<br><br>McNeal, the Delaware disability advocate, says that’s certainly true for him. “This is probably the most important program that has come into my life,” he says. “It has allowed me the opportunity to have everything that anybody else in the community has.”<br><br><b><u>Growing demand, workforce crunch</u></b><br><br>Self-directed services are one of many state-level innovations highlighted in the Scorecard as a way states can meet the growing demand for home- and community-based care. In the Mid-Atlantic region, D.C., Virginia and New Jersey posted the highest numbers of people enrolled in self-directed programs relative to their disabled populations.<br><br>Pennsylvania is the only state in the region that did not see an increase, but that could change as Jason Kavulich—who became Pennsylvania’s Secretary of Aging in January 2023—leads the state’s effort to develop a 10-year master plan for aging. “It is our top-most priority to make sure that people can age in place, how they choose, and to make sure that the services that we have really are responsive,” Kavulich says.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/90/ca/722b3834468a82b147701fcee20d/midatlanticranks.png" alt="midatlanticranks.png" width="3166" height="6717" style="height: auto; max-width: 350px;"/> </figure> </div> </div><p>One of the biggest challenges states face in expanding HCBS is the <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">shortage of</a></span></span> <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">direct-care workers</a></span></span> to fill those jobs. The work can be emotionally and physically taxing and usually comes with low pay, poor benefits and limited support and training.<br><br>The Scorecard shows that across the U.S., wages for direct-care workers are lower than in jobs with similar or lower entry requirements. Their median income is about $30,000 a year—approximately $5,000 less than workers in comparable jobs are paid in most states. D.C. has the highest wage gap in the country, with direct-care workers earning $5.03 less per hour than their counterparts in other sectors.<br><br>“I’m in competition with fast-food places. It’s as simple as that,” says 63-year-old Keith Williams of Clarks Green, Pennsylvania, outside Scranton. He was born with arthrogryposis, a combination of conditions that causes joint contractures and weak muscles.<br><br>Through a self-directed program, he hires care workers to help him with everything from showering to eating. He recruits through word of mouth and online postings. When that fails, he hires his sister-in-law.<br><br>It’s not easy, says Williams, the manager of independent living services for the Northeast Pennsylvania Center for Independent Living, a community-based organization staffed in part by people with disabilities. But the control he has over his care has allowed him to have a meaningful life.<br><br>“It’s meant that I’ve been able to live life on my own terms,” he says.<br><br><i>Ann Hardie spent a decade covering aging issues for The Atlanta Journal-Constitution. She has written for the Bulletin for 15 years.</i><br><br><b>More on Home Care</b><br></p><ul><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2023/rise-of-companion-care.html" target="_blank" rel="noopener noreferrer">Care Companions: A Watchful Eye and Willing Ear for Older Adults</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2019/home-health-aides.html" target="_blank" rel="noopener noreferrer">Find the Right Home Aide for Your Loved One</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://press.aarp.org/2021-11-18-AARP-Survey-Shows-8-in-10-Older-Adults-Want-to-Age-in-Their-Homes-While-Number-and-Needs-of-Households-Headed-Older-Adults-Grow-Dramatically" target="_blank" rel="noopener noreferrer">AARP Survey: 8 in 10 Older Adults Want to Age at Home</a></span></span></li></ul><div class="Enhancement" > <div class="Enhancement-item"><span class="VideoEnhancement" data-video-disable-history data-embeddedvideo-container> <div class="VideoEnhancement-player"><bsp-brightcoveplayer data-video-player class="BrightcoveVideoPlayer" data-account="3772599298001" data-player="KM9xJAJa4" data-video-id="5754403576001" data-video-title="How In-Home Care Helps — AARP" > <video class="video-js" id="BrightcoveVideoPlayer-5754403576001" data-video-id="5754403576001" data-account="" data-player="KM9xJAJa4" data-embed="default" controls ></video> </bsp-brightcoveplayer> </div> <div class="VideoEnhancement-title">How In-Home Care Helps — AARP</div> </span> </div> </div><p></p></div> </div> </p></span> </div> </div> </div> </div><div class="module clearfix"><script src="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.c85a242a55150cd195e494cd6e5b9c77.gz.js" async=""></script> <link rel="stylesheet" media="all" href="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.bfe6eb5a8301841feef3af4e9bd1e26d.gz.css"> <!-- bypass --> <style> a:focus, a:hover { text-decoration: underline; } h1.article-headline { margin: 0 0 1rem; } </style> <!-- <style> .Enhancement-item .Figure { margin-bottom: 24px; } .RichTextArticleBody-body ul { margin-bottom: 24px; } .RichTextArticleBody-body p{ margin: 12px 0; } .RichTextModule-items { clear: both; display: table; width: 100%; margin-bottom: 12px; } .VideoEnhancement>* { color: var(--primaryTextColor); font-size: 13px; font-weight: 400; line-height: 1.4; font-style: italic; background: #f0efed } @media only screen and (min-width: 768px) { .VideoEnhancement>* { font-size:14px; font-weight: 400; line-height: 1.47 } } .VideoEnhancement-title { padding: 20px } @media only screen and (min-width: 768px) { .VideoEnhancement-title { padding:30px } } .VideoEnhancement-player>* { position: relative; width: 100%; height: 0; padding-bottom: 56.25% } .VideoEnhancement iframe { border: 0; position: absolute; top: 0; left: 0; width: 100%; height: 100% } [data-video-player] { display: block; padding-bottom: 56.25%; height: 0; margin: 0 auto; } [data-video-player][data-aspect-ratio="4x3"] { padding-bottom: 56.25%; } [data-video-player][data-aspect-ratio="16x9"] { padding-bottom: 56.25% } </style> --></div><div class="module clearfix"><div class="module-spacer tout-homefit-750"> <a data-formelementid="CSN-LOCAL-HC-NEWSSK-02272024" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-HC-NEWSSK-02272024"><img class="img-responsive" alt="Explore the free AARP HomeFit Guide" title="Explore the free AARP HomeFit Guide" src="https://cdn-aarp.americantowns.com/img/touts/HomeFit_750x150.png"></a> </div></div></div> <div class="col-md-4 right-rail thin-rhs"><div class="module clearfix"><!--default--> <!-- module_RHS - AARP Events --> <div class="ar-basic-box module-spacer"> <header> <div class="pull-right"> <a href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS"> <img style="width:30px;" src="https://cdn-aarp.americantowns.com/img/template/icons/aarp_event_icon.png" alt="Upcoming AARP Events" /> </a> </div> <h2 class="visible-lg">AARP Events for Washington</h2> <h2 class="hidden-lg">AARP Events for Washington</h2> </header> <div class="wrap"> <div class="ar-listing snippet"> <ul class="list"> <li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-co-virtual-functional-fitness-online-99-10142024-sgnszx3wwws.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-FUNCTIONAL-FITNESS-WITH-BASIC-BODY-MOVEMENTS">Functional Fitness with Basic Body Movements</a></h2> <p class="time">Monday, Oct 7, 2024 at 9:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-nm-tai-ji-quan-moving-for-better-balance-albuquerque-nm-100724-j7nhvzxdkxd.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TAI-JI-QUAN-MOVING-FOR-BETTER-BALANCE">Tai Ji Quan: Moving for Better Balance</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/virtual-aarp-tx-mobility-mondays-houston-tx-100724-f5n2bjqhntc.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TRY-A-LOWIMPACT-WORKOUT-TO-IMPROVE-MOBILITY">Try A Low-Impact Workout to Improve Mobility</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom and Facebook</p> <p class="loc">Online Event</p> </li> </ul> <p><a class="link-red" href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS">View All AARP Events<i class="ml-1 fas fa-chevron-right"></i></a></p> </div> </div> </div> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_53475" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_53475', size:'300x250'}); } </script> </div> </div> <div class="card-tout card-dark membership-tout" style="margin:0 0 30px 0;"> <img class="img-responsive image" title="image of two AARP membership cards" alt="image of two AARP membership cards" src="https://cdn-aarp.americantowns.com/img/tout-two-cards.png"> <div class="title">Only $12 your first year with Automatic Renewal</div> <ul class="list"> <li>Immediate access to your <a href="https://www.aarp.org/benefits-discounts/">member benefits</a></li> <li>Discounts on travel and everyday savings</li> <li>Subscription to AARP The Magazine</li> <li>FREE second membership</li> </ul> <div class="action"> <a class="btn" href="https://appsec.aarp.org/mem/join?campaignid=UAJFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Join AARP</a> <div class="body">Already a member? <a href="https://appsec.aarp.org/mem/renew?campaignid= UARFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Renew</a> or <a href="https://www.aarp.org/benefits-discounts/my-membership/print-your-card/">Print Card</a></div> </div> </div> <style> .membership-tout {padding:16px 20px;} .membership-tout .list li { margin: 0; } </style> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_93505" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_93505', size:'300x250'}); } </script> </div> </div> <div class="module-spacer text-center"> <div class="fb-page" alt="Image of AARP District of Columbia Facebook Page" title="Image of AARP District of Columbia Facebook Page" data-href="https://www.facebook.com/aarpdc" data-tabs="timeline" width="320" height="" data-small-header="false" data-adapt-container-width="true" data-hide-cover="false" data-show-facepile="true" lazy="true"> <blockquote cite="https://www.facebook.com/aarpdc" class="fb-xfbml-parse-ignore"><a href="https://www.facebook.com/aarpdc">Facebook</a></blockquote> </div> </div> <div class="ar-basic-box module-spacer"> <header> <h2>Contact AARP<br />District of Columbia</h2> </header> <div class="wrap"> <div class="ar-quick-list module-spacer"> <ul class="list-unstyled"> <li><i class="list-icon fa fa-envelope" alt="Email icon" title="Email icon" aria-hidden="true"></i><a href="mailto:DCAARP@aarp.org " target="_blank" rel="noopener">DCAARP@aarp.org </a></li> <li><i class="list-icon fa fa-globe" alt="Globe icon" title="Globe icon" aria-hidden="true"></i><a href="https://states.aarp.org/region/washington-dc/" target="_blank" rel="noopener">AARP Washington, DC</a></li> <li><i class="list-icon fa fa-map-marker" alt="Map Marker icon" title="Map Marker icon" aria-hidden="true"></i><a href="https://states.aarp.org/aarp-district-of-columbia-state-office/?intcmp=SNG-LNK-AARPLOCAL-CONTACT-20140101-WASHINGTON-DC" target="_blank" rel="noopener">Contact Us</a></li> </ul> </div> <a href="https://www.facebook.com/aarpdc" target="_blank" rel="noopener" aria-label="Open Facebook"><img alt="Facebook icon" title="Facebook icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/facebook-dreamstale25.png"></a> <a href="https://twitter.com/AARPDC" target="_blank" rel="noopener" aria-label="Open Twitter"><img alt="Twitter icon" title="Twitter icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/x-logo-black.png"></a> </div> </div> </div></div> <div class="col-md-8 left-rail left-bot"></div> <div class="col-md-4 right-rail right-bot thin-rhs"></div> </div> <div class="row oneColumnLayout"> </div> <div class="row oneColumnLayout"> <div class="col-md-12"><!-- script to activate navbar --> <script type="text/javascript"> jQuery(".channelBarMain ul.left li a").click(function() { window.location = jQuery(this).attr('href'); }); </script> </div> </div> ' $scripts_for_layout = '<title>How Mid-Atlantic States Are Expanding Home Care</title> <meta name="page_title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="robots" content="noindex, nofollow"/> <meta content="John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The" name="description"/> <meta content="How, Mid, Atlantic, States, Expanding, Home, Care" name="keywords"/> <link rel="canonical" href="https://states.aarp.org/ltss-in-the-mid-atlantic" /> <meta property="og:url" content="https://vccstaging.local.aarp.org/news/how-midatlantic-states-are-expanding-home-care-2023-12-03.html"/> <meta name="twitter:card" content="summary_large_image"/> <meta name="twitter:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="twitter:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta name="twitter:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> <meta property="og:type" content="article"/> <meta property="og:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta property="og:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta property="og:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }' $title_for_layout = '{local_city_c}, {local_state} Happenings - AARP' $asset_version = '230831' $min = true $nowrapper = false $css = ' :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }'include - APP/View/Layouts/aarp_2023.ctp, line 54 include - APP/View/Layouts/aarp_2023.ctp, line 54 View::_evaluate() - CORE/Cake/View/View.php, line 971 View::_render() - CORE/Cake/View/View.php, line 933 View::renderLayout() - CORE/Cake/View/View.php, line 546 View::render() - CORE/Cake/View/View.php, line 481 Controller::render() - CORE/Cake/Controller/Controller.php, line 963 AppController::renderPage() - APP/Controller/AppController.php, line 136 BlogsController::display() - APP/Controller/BlogsController.php, line 81 ReflectionMethod::invokeArgs() - [internal], line ?? Controller::invokeAction() - CORE/Cake/Controller/Controller.php, line 491 Dispatcher::_invoke() - CORE/Cake/Routing/Dispatcher.php, line 193 Dispatcher::dispatch() - CORE/Cake/Routing/Dispatcher.php, line 167 [main] - APP/webroot/index.php, line 118
John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The 55-year-old from Dover, Delaware, goes to work every day, helps his 8-year-old son with basketball drills and watches his beloved Philadelphia Eagles with friends at Buffalo Wild Wings.
McNeal does so with the assistance of direct-care workers who help him get dressed in the morning, fix his meals and drive him where he needs to go.
“My life is unique in that I have a significant disability,” says McNeal, director of Delaware’s State Council for Persons with Disabilities. But, he says, it’s “a productive life that is every bit as normal as anybody else’s.”
Across the country, states such as Delaware are spending a growing percentage of long-term care funding to keep people in their homes and communities instead of institutional settings. That’s according to AARP’s most recent Long-Term Services and Supports State Scorecard, which uses 50 spending, quality and access indicators to rank each state’s long-term care system.
The new data shows that for the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid’s long-term care dollars nationally for older people and adults with physical disabilities went to home- and community-based services instead of nursing homes or other facilities.
EXPLORE: AARP Long-Term Care Scorecard
“This is a big deal. We are seeing a breaking point,” says Susan Reinhard, senior vice president of the AARP Public Policy Institute, which published the Scorecard in September.
The shift to home- and community-based services comes as demand for such care has increased, fueled in part by a pandemic that took a horrific toll on nursing home residents. Polls have consistently shown that most older Americans want to age in place. A 2021 AARP survey found that more than three-quarters of adults 50-plus say they want to remain in their homes as they grow older.
But with America’s population of older adults growing, the chasm between the availability of HCBS and access to such services is poised to widen.
“We’re going to see a dramatic increase in the 80-plus and 85-plus population” as the boomer generation gets older, says Robert Applebaum, a senior research scholar at Miami University’s Scripps Gerontology Center in Ohio. “So the demand for long-term services ... is going to be tremendous.”
A person-centered approach
In the Mid-Atlantic region, Delaware, the District of Columbia, Maryland, New Jersey and West Virginia have all increased the percentage of their Medicaid dollars going to HCBS for older people and adults with physical disabilities in recent years, the Scorecard shows. One way they are doing that: giving more older adults the power to direct their own care, funded through Medicaid initiatives. (Medicaid, a joint federal-state program for low-income Americans, includes coverage for nursing homes and other long-term care.)
Enrollment in these “self-directed” care programs increased by 10 percent or more across 34 states and the District of Columbia in recent years, the Scorecard shows. Such programs give people a greater say over how to spend government dollars on their own care.
“It’s like the ultimate person-centered approach,” says Lisa Alecxih, who researches long-term care for The Lewin Group, a health care and human services consulting firm. She notes that such programs often have the added benefit of allowing participants to hire family members as caregivers. That’s crucial because there’s a national shortage of direct-care workers.
Applebaum says his research on self-directed programs has also shown the satisfaction levels were “beyond anything I’ve ever seen as an evaluator.”
McNeal, the Delaware disability advocate, says that’s certainly true for him. “This is probably the most important program that has come into my life,” he says. “It has allowed me the opportunity to have everything that anybody else in the community has.”
Growing demand, workforce crunch
Self-directed services are one of many state-level innovations highlighted in the Scorecard as a way states can meet the growing demand for home- and community-based care. In the Mid-Atlantic region, D.C., Virginia and New Jersey posted the highest numbers of people enrolled in self-directed programs relative to their disabled populations.
Pennsylvania is the only state in the region that did not see an increase, but that could change as Jason Kavulich—who became Pennsylvania’s Secretary of Aging in January 2023—leads the state’s effort to develop a 10-year master plan for aging. “It is our top-most priority to make sure that people can age in place, how they choose, and to make sure that the services that we have really are responsive,” Kavulich says.
One of the biggest challenges states face in expanding HCBS is the shortage of direct-care workers to fill those jobs. The work can be emotionally and physically taxing and usually comes with low pay, poor benefits and limited support and training.
The Scorecard shows that across the U.S., wages for direct-care workers are lower than in jobs with similar or lower entry requirements. Their median income is about $30,000 a year—approximately $5,000 less than workers in comparable jobs are paid in most states. D.C. has the highest wage gap in the country, with direct-care workers earning $5.03 less per hour than their counterparts in other sectors.
“I’m in competition with fast-food places. It’s as simple as that,” says 63-year-old Keith Williams of Clarks Green, Pennsylvania, outside Scranton. He was born with arthrogryposis, a combination of conditions that causes joint contractures and weak muscles.
Through a self-directed program, he hires care workers to help him with everything from showering to eating. He recruits through word of mouth and online postings. When that fails, he hires his sister-in-law.
It’s not easy, says Williams, the manager of independent living services for the Northeast Pennsylvania Center for Independent Living, a community-based organization staffed in part by people with disabilities. But the control he has over his care has allowed him to have a meaningful life.
“It’s meant that I’ve been able to live life on my own terms,” he says.
Ann Hardie spent a decade covering aging issues for The Atlanta Journal-Constitution. She has written for the Bulletin for 15 years.
More on Home Care
Monday, Oct 7, 2024 at 9:00 a.m. ET
Zoom
Online Event
Monday, Oct 7, 2024 at 11:00 a.m. ET
Zoom
Online Event
Monday, Oct 7, 2024 at 11:00 a.m. ET
Zoom and Facebook
Online Event
Warning (2): include(/var/www/vhosts/vcc_staging/app/Resource/aarp2_master.footer.html) [<a href='http://php.net/function.include'>function.include</a>]: failed to open stream: No such file or directory [APP/View/Layouts/aarp_2023.ctp, line 242]Code Context<?php // if (!$nowrapper) (Globals::$language == 'es') ? include(APP . "/Resource/aarpe_footer_es.html") : include(APP . "/Resource/aarpe_footer.html"); ?>
<?php if (!$nowrapper): // MLW - Spanish wrappers TBD
include (APP . "Resource/aarp2_master.footer.html");
$viewFile = '/var/www/vhosts/vcc_staging/app/View/Layouts/aarp_2023.ctp' $dataForView = array( 'content_for_layout' => '<div class="row twoColumnLayout"> <div class="col-md-8 left-rail"><div class="module clearfix"><div class="ar-basic-box"> <div> <div class="module-spacer"> <header><h1 class="article-headline">How Mid-Atlantic States Are Expanding Home Care</h1></header> <div class="posted-on"> Posted on 12/03/23 by <b>Ann Hardie</b> </div> </div> <div class="module-spacer"> <span class="blog-content"><p><div class="RichTextArticleBody"> <div class="RichTextArticleBody-body"><p>John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The 55-year-old from Dover, Delaware, goes to work every day, helps his 8-year-old son with basketball drills and watches his beloved Philadelphia Eagles with friends at Buffalo Wild Wings.<br><br>McNeal does so with the assistance of direct-care workers who help him get dressed in the morning, fix his meals and drive him where he needs to go.<br><br>“My life is unique in that I have a significant disability,” says McNeal, director of Delaware’s State Council for Persons with Disabilities. But, he says, it’s “a productive life that is every bit as normal as anybody else’s.”<br><br>Across the country, states such as Delaware are spending a growing percentage of long-term care funding to keep people in their homes and communities instead of institutional settings. That’s according to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023" target="_blank" rel="noopener noreferrer">AARP’s most recent Long-Term Services and Supports State Scorecard</a></span></span>, which uses 50 spending, quality and access indicators to rank each state’s long-term care system.<br><br>The new data shows that for the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid’s long-term care dollars nationally for older people and adults with physical disabilities went to home- and community-based services instead of nursing homes or other facilities.<br></p><p class="cms-textAlign-center"><b>EXPLORE: </b><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/" target="_blank" rel="noopener noreferrer"><b>AARP Long-Term Care Scorecard</b></a></span></span></p><p>“This is a big deal. We are seeing a breaking point,” says Susan Reinhard, senior vice president of the AARP Public Policy Institute, which published the Scorecard in September.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/da/c2/a471a2d346088edaf8c38a8b7a46/midalantic.png" alt="midalantic.png" width="6900" height="5761"/> <figcaption class="Figure-caption">Nicolas Rapp</figcaption> </figure> </div> </div><p>The shift to home- and community-based services comes as demand for such care has increased, fueled in part by a pandemic that took a horrific toll on nursing home residents. Polls have consistently shown that most older Americans want to age in place. A 2021 AARP survey found that more than three-quarters of adults 50-plus say they want to remain in their homes as they grow older.<br><br>But with America’s population of older adults growing, the chasm between the availability of HCBS and access to such services is poised to widen. <br><br>“We’re going to see a dramatic increase in the 80-plus and 85-plus population” as the boomer generation gets older, says Robert Applebaum, a senior research scholar at Miami University’s Scripps Gerontology Center in Ohio. “So the demand for long-term services ... is going to be tremendous.”<br><br><b><u>A person-centered approach</u></b><br><br>In the Mid-Atlantic region, Delaware, the District of Columbia, Maryland, New Jersey and West Virginia have all increased the percentage of their Medicaid dollars going to HCBS for older people and adults with physical disabilities in recent years, the Scorecard shows. One way they are doing that: giving more older adults the power to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">direct their own care</a></span></span>, funded through Medicaid initiatives. (Medicaid, a joint federal-state program for low-income Americans, includes coverage for nursing homes and other long-term care.) <br><br>Enrollment in these <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">“self-directed” care </a></span></span>programs increased by 10 percent or more across 34 states and the District of Columbia in recent years, the Scorecard shows. Such programs give people a greater say over how to spend government dollars on their own care.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/25/1e/2926ddba4cd09d7af135e7604561/1140-inset1-de-john-mcneal.jpg" alt="John McNeal, Director of the State Council for Persons with Disabilities for the State of Delaware, photographed at his office in Dover DE for AARP Bulletin, 7 December 2023. Photo by Mike Morgan." width="655" height="1140" style="height: auto; max-width: 380px;"/> <figcaption class="Figure-caption">John McNeal exits his car. Photo by Mike Morgan.</figcaption> </figure> </div> </div><p>“It’s like the ultimate person-centered approach,” says Lisa Alecxih, who researches long-term care for The Lewin Group, a health care and human services consulting firm. She notes that such programs often have the added benefit of allowing participants to hire family members as caregivers. That’s crucial because there’s a national shortage of direct-care workers.<br><br>Applebaum says his research on self-directed programs has also shown the satisfaction levels were “beyond anything I’ve ever seen as an evaluator.”<br><br>McNeal, the Delaware disability advocate, says that’s certainly true for him. “This is probably the most important program that has come into my life,” he says. “It has allowed me the opportunity to have everything that anybody else in the community has.”<br><br><b><u>Growing demand, workforce crunch</u></b><br><br>Self-directed services are one of many state-level innovations highlighted in the Scorecard as a way states can meet the growing demand for home- and community-based care. In the Mid-Atlantic region, D.C., Virginia and New Jersey posted the highest numbers of people enrolled in self-directed programs relative to their disabled populations.<br><br>Pennsylvania is the only state in the region that did not see an increase, but that could change as Jason Kavulich—who became Pennsylvania’s Secretary of Aging in January 2023—leads the state’s effort to develop a 10-year master plan for aging. “It is our top-most priority to make sure that people can age in place, how they choose, and to make sure that the services that we have really are responsive,” Kavulich says.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/90/ca/722b3834468a82b147701fcee20d/midatlanticranks.png" alt="midatlanticranks.png" width="3166" height="6717" style="height: auto; max-width: 350px;"/> </figure> </div> </div><p>One of the biggest challenges states face in expanding HCBS is the <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">shortage of</a></span></span> <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">direct-care workers</a></span></span> to fill those jobs. The work can be emotionally and physically taxing and usually comes with low pay, poor benefits and limited support and training.<br><br>The Scorecard shows that across the U.S., wages for direct-care workers are lower than in jobs with similar or lower entry requirements. Their median income is about $30,000 a year—approximately $5,000 less than workers in comparable jobs are paid in most states. D.C. has the highest wage gap in the country, with direct-care workers earning $5.03 less per hour than their counterparts in other sectors.<br><br>“I’m in competition with fast-food places. It’s as simple as that,” says 63-year-old Keith Williams of Clarks Green, Pennsylvania, outside Scranton. He was born with arthrogryposis, a combination of conditions that causes joint contractures and weak muscles.<br><br>Through a self-directed program, he hires care workers to help him with everything from showering to eating. He recruits through word of mouth and online postings. When that fails, he hires his sister-in-law.<br><br>It’s not easy, says Williams, the manager of independent living services for the Northeast Pennsylvania Center for Independent Living, a community-based organization staffed in part by people with disabilities. But the control he has over his care has allowed him to have a meaningful life.<br><br>“It’s meant that I’ve been able to live life on my own terms,” he says.<br><br><i>Ann Hardie spent a decade covering aging issues for The Atlanta Journal-Constitution. She has written for the Bulletin for 15 years.</i><br><br><b>More on Home Care</b><br></p><ul><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2023/rise-of-companion-care.html" target="_blank" rel="noopener noreferrer">Care Companions: A Watchful Eye and Willing Ear for Older Adults</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2019/home-health-aides.html" target="_blank" rel="noopener noreferrer">Find the Right Home Aide for Your Loved One</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://press.aarp.org/2021-11-18-AARP-Survey-Shows-8-in-10-Older-Adults-Want-to-Age-in-Their-Homes-While-Number-and-Needs-of-Households-Headed-Older-Adults-Grow-Dramatically" target="_blank" rel="noopener noreferrer">AARP Survey: 8 in 10 Older Adults Want to Age at Home</a></span></span></li></ul><div class="Enhancement" > <div class="Enhancement-item"><span class="VideoEnhancement" data-video-disable-history data-embeddedvideo-container> <div class="VideoEnhancement-player"><bsp-brightcoveplayer data-video-player class="BrightcoveVideoPlayer" data-account="3772599298001" data-player="KM9xJAJa4" data-video-id="5754403576001" data-video-title="How In-Home Care Helps — AARP" > <video class="video-js" id="BrightcoveVideoPlayer-5754403576001" data-video-id="5754403576001" data-account="" data-player="KM9xJAJa4" data-embed="default" controls ></video> </bsp-brightcoveplayer> </div> <div class="VideoEnhancement-title">How In-Home Care Helps — AARP</div> </span> </div> </div><p></p></div> </div> </p></span> </div> </div> </div> </div><div class="module clearfix"><script src="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.c85a242a55150cd195e494cd6e5b9c77.gz.js" async=""></script> <link rel="stylesheet" media="all" href="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.bfe6eb5a8301841feef3af4e9bd1e26d.gz.css"> <!-- bypass --> <style> a:focus, a:hover { text-decoration: underline; } h1.article-headline { margin: 0 0 1rem; } </style> <!-- <style> .Enhancement-item .Figure { margin-bottom: 24px; } .RichTextArticleBody-body ul { margin-bottom: 24px; } .RichTextArticleBody-body p{ margin: 12px 0; } .RichTextModule-items { clear: both; display: table; width: 100%; margin-bottom: 12px; } .VideoEnhancement>* { color: var(--primaryTextColor); font-size: 13px; font-weight: 400; line-height: 1.4; font-style: italic; background: #f0efed } @media only screen and (min-width: 768px) { .VideoEnhancement>* { font-size:14px; font-weight: 400; line-height: 1.47 } } .VideoEnhancement-title { padding: 20px } @media only screen and (min-width: 768px) { .VideoEnhancement-title { padding:30px } } .VideoEnhancement-player>* { position: relative; width: 100%; height: 0; padding-bottom: 56.25% } .VideoEnhancement iframe { border: 0; position: absolute; top: 0; left: 0; width: 100%; height: 100% } [data-video-player] { display: block; padding-bottom: 56.25%; height: 0; margin: 0 auto; } [data-video-player][data-aspect-ratio="4x3"] { padding-bottom: 56.25%; } [data-video-player][data-aspect-ratio="16x9"] { padding-bottom: 56.25% } </style> --></div><div class="module clearfix"><div class="module-spacer tout-homefit-750"> <a data-formelementid="CSN-LOCAL-HC-NEWSSK-02272024" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-HC-NEWSSK-02272024"><img class="img-responsive" alt="Explore the free AARP HomeFit Guide" title="Explore the free AARP HomeFit Guide" src="https://cdn-aarp.americantowns.com/img/touts/HomeFit_750x150.png"></a> </div></div></div> <div class="col-md-4 right-rail thin-rhs"><div class="module clearfix"><!--default--> <!-- module_RHS - AARP Events --> <div class="ar-basic-box module-spacer"> <header> <div class="pull-right"> <a href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS"> <img style="width:30px;" src="https://cdn-aarp.americantowns.com/img/template/icons/aarp_event_icon.png" alt="Upcoming AARP Events" /> </a> </div> <h2 class="visible-lg">AARP Events for Washington</h2> <h2 class="hidden-lg">AARP Events for Washington</h2> </header> <div class="wrap"> <div class="ar-listing snippet"> <ul class="list"> <li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-co-virtual-functional-fitness-online-99-10142024-sgnszx3wwws.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-FUNCTIONAL-FITNESS-WITH-BASIC-BODY-MOVEMENTS">Functional Fitness with Basic Body Movements</a></h2> <p class="time">Monday, Oct 7, 2024 at 9:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-nm-tai-ji-quan-moving-for-better-balance-albuquerque-nm-100724-j7nhvzxdkxd.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TAI-JI-QUAN-MOVING-FOR-BETTER-BALANCE">Tai Ji Quan: Moving for Better Balance</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/virtual-aarp-tx-mobility-mondays-houston-tx-100724-f5n2bjqhntc.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TRY-A-LOWIMPACT-WORKOUT-TO-IMPROVE-MOBILITY">Try A Low-Impact Workout to Improve Mobility</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom and Facebook</p> <p class="loc">Online Event</p> </li> </ul> <p><a class="link-red" href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS">View All AARP Events<i class="ml-1 fas fa-chevron-right"></i></a></p> </div> </div> </div> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_53475" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_53475', size:'300x250'}); } </script> </div> </div> <div class="card-tout card-dark membership-tout" style="margin:0 0 30px 0;"> <img class="img-responsive image" title="image of two AARP membership cards" alt="image of two AARP membership cards" src="https://cdn-aarp.americantowns.com/img/tout-two-cards.png"> <div class="title">Only $12 your first year with Automatic Renewal</div> <ul class="list"> <li>Immediate access to your <a href="https://www.aarp.org/benefits-discounts/">member benefits</a></li> <li>Discounts on travel and everyday savings</li> <li>Subscription to AARP The Magazine</li> <li>FREE second membership</li> </ul> <div class="action"> <a class="btn" href="https://appsec.aarp.org/mem/join?campaignid=UAJFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Join AARP</a> <div class="body">Already a member? <a href="https://appsec.aarp.org/mem/renew?campaignid= UARFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Renew</a> or <a href="https://www.aarp.org/benefits-discounts/my-membership/print-your-card/">Print Card</a></div> </div> </div> <style> .membership-tout {padding:16px 20px;} .membership-tout .list li { margin: 0; } </style> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_93505" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_93505', size:'300x250'}); } </script> </div> </div> <div class="module-spacer text-center"> <div class="fb-page" alt="Image of AARP District of Columbia Facebook Page" title="Image of AARP District of Columbia Facebook Page" data-href="https://www.facebook.com/aarpdc" data-tabs="timeline" width="320" height="" data-small-header="false" data-adapt-container-width="true" data-hide-cover="false" data-show-facepile="true" lazy="true"> <blockquote cite="https://www.facebook.com/aarpdc" class="fb-xfbml-parse-ignore"><a href="https://www.facebook.com/aarpdc">Facebook</a></blockquote> </div> </div> <div class="ar-basic-box module-spacer"> <header> <h2>Contact AARP<br />District of Columbia</h2> </header> <div class="wrap"> <div class="ar-quick-list module-spacer"> <ul class="list-unstyled"> <li><i class="list-icon fa fa-envelope" alt="Email icon" title="Email icon" aria-hidden="true"></i><a href="mailto:DCAARP@aarp.org " target="_blank" rel="noopener">DCAARP@aarp.org </a></li> <li><i class="list-icon fa fa-globe" alt="Globe icon" title="Globe icon" aria-hidden="true"></i><a href="https://states.aarp.org/region/washington-dc/" target="_blank" rel="noopener">AARP Washington, DC</a></li> <li><i class="list-icon fa fa-map-marker" alt="Map Marker icon" title="Map Marker icon" aria-hidden="true"></i><a href="https://states.aarp.org/aarp-district-of-columbia-state-office/?intcmp=SNG-LNK-AARPLOCAL-CONTACT-20140101-WASHINGTON-DC" target="_blank" rel="noopener">Contact Us</a></li> </ul> </div> <a href="https://www.facebook.com/aarpdc" target="_blank" rel="noopener" aria-label="Open Facebook"><img alt="Facebook icon" title="Facebook icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/facebook-dreamstale25.png"></a> <a href="https://twitter.com/AARPDC" target="_blank" rel="noopener" aria-label="Open Twitter"><img alt="Twitter icon" title="Twitter icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/x-logo-black.png"></a> </div> </div> </div></div> <div class="col-md-8 left-rail left-bot"></div> <div class="col-md-4 right-rail right-bot thin-rhs"></div> </div> <div class="row oneColumnLayout"> </div> <div class="row oneColumnLayout"> <div class="col-md-12"><!-- script to activate navbar --> <script type="text/javascript"> jQuery(".channelBarMain ul.left li a").click(function() { window.location = jQuery(this).attr('href'); }); </script> </div> </div> ', 'scripts_for_layout' => '<title>How Mid-Atlantic States Are Expanding Home Care</title> <meta name="page_title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="robots" content="noindex, nofollow"/> <meta content="John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The" name="description"/> <meta content="How, Mid, Atlantic, States, Expanding, Home, Care" name="keywords"/> <link rel="canonical" href="https://states.aarp.org/ltss-in-the-mid-atlantic" /> <meta property="og:url" content="https://vccstaging.local.aarp.org/news/how-midatlantic-states-are-expanding-home-care-2023-12-03.html"/> <meta name="twitter:card" content="summary_large_image"/> <meta name="twitter:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="twitter:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta name="twitter:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> <meta property="og:type" content="article"/> <meta property="og:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta property="og:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta property="og:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }', 'title_for_layout' => '{local_city_c}, {local_state} Happenings - AARP' ) $content_for_layout = '<div class="row twoColumnLayout"> <div class="col-md-8 left-rail"><div class="module clearfix"><div class="ar-basic-box"> <div> <div class="module-spacer"> <header><h1 class="article-headline">How Mid-Atlantic States Are Expanding Home Care</h1></header> <div class="posted-on"> Posted on 12/03/23 by <b>Ann Hardie</b> </div> </div> <div class="module-spacer"> <span class="blog-content"><p><div class="RichTextArticleBody"> <div class="RichTextArticleBody-body"><p>John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The 55-year-old from Dover, Delaware, goes to work every day, helps his 8-year-old son with basketball drills and watches his beloved Philadelphia Eagles with friends at Buffalo Wild Wings.<br><br>McNeal does so with the assistance of direct-care workers who help him get dressed in the morning, fix his meals and drive him where he needs to go.<br><br>“My life is unique in that I have a significant disability,” says McNeal, director of Delaware’s State Council for Persons with Disabilities. But, he says, it’s “a productive life that is every bit as normal as anybody else’s.”<br><br>Across the country, states such as Delaware are spending a growing percentage of long-term care funding to keep people in their homes and communities instead of institutional settings. That’s according to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023" target="_blank" rel="noopener noreferrer">AARP’s most recent Long-Term Services and Supports State Scorecard</a></span></span>, which uses 50 spending, quality and access indicators to rank each state’s long-term care system.<br><br>The new data shows that for the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid’s long-term care dollars nationally for older people and adults with physical disabilities went to home- and community-based services instead of nursing homes or other facilities.<br></p><p class="cms-textAlign-center"><b>EXPLORE: </b><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/" target="_blank" rel="noopener noreferrer"><b>AARP Long-Term Care Scorecard</b></a></span></span></p><p>“This is a big deal. We are seeing a breaking point,” says Susan Reinhard, senior vice president of the AARP Public Policy Institute, which published the Scorecard in September.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/da/c2/a471a2d346088edaf8c38a8b7a46/midalantic.png" alt="midalantic.png" width="6900" height="5761"/> <figcaption class="Figure-caption">Nicolas Rapp</figcaption> </figure> </div> </div><p>The shift to home- and community-based services comes as demand for such care has increased, fueled in part by a pandemic that took a horrific toll on nursing home residents. Polls have consistently shown that most older Americans want to age in place. A 2021 AARP survey found that more than three-quarters of adults 50-plus say they want to remain in their homes as they grow older.<br><br>But with America’s population of older adults growing, the chasm between the availability of HCBS and access to such services is poised to widen. <br><br>“We’re going to see a dramatic increase in the 80-plus and 85-plus population” as the boomer generation gets older, says Robert Applebaum, a senior research scholar at Miami University’s Scripps Gerontology Center in Ohio. “So the demand for long-term services ... is going to be tremendous.”<br><br><b><u>A person-centered approach</u></b><br><br>In the Mid-Atlantic region, Delaware, the District of Columbia, Maryland, New Jersey and West Virginia have all increased the percentage of their Medicaid dollars going to HCBS for older people and adults with physical disabilities in recent years, the Scorecard shows. One way they are doing that: giving more older adults the power to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">direct their own care</a></span></span>, funded through Medicaid initiatives. (Medicaid, a joint federal-state program for low-income Americans, includes coverage for nursing homes and other long-term care.) <br><br>Enrollment in these <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">“self-directed” care </a></span></span>programs increased by 10 percent or more across 34 states and the District of Columbia in recent years, the Scorecard shows. Such programs give people a greater say over how to spend government dollars on their own care.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/25/1e/2926ddba4cd09d7af135e7604561/1140-inset1-de-john-mcneal.jpg" alt="John McNeal, Director of the State Council for Persons with Disabilities for the State of Delaware, photographed at his office in Dover DE for AARP Bulletin, 7 December 2023. Photo by Mike Morgan." width="655" height="1140" style="height: auto; max-width: 380px;"/> <figcaption class="Figure-caption">John McNeal exits his car. Photo by Mike Morgan.</figcaption> </figure> </div> </div><p>“It’s like the ultimate person-centered approach,” says Lisa Alecxih, who researches long-term care for The Lewin Group, a health care and human services consulting firm. She notes that such programs often have the added benefit of allowing participants to hire family members as caregivers. That’s crucial because there’s a national shortage of direct-care workers.<br><br>Applebaum says his research on self-directed programs has also shown the satisfaction levels were “beyond anything I’ve ever seen as an evaluator.”<br><br>McNeal, the Delaware disability advocate, says that’s certainly true for him. “This is probably the most important program that has come into my life,” he says. “It has allowed me the opportunity to have everything that anybody else in the community has.”<br><br><b><u>Growing demand, workforce crunch</u></b><br><br>Self-directed services are one of many state-level innovations highlighted in the Scorecard as a way states can meet the growing demand for home- and community-based care. In the Mid-Atlantic region, D.C., Virginia and New Jersey posted the highest numbers of people enrolled in self-directed programs relative to their disabled populations.<br><br>Pennsylvania is the only state in the region that did not see an increase, but that could change as Jason Kavulich—who became Pennsylvania’s Secretary of Aging in January 2023—leads the state’s effort to develop a 10-year master plan for aging. “It is our top-most priority to make sure that people can age in place, how they choose, and to make sure that the services that we have really are responsive,” Kavulich says.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/90/ca/722b3834468a82b147701fcee20d/midatlanticranks.png" alt="midatlanticranks.png" width="3166" height="6717" style="height: auto; max-width: 350px;"/> </figure> </div> </div><p>One of the biggest challenges states face in expanding HCBS is the <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">shortage of</a></span></span> <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">direct-care workers</a></span></span> to fill those jobs. The work can be emotionally and physically taxing and usually comes with low pay, poor benefits and limited support and training.<br><br>The Scorecard shows that across the U.S., wages for direct-care workers are lower than in jobs with similar or lower entry requirements. Their median income is about $30,000 a year—approximately $5,000 less than workers in comparable jobs are paid in most states. D.C. has the highest wage gap in the country, with direct-care workers earning $5.03 less per hour than their counterparts in other sectors.<br><br>“I’m in competition with fast-food places. It’s as simple as that,” says 63-year-old Keith Williams of Clarks Green, Pennsylvania, outside Scranton. He was born with arthrogryposis, a combination of conditions that causes joint contractures and weak muscles.<br><br>Through a self-directed program, he hires care workers to help him with everything from showering to eating. He recruits through word of mouth and online postings. When that fails, he hires his sister-in-law.<br><br>It’s not easy, says Williams, the manager of independent living services for the Northeast Pennsylvania Center for Independent Living, a community-based organization staffed in part by people with disabilities. But the control he has over his care has allowed him to have a meaningful life.<br><br>“It’s meant that I’ve been able to live life on my own terms,” he says.<br><br><i>Ann Hardie spent a decade covering aging issues for The Atlanta Journal-Constitution. She has written for the Bulletin for 15 years.</i><br><br><b>More on Home Care</b><br></p><ul><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2023/rise-of-companion-care.html" target="_blank" rel="noopener noreferrer">Care Companions: A Watchful Eye and Willing Ear for Older Adults</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2019/home-health-aides.html" target="_blank" rel="noopener noreferrer">Find the Right Home Aide for Your Loved One</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://press.aarp.org/2021-11-18-AARP-Survey-Shows-8-in-10-Older-Adults-Want-to-Age-in-Their-Homes-While-Number-and-Needs-of-Households-Headed-Older-Adults-Grow-Dramatically" target="_blank" rel="noopener noreferrer">AARP Survey: 8 in 10 Older Adults Want to Age at Home</a></span></span></li></ul><div class="Enhancement" > <div class="Enhancement-item"><span class="VideoEnhancement" data-video-disable-history data-embeddedvideo-container> <div class="VideoEnhancement-player"><bsp-brightcoveplayer data-video-player class="BrightcoveVideoPlayer" data-account="3772599298001" data-player="KM9xJAJa4" data-video-id="5754403576001" data-video-title="How In-Home Care Helps — AARP" > <video class="video-js" id="BrightcoveVideoPlayer-5754403576001" data-video-id="5754403576001" data-account="" data-player="KM9xJAJa4" data-embed="default" controls ></video> </bsp-brightcoveplayer> </div> <div class="VideoEnhancement-title">How In-Home Care Helps — AARP</div> </span> </div> </div><p></p></div> </div> </p></span> </div> </div> </div> </div><div class="module clearfix"><script src="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.c85a242a55150cd195e494cd6e5b9c77.gz.js" async=""></script> <link rel="stylesheet" media="all" href="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.bfe6eb5a8301841feef3af4e9bd1e26d.gz.css"> <!-- bypass --> <style> a:focus, a:hover { text-decoration: underline; } h1.article-headline { margin: 0 0 1rem; } </style> <!-- <style> .Enhancement-item .Figure { margin-bottom: 24px; } .RichTextArticleBody-body ul { margin-bottom: 24px; } .RichTextArticleBody-body p{ margin: 12px 0; } .RichTextModule-items { clear: both; display: table; width: 100%; margin-bottom: 12px; } .VideoEnhancement>* { color: var(--primaryTextColor); font-size: 13px; font-weight: 400; line-height: 1.4; font-style: italic; background: #f0efed } @media only screen and (min-width: 768px) { .VideoEnhancement>* { font-size:14px; font-weight: 400; line-height: 1.47 } } .VideoEnhancement-title { padding: 20px } @media only screen and (min-width: 768px) { .VideoEnhancement-title { padding:30px } } .VideoEnhancement-player>* { position: relative; width: 100%; height: 0; padding-bottom: 56.25% } .VideoEnhancement iframe { border: 0; position: absolute; top: 0; left: 0; width: 100%; height: 100% } [data-video-player] { display: block; padding-bottom: 56.25%; height: 0; margin: 0 auto; } [data-video-player][data-aspect-ratio="4x3"] { padding-bottom: 56.25%; } [data-video-player][data-aspect-ratio="16x9"] { padding-bottom: 56.25% } </style> --></div><div class="module clearfix"><div class="module-spacer tout-homefit-750"> <a data-formelementid="CSN-LOCAL-HC-NEWSSK-02272024" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-HC-NEWSSK-02272024"><img class="img-responsive" alt="Explore the free AARP HomeFit Guide" title="Explore the free AARP HomeFit Guide" src="https://cdn-aarp.americantowns.com/img/touts/HomeFit_750x150.png"></a> </div></div></div> <div class="col-md-4 right-rail thin-rhs"><div class="module clearfix"><!--default--> <!-- module_RHS - AARP Events --> <div class="ar-basic-box module-spacer"> <header> <div class="pull-right"> <a href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS"> <img style="width:30px;" src="https://cdn-aarp.americantowns.com/img/template/icons/aarp_event_icon.png" alt="Upcoming AARP Events" /> </a> </div> <h2 class="visible-lg">AARP Events for Washington</h2> <h2 class="hidden-lg">AARP Events for Washington</h2> </header> <div class="wrap"> <div class="ar-listing snippet"> <ul class="list"> <li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-co-virtual-functional-fitness-online-99-10142024-sgnszx3wwws.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-FUNCTIONAL-FITNESS-WITH-BASIC-BODY-MOVEMENTS">Functional Fitness with Basic Body Movements</a></h2> <p class="time">Monday, Oct 7, 2024 at 9:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-nm-tai-ji-quan-moving-for-better-balance-albuquerque-nm-100724-j7nhvzxdkxd.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TAI-JI-QUAN-MOVING-FOR-BETTER-BALANCE">Tai Ji Quan: Moving for Better Balance</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/virtual-aarp-tx-mobility-mondays-houston-tx-100724-f5n2bjqhntc.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TRY-A-LOWIMPACT-WORKOUT-TO-IMPROVE-MOBILITY">Try A Low-Impact Workout to Improve Mobility</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom and Facebook</p> <p class="loc">Online Event</p> </li> </ul> <p><a class="link-red" href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS">View All AARP Events<i class="ml-1 fas fa-chevron-right"></i></a></p> </div> </div> </div> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_53475" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_53475', size:'300x250'}); } </script> </div> </div> <div class="card-tout card-dark membership-tout" style="margin:0 0 30px 0;"> <img class="img-responsive image" title="image of two AARP membership cards" alt="image of two AARP membership cards" src="https://cdn-aarp.americantowns.com/img/tout-two-cards.png"> <div class="title">Only $12 your first year with Automatic Renewal</div> <ul class="list"> <li>Immediate access to your <a href="https://www.aarp.org/benefits-discounts/">member benefits</a></li> <li>Discounts on travel and everyday savings</li> <li>Subscription to AARP The Magazine</li> <li>FREE second membership</li> </ul> <div class="action"> <a class="btn" href="https://appsec.aarp.org/mem/join?campaignid=UAJFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Join AARP</a> <div class="body">Already a member? <a href="https://appsec.aarp.org/mem/renew?campaignid= UARFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Renew</a> or <a href="https://www.aarp.org/benefits-discounts/my-membership/print-your-card/">Print Card</a></div> </div> </div> <style> .membership-tout {padding:16px 20px;} .membership-tout .list li { margin: 0; } </style> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_93505" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_93505', size:'300x250'}); } </script> </div> </div> <div class="module-spacer text-center"> <div class="fb-page" alt="Image of AARP District of Columbia Facebook Page" title="Image of AARP District of Columbia Facebook Page" data-href="https://www.facebook.com/aarpdc" data-tabs="timeline" width="320" height="" data-small-header="false" data-adapt-container-width="true" data-hide-cover="false" data-show-facepile="true" lazy="true"> <blockquote cite="https://www.facebook.com/aarpdc" class="fb-xfbml-parse-ignore"><a href="https://www.facebook.com/aarpdc">Facebook</a></blockquote> </div> </div> <div class="ar-basic-box module-spacer"> <header> <h2>Contact AARP<br />District of Columbia</h2> </header> <div class="wrap"> <div class="ar-quick-list module-spacer"> <ul class="list-unstyled"> <li><i class="list-icon fa fa-envelope" alt="Email icon" title="Email icon" aria-hidden="true"></i><a href="mailto:DCAARP@aarp.org " target="_blank" rel="noopener">DCAARP@aarp.org </a></li> <li><i class="list-icon fa fa-globe" alt="Globe icon" title="Globe icon" aria-hidden="true"></i><a href="https://states.aarp.org/region/washington-dc/" target="_blank" rel="noopener">AARP Washington, DC</a></li> <li><i class="list-icon fa fa-map-marker" alt="Map Marker icon" title="Map Marker icon" aria-hidden="true"></i><a href="https://states.aarp.org/aarp-district-of-columbia-state-office/?intcmp=SNG-LNK-AARPLOCAL-CONTACT-20140101-WASHINGTON-DC" target="_blank" rel="noopener">Contact Us</a></li> </ul> </div> <a href="https://www.facebook.com/aarpdc" target="_blank" rel="noopener" aria-label="Open Facebook"><img alt="Facebook icon" title="Facebook icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/facebook-dreamstale25.png"></a> <a href="https://twitter.com/AARPDC" target="_blank" rel="noopener" aria-label="Open Twitter"><img alt="Twitter icon" title="Twitter icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/x-logo-black.png"></a> </div> </div> </div></div> <div class="col-md-8 left-rail left-bot"></div> <div class="col-md-4 right-rail right-bot thin-rhs"></div> </div> <div class="row oneColumnLayout"> </div> <div class="row oneColumnLayout"> <div class="col-md-12"><!-- script to activate navbar --> <script type="text/javascript"> jQuery(".channelBarMain ul.left li a").click(function() { window.location = jQuery(this).attr('href'); }); </script> </div> </div> ' $scripts_for_layout = '<title>How Mid-Atlantic States Are Expanding Home Care</title> <meta name="page_title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="robots" content="noindex, nofollow"/> <meta content="John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The" name="description"/> <meta content="How, Mid, Atlantic, States, Expanding, Home, Care" name="keywords"/> <link rel="canonical" href="https://states.aarp.org/ltss-in-the-mid-atlantic" /> <meta property="og:url" content="https://vccstaging.local.aarp.org/news/how-midatlantic-states-are-expanding-home-care-2023-12-03.html"/> <meta name="twitter:card" content="summary_large_image"/> <meta name="twitter:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="twitter:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta name="twitter:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> <meta property="og:type" content="article"/> <meta property="og:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta property="og:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta property="og:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }' $title_for_layout = '{local_city_c}, {local_state} Happenings - AARP' $asset_version = '230831' $min = true $nowrapper = false $css = ' :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }' $highlighting = '' $location = '<a href="/washington-dc/?intcmp=CSN-LOCAL-NAV-HOME">Washington, DC</a>' $no_header = false $header_title = '<a href="/washington-dc/happenings/">News Feed</a>' $header_subtitle = '' $isPR = false $navbar = '<nav class="section" role="button" aria-expanded="false" aria-controls="collapse"> <div class="section-toggle">Sections <i class="fas fa-chevron-down"></i></div> <ul class="secondary-menu" id="secondary-menu" role="menu" aria-busy="true"> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/aarp-events/?intcmp=CSN-LOCAL-NAV-OLE" data-formelementid="LOCAL-LNK-CLK-EVENTS">Online & Local Events</a> </li> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/things-to-do/?intcmp=CSN-LOCAL-NAV-TTD" data-formelementid="LOCAL-LNK-CLK-THINGSTODO">Things to Do</a></li> <li role="presentation" class="active"><a role="menuitem" class="menuitem" href="/washington-dc/happenings/?intcmp=CSN-LOCAL-NAV-NF" data-formelementid="LOCAL-LNK-CLK-HAPPENINGS">News Feed</a> </li> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/volunteering/?intcmp=CSN-LOCAL-NAV-VOL" data-formelementid="LOCAL-LNK-CLK-VOLUNTEERING">Volunteering</a> </li> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-NAV-HC" data-formelementid="LOCAL-LNK-CLK-HC">Home & Community</a> </li> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/movies/?intcmp=CSN-LOCAL-NAV-MFG" data-formelementid="LOCAL-LNK-CLK-MOVIESFORGROWNUPS">Movies for Grownups</a> </li> <li role="presentation" class="more nosep " id="submenu-more"> <span role="menuitem" class="menuitem" data-formelementid="LOCAL-LNK-CLK-MORE">More<i class="fas fa-chevron-down"></i></span> <ul class="secondary-submenu animate slide-in" id="secondary-submenu"> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/discounts/?intcmp=CSN-LOCAL-NAV-LO" data-formelementid="LOCAL-LNK-CLK-OFFERS">Local Offers</a></li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/local-resources/?intcmp=CSN-LOCAL-NAV-LR" data-formelementid="LOCAL-LNK-CLK-LOCALRESOURCES">Local Resources</a> </li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/jobs/?intcmp=CSN-LOCAL-NAV-WJ" data-formelementid="LOCAL-LNK-CLK-WORK&JOBS">Work & Jobs</a></li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/events/?intcmp=CSN-LOCAL-NAV-CC" data-formelementid="LOCAL-LNK-CLK-EVENTS">Community Calendar</a></li> <!-- <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/healthy-living/?intcmp=CSN-LOCAL-NAV-HEALTHY_LIVING" data-formelementid="LOCAL-LNK-CLK-HEALTHY_LIVING">Healthy Living</a></li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/arts-entertainment/?intcmp=CSN-LOCAL-NAV-ARTS_ENT" data-formelementid="LOCAL-LNK-CLK-ARTS_ENT">Arts & Entertainment</a></li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/museums/?intcmp=CSN-LOCAL-NAV-MUSEUMS" data-formelementid="LOCAL-LNK-CLK-MUSEUMS">Museums</a></li> --> </ul> </li> </ul> </nav>' $header_custom = '' $breadcrumbs = array( (int) 0 => array( 'title' => 'News Feed', 'slug' => 'happenings' ) ) $row = array( 'title' => 'Back to News Feed', 'slug' => 'happenings' ) $i = (int) 0include - APP/View/Layouts/aarp_2023.ctp, line 242 include - APP/View/Layouts/aarp_2023.ctp, line 242 View::_evaluate() - CORE/Cake/View/View.php, line 971 View::_render() - CORE/Cake/View/View.php, line 933 View::renderLayout() - CORE/Cake/View/View.php, line 546 View::render() - CORE/Cake/View/View.php, line 481 Controller::render() - CORE/Cake/Controller/Controller.php, line 963 AppController::renderPage() - APP/Controller/AppController.php, line 136 BlogsController::display() - APP/Controller/BlogsController.php, line 81 ReflectionMethod::invokeArgs() - [internal], line ?? Controller::invokeAction() - CORE/Cake/Controller/Controller.php, line 491 Dispatcher::_invoke() - CORE/Cake/Routing/Dispatcher.php, line 193 Dispatcher::dispatch() - CORE/Cake/Routing/Dispatcher.php, line 167 [main] - APP/webroot/index.php, line 118
Warning (2): include() [<a href='http://php.net/function.include'>function.include</a>]: Failed opening '/var/www/vhosts/vcc_staging/app/Resource/aarp2_master.footer.html' for inclusion (include_path='/var/www/vhosts/vcc_staging/lib:.:/usr/share/pear:/usr/share/php') [APP/View/Layouts/aarp_2023.ctp, line 242]Code Context<?php // if (!$nowrapper) (Globals::$language == 'es') ? include(APP . "/Resource/aarpe_footer_es.html") : include(APP . "/Resource/aarpe_footer.html"); ?>
<?php if (!$nowrapper): // MLW - Spanish wrappers TBD
include (APP . "Resource/aarp2_master.footer.html");
$viewFile = '/var/www/vhosts/vcc_staging/app/View/Layouts/aarp_2023.ctp' $dataForView = array( 'content_for_layout' => '<div class="row twoColumnLayout"> <div class="col-md-8 left-rail"><div class="module clearfix"><div class="ar-basic-box"> <div> <div class="module-spacer"> <header><h1 class="article-headline">How Mid-Atlantic States Are Expanding Home Care</h1></header> <div class="posted-on"> Posted on 12/03/23 by <b>Ann Hardie</b> </div> </div> <div class="module-spacer"> <span class="blog-content"><p><div class="RichTextArticleBody"> <div class="RichTextArticleBody-body"><p>John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The 55-year-old from Dover, Delaware, goes to work every day, helps his 8-year-old son with basketball drills and watches his beloved Philadelphia Eagles with friends at Buffalo Wild Wings.<br><br>McNeal does so with the assistance of direct-care workers who help him get dressed in the morning, fix his meals and drive him where he needs to go.<br><br>“My life is unique in that I have a significant disability,” says McNeal, director of Delaware’s State Council for Persons with Disabilities. But, he says, it’s “a productive life that is every bit as normal as anybody else’s.”<br><br>Across the country, states such as Delaware are spending a growing percentage of long-term care funding to keep people in their homes and communities instead of institutional settings. That’s according to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023" target="_blank" rel="noopener noreferrer">AARP’s most recent Long-Term Services and Supports State Scorecard</a></span></span>, which uses 50 spending, quality and access indicators to rank each state’s long-term care system.<br><br>The new data shows that for the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid’s long-term care dollars nationally for older people and adults with physical disabilities went to home- and community-based services instead of nursing homes or other facilities.<br></p><p class="cms-textAlign-center"><b>EXPLORE: </b><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/" target="_blank" rel="noopener noreferrer"><b>AARP Long-Term Care Scorecard</b></a></span></span></p><p>“This is a big deal. We are seeing a breaking point,” says Susan Reinhard, senior vice president of the AARP Public Policy Institute, which published the Scorecard in September.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/da/c2/a471a2d346088edaf8c38a8b7a46/midalantic.png" alt="midalantic.png" width="6900" height="5761"/> <figcaption class="Figure-caption">Nicolas Rapp</figcaption> </figure> </div> </div><p>The shift to home- and community-based services comes as demand for such care has increased, fueled in part by a pandemic that took a horrific toll on nursing home residents. Polls have consistently shown that most older Americans want to age in place. A 2021 AARP survey found that more than three-quarters of adults 50-plus say they want to remain in their homes as they grow older.<br><br>But with America’s population of older adults growing, the chasm between the availability of HCBS and access to such services is poised to widen. <br><br>“We’re going to see a dramatic increase in the 80-plus and 85-plus population” as the boomer generation gets older, says Robert Applebaum, a senior research scholar at Miami University’s Scripps Gerontology Center in Ohio. “So the demand for long-term services ... is going to be tremendous.”<br><br><b><u>A person-centered approach</u></b><br><br>In the Mid-Atlantic region, Delaware, the District of Columbia, Maryland, New Jersey and West Virginia have all increased the percentage of their Medicaid dollars going to HCBS for older people and adults with physical disabilities in recent years, the Scorecard shows. One way they are doing that: giving more older adults the power to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">direct their own care</a></span></span>, funded through Medicaid initiatives. (Medicaid, a joint federal-state program for low-income Americans, includes coverage for nursing homes and other long-term care.) <br><br>Enrollment in these <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">“self-directed” care </a></span></span>programs increased by 10 percent or more across 34 states and the District of Columbia in recent years, the Scorecard shows. Such programs give people a greater say over how to spend government dollars on their own care.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/25/1e/2926ddba4cd09d7af135e7604561/1140-inset1-de-john-mcneal.jpg" alt="John McNeal, Director of the State Council for Persons with Disabilities for the State of Delaware, photographed at his office in Dover DE for AARP Bulletin, 7 December 2023. Photo by Mike Morgan." width="655" height="1140" style="height: auto; max-width: 380px;"/> <figcaption class="Figure-caption">John McNeal exits his car. Photo by Mike Morgan.</figcaption> </figure> </div> </div><p>“It’s like the ultimate person-centered approach,” says Lisa Alecxih, who researches long-term care for The Lewin Group, a health care and human services consulting firm. She notes that such programs often have the added benefit of allowing participants to hire family members as caregivers. That’s crucial because there’s a national shortage of direct-care workers.<br><br>Applebaum says his research on self-directed programs has also shown the satisfaction levels were “beyond anything I’ve ever seen as an evaluator.”<br><br>McNeal, the Delaware disability advocate, says that’s certainly true for him. “This is probably the most important program that has come into my life,” he says. “It has allowed me the opportunity to have everything that anybody else in the community has.”<br><br><b><u>Growing demand, workforce crunch</u></b><br><br>Self-directed services are one of many state-level innovations highlighted in the Scorecard as a way states can meet the growing demand for home- and community-based care. In the Mid-Atlantic region, D.C., Virginia and New Jersey posted the highest numbers of people enrolled in self-directed programs relative to their disabled populations.<br><br>Pennsylvania is the only state in the region that did not see an increase, but that could change as Jason Kavulich—who became Pennsylvania’s Secretary of Aging in January 2023—leads the state’s effort to develop a 10-year master plan for aging. “It is our top-most priority to make sure that people can age in place, how they choose, and to make sure that the services that we have really are responsive,” Kavulich says.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/90/ca/722b3834468a82b147701fcee20d/midatlanticranks.png" alt="midatlanticranks.png" width="3166" height="6717" style="height: auto; max-width: 350px;"/> </figure> </div> </div><p>One of the biggest challenges states face in expanding HCBS is the <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">shortage of</a></span></span> <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">direct-care workers</a></span></span> to fill those jobs. The work can be emotionally and physically taxing and usually comes with low pay, poor benefits and limited support and training.<br><br>The Scorecard shows that across the U.S., wages for direct-care workers are lower than in jobs with similar or lower entry requirements. Their median income is about $30,000 a year—approximately $5,000 less than workers in comparable jobs are paid in most states. D.C. has the highest wage gap in the country, with direct-care workers earning $5.03 less per hour than their counterparts in other sectors.<br><br>“I’m in competition with fast-food places. It’s as simple as that,” says 63-year-old Keith Williams of Clarks Green, Pennsylvania, outside Scranton. He was born with arthrogryposis, a combination of conditions that causes joint contractures and weak muscles.<br><br>Through a self-directed program, he hires care workers to help him with everything from showering to eating. He recruits through word of mouth and online postings. When that fails, he hires his sister-in-law.<br><br>It’s not easy, says Williams, the manager of independent living services for the Northeast Pennsylvania Center for Independent Living, a community-based organization staffed in part by people with disabilities. But the control he has over his care has allowed him to have a meaningful life.<br><br>“It’s meant that I’ve been able to live life on my own terms,” he says.<br><br><i>Ann Hardie spent a decade covering aging issues for The Atlanta Journal-Constitution. She has written for the Bulletin for 15 years.</i><br><br><b>More on Home Care</b><br></p><ul><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2023/rise-of-companion-care.html" target="_blank" rel="noopener noreferrer">Care Companions: A Watchful Eye and Willing Ear for Older Adults</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2019/home-health-aides.html" target="_blank" rel="noopener noreferrer">Find the Right Home Aide for Your Loved One</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://press.aarp.org/2021-11-18-AARP-Survey-Shows-8-in-10-Older-Adults-Want-to-Age-in-Their-Homes-While-Number-and-Needs-of-Households-Headed-Older-Adults-Grow-Dramatically" target="_blank" rel="noopener noreferrer">AARP Survey: 8 in 10 Older Adults Want to Age at Home</a></span></span></li></ul><div class="Enhancement" > <div class="Enhancement-item"><span class="VideoEnhancement" data-video-disable-history data-embeddedvideo-container> <div class="VideoEnhancement-player"><bsp-brightcoveplayer data-video-player class="BrightcoveVideoPlayer" data-account="3772599298001" data-player="KM9xJAJa4" data-video-id="5754403576001" data-video-title="How In-Home Care Helps — AARP" > <video class="video-js" id="BrightcoveVideoPlayer-5754403576001" data-video-id="5754403576001" data-account="" data-player="KM9xJAJa4" data-embed="default" controls ></video> </bsp-brightcoveplayer> </div> <div class="VideoEnhancement-title">How In-Home Care Helps — AARP</div> </span> </div> </div><p></p></div> </div> </p></span> </div> </div> </div> </div><div class="module clearfix"><script src="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.c85a242a55150cd195e494cd6e5b9c77.gz.js" async=""></script> <link rel="stylesheet" media="all" href="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.bfe6eb5a8301841feef3af4e9bd1e26d.gz.css"> <!-- bypass --> <style> a:focus, a:hover { text-decoration: underline; } h1.article-headline { margin: 0 0 1rem; } </style> <!-- <style> .Enhancement-item .Figure { margin-bottom: 24px; } .RichTextArticleBody-body ul { margin-bottom: 24px; } .RichTextArticleBody-body p{ margin: 12px 0; } .RichTextModule-items { clear: both; display: table; width: 100%; margin-bottom: 12px; } .VideoEnhancement>* { color: var(--primaryTextColor); font-size: 13px; font-weight: 400; line-height: 1.4; font-style: italic; background: #f0efed } @media only screen and (min-width: 768px) { .VideoEnhancement>* { font-size:14px; font-weight: 400; line-height: 1.47 } } .VideoEnhancement-title { padding: 20px } @media only screen and (min-width: 768px) { .VideoEnhancement-title { padding:30px } } .VideoEnhancement-player>* { position: relative; width: 100%; height: 0; padding-bottom: 56.25% } .VideoEnhancement iframe { border: 0; position: absolute; top: 0; left: 0; width: 100%; height: 100% } [data-video-player] { display: block; padding-bottom: 56.25%; height: 0; margin: 0 auto; } [data-video-player][data-aspect-ratio="4x3"] { padding-bottom: 56.25%; } [data-video-player][data-aspect-ratio="16x9"] { padding-bottom: 56.25% } </style> --></div><div class="module clearfix"><div class="module-spacer tout-homefit-750"> <a data-formelementid="CSN-LOCAL-HC-NEWSSK-02272024" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-HC-NEWSSK-02272024"><img class="img-responsive" alt="Explore the free AARP HomeFit Guide" title="Explore the free AARP HomeFit Guide" src="https://cdn-aarp.americantowns.com/img/touts/HomeFit_750x150.png"></a> </div></div></div> <div class="col-md-4 right-rail thin-rhs"><div class="module clearfix"><!--default--> <!-- module_RHS - AARP Events --> <div class="ar-basic-box module-spacer"> <header> <div class="pull-right"> <a href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS"> <img style="width:30px;" src="https://cdn-aarp.americantowns.com/img/template/icons/aarp_event_icon.png" alt="Upcoming AARP Events" /> </a> </div> <h2 class="visible-lg">AARP Events for Washington</h2> <h2 class="hidden-lg">AARP Events for Washington</h2> </header> <div class="wrap"> <div class="ar-listing snippet"> <ul class="list"> <li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-co-virtual-functional-fitness-online-99-10142024-sgnszx3wwws.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-FUNCTIONAL-FITNESS-WITH-BASIC-BODY-MOVEMENTS">Functional Fitness with Basic Body Movements</a></h2> <p class="time">Monday, Oct 7, 2024 at 9:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-nm-tai-ji-quan-moving-for-better-balance-albuquerque-nm-100724-j7nhvzxdkxd.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TAI-JI-QUAN-MOVING-FOR-BETTER-BALANCE">Tai Ji Quan: Moving for Better Balance</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/virtual-aarp-tx-mobility-mondays-houston-tx-100724-f5n2bjqhntc.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TRY-A-LOWIMPACT-WORKOUT-TO-IMPROVE-MOBILITY">Try A Low-Impact Workout to Improve Mobility</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom and Facebook</p> <p class="loc">Online Event</p> </li> </ul> <p><a class="link-red" href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS">View All AARP Events<i class="ml-1 fas fa-chevron-right"></i></a></p> </div> </div> </div> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_53475" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_53475', size:'300x250'}); } </script> </div> </div> <div class="card-tout card-dark membership-tout" style="margin:0 0 30px 0;"> <img class="img-responsive image" title="image of two AARP membership cards" alt="image of two AARP membership cards" src="https://cdn-aarp.americantowns.com/img/tout-two-cards.png"> <div class="title">Only $12 your first year with Automatic Renewal</div> <ul class="list"> <li>Immediate access to your <a href="https://www.aarp.org/benefits-discounts/">member benefits</a></li> <li>Discounts on travel and everyday savings</li> <li>Subscription to AARP The Magazine</li> <li>FREE second membership</li> </ul> <div class="action"> <a class="btn" href="https://appsec.aarp.org/mem/join?campaignid=UAJFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Join AARP</a> <div class="body">Already a member? <a href="https://appsec.aarp.org/mem/renew?campaignid= UARFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Renew</a> or <a href="https://www.aarp.org/benefits-discounts/my-membership/print-your-card/">Print Card</a></div> </div> </div> <style> .membership-tout {padding:16px 20px;} .membership-tout .list li { margin: 0; } </style> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_93505" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_93505', size:'300x250'}); } </script> </div> </div> <div class="module-spacer text-center"> <div class="fb-page" alt="Image of AARP District of Columbia Facebook Page" title="Image of AARP District of Columbia Facebook Page" data-href="https://www.facebook.com/aarpdc" data-tabs="timeline" width="320" height="" data-small-header="false" data-adapt-container-width="true" data-hide-cover="false" data-show-facepile="true" lazy="true"> <blockquote cite="https://www.facebook.com/aarpdc" class="fb-xfbml-parse-ignore"><a href="https://www.facebook.com/aarpdc">Facebook</a></blockquote> </div> </div> <div class="ar-basic-box module-spacer"> <header> <h2>Contact AARP<br />District of Columbia</h2> </header> <div class="wrap"> <div class="ar-quick-list module-spacer"> <ul class="list-unstyled"> <li><i class="list-icon fa fa-envelope" alt="Email icon" title="Email icon" aria-hidden="true"></i><a href="mailto:DCAARP@aarp.org " target="_blank" rel="noopener">DCAARP@aarp.org </a></li> <li><i class="list-icon fa fa-globe" alt="Globe icon" title="Globe icon" aria-hidden="true"></i><a href="https://states.aarp.org/region/washington-dc/" target="_blank" rel="noopener">AARP Washington, DC</a></li> <li><i class="list-icon fa fa-map-marker" alt="Map Marker icon" title="Map Marker icon" aria-hidden="true"></i><a href="https://states.aarp.org/aarp-district-of-columbia-state-office/?intcmp=SNG-LNK-AARPLOCAL-CONTACT-20140101-WASHINGTON-DC" target="_blank" rel="noopener">Contact Us</a></li> </ul> </div> <a href="https://www.facebook.com/aarpdc" target="_blank" rel="noopener" aria-label="Open Facebook"><img alt="Facebook icon" title="Facebook icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/facebook-dreamstale25.png"></a> <a href="https://twitter.com/AARPDC" target="_blank" rel="noopener" aria-label="Open Twitter"><img alt="Twitter icon" title="Twitter icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/x-logo-black.png"></a> </div> </div> </div></div> <div class="col-md-8 left-rail left-bot"></div> <div class="col-md-4 right-rail right-bot thin-rhs"></div> </div> <div class="row oneColumnLayout"> </div> <div class="row oneColumnLayout"> <div class="col-md-12"><!-- script to activate navbar --> <script type="text/javascript"> jQuery(".channelBarMain ul.left li a").click(function() { window.location = jQuery(this).attr('href'); }); </script> </div> </div> ', 'scripts_for_layout' => '<title>How Mid-Atlantic States Are Expanding Home Care</title> <meta name="page_title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="robots" content="noindex, nofollow"/> <meta content="John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The" name="description"/> <meta content="How, Mid, Atlantic, States, Expanding, Home, Care" name="keywords"/> <link rel="canonical" href="https://states.aarp.org/ltss-in-the-mid-atlantic" /> <meta property="og:url" content="https://vccstaging.local.aarp.org/news/how-midatlantic-states-are-expanding-home-care-2023-12-03.html"/> <meta name="twitter:card" content="summary_large_image"/> <meta name="twitter:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="twitter:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta name="twitter:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> <meta property="og:type" content="article"/> <meta property="og:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta property="og:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta property="og:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }', 'title_for_layout' => '{local_city_c}, {local_state} Happenings - AARP' ) $content_for_layout = '<div class="row twoColumnLayout"> <div class="col-md-8 left-rail"><div class="module clearfix"><div class="ar-basic-box"> <div> <div class="module-spacer"> <header><h1 class="article-headline">How Mid-Atlantic States Are Expanding Home Care</h1></header> <div class="posted-on"> Posted on 12/03/23 by <b>Ann Hardie</b> </div> </div> <div class="module-spacer"> <span class="blog-content"><p><div class="RichTextArticleBody"> <div class="RichTextArticleBody-body"><p>John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The 55-year-old from Dover, Delaware, goes to work every day, helps his 8-year-old son with basketball drills and watches his beloved Philadelphia Eagles with friends at Buffalo Wild Wings.<br><br>McNeal does so with the assistance of direct-care workers who help him get dressed in the morning, fix his meals and drive him where he needs to go.<br><br>“My life is unique in that I have a significant disability,” says McNeal, director of Delaware’s State Council for Persons with Disabilities. But, he says, it’s “a productive life that is every bit as normal as anybody else’s.”<br><br>Across the country, states such as Delaware are spending a growing percentage of long-term care funding to keep people in their homes and communities instead of institutional settings. That’s according to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023" target="_blank" rel="noopener noreferrer">AARP’s most recent Long-Term Services and Supports State Scorecard</a></span></span>, which uses 50 spending, quality and access indicators to rank each state’s long-term care system.<br><br>The new data shows that for the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid’s long-term care dollars nationally for older people and adults with physical disabilities went to home- and community-based services instead of nursing homes or other facilities.<br></p><p class="cms-textAlign-center"><b>EXPLORE: </b><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/" target="_blank" rel="noopener noreferrer"><b>AARP Long-Term Care Scorecard</b></a></span></span></p><p>“This is a big deal. We are seeing a breaking point,” says Susan Reinhard, senior vice president of the AARP Public Policy Institute, which published the Scorecard in September.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/da/c2/a471a2d346088edaf8c38a8b7a46/midalantic.png" alt="midalantic.png" width="6900" height="5761"/> <figcaption class="Figure-caption">Nicolas Rapp</figcaption> </figure> </div> </div><p>The shift to home- and community-based services comes as demand for such care has increased, fueled in part by a pandemic that took a horrific toll on nursing home residents. Polls have consistently shown that most older Americans want to age in place. A 2021 AARP survey found that more than three-quarters of adults 50-plus say they want to remain in their homes as they grow older.<br><br>But with America’s population of older adults growing, the chasm between the availability of HCBS and access to such services is poised to widen. <br><br>“We’re going to see a dramatic increase in the 80-plus and 85-plus population” as the boomer generation gets older, says Robert Applebaum, a senior research scholar at Miami University’s Scripps Gerontology Center in Ohio. “So the demand for long-term services ... is going to be tremendous.”<br><br><b><u>A person-centered approach</u></b><br><br>In the Mid-Atlantic region, Delaware, the District of Columbia, Maryland, New Jersey and West Virginia have all increased the percentage of their Medicaid dollars going to HCBS for older people and adults with physical disabilities in recent years, the Scorecard shows. One way they are doing that: giving more older adults the power to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">direct their own care</a></span></span>, funded through Medicaid initiatives. (Medicaid, a joint federal-state program for low-income Americans, includes coverage for nursing homes and other long-term care.) <br><br>Enrollment in these <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">“self-directed” care </a></span></span>programs increased by 10 percent or more across 34 states and the District of Columbia in recent years, the Scorecard shows. Such programs give people a greater say over how to spend government dollars on their own care.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/25/1e/2926ddba4cd09d7af135e7604561/1140-inset1-de-john-mcneal.jpg" alt="John McNeal, Director of the State Council for Persons with Disabilities for the State of Delaware, photographed at his office in Dover DE for AARP Bulletin, 7 December 2023. Photo by Mike Morgan." width="655" height="1140" style="height: auto; max-width: 380px;"/> <figcaption class="Figure-caption">John McNeal exits his car. Photo by Mike Morgan.</figcaption> </figure> </div> </div><p>“It’s like the ultimate person-centered approach,” says Lisa Alecxih, who researches long-term care for The Lewin Group, a health care and human services consulting firm. She notes that such programs often have the added benefit of allowing participants to hire family members as caregivers. That’s crucial because there’s a national shortage of direct-care workers.<br><br>Applebaum says his research on self-directed programs has also shown the satisfaction levels were “beyond anything I’ve ever seen as an evaluator.”<br><br>McNeal, the Delaware disability advocate, says that’s certainly true for him. “This is probably the most important program that has come into my life,” he says. “It has allowed me the opportunity to have everything that anybody else in the community has.”<br><br><b><u>Growing demand, workforce crunch</u></b><br><br>Self-directed services are one of many state-level innovations highlighted in the Scorecard as a way states can meet the growing demand for home- and community-based care. In the Mid-Atlantic region, D.C., Virginia and New Jersey posted the highest numbers of people enrolled in self-directed programs relative to their disabled populations.<br><br>Pennsylvania is the only state in the region that did not see an increase, but that could change as Jason Kavulich—who became Pennsylvania’s Secretary of Aging in January 2023—leads the state’s effort to develop a 10-year master plan for aging. “It is our top-most priority to make sure that people can age in place, how they choose, and to make sure that the services that we have really are responsive,” Kavulich says.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/90/ca/722b3834468a82b147701fcee20d/midatlanticranks.png" alt="midatlanticranks.png" width="3166" height="6717" style="height: auto; max-width: 350px;"/> </figure> </div> </div><p>One of the biggest challenges states face in expanding HCBS is the <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">shortage of</a></span></span> <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">direct-care workers</a></span></span> to fill those jobs. The work can be emotionally and physically taxing and usually comes with low pay, poor benefits and limited support and training.<br><br>The Scorecard shows that across the U.S., wages for direct-care workers are lower than in jobs with similar or lower entry requirements. Their median income is about $30,000 a year—approximately $5,000 less than workers in comparable jobs are paid in most states. D.C. has the highest wage gap in the country, with direct-care workers earning $5.03 less per hour than their counterparts in other sectors.<br><br>“I’m in competition with fast-food places. It’s as simple as that,” says 63-year-old Keith Williams of Clarks Green, Pennsylvania, outside Scranton. He was born with arthrogryposis, a combination of conditions that causes joint contractures and weak muscles.<br><br>Through a self-directed program, he hires care workers to help him with everything from showering to eating. He recruits through word of mouth and online postings. When that fails, he hires his sister-in-law.<br><br>It’s not easy, says Williams, the manager of independent living services for the Northeast Pennsylvania Center for Independent Living, a community-based organization staffed in part by people with disabilities. But the control he has over his care has allowed him to have a meaningful life.<br><br>“It’s meant that I’ve been able to live life on my own terms,” he says.<br><br><i>Ann Hardie spent a decade covering aging issues for The Atlanta Journal-Constitution. She has written for the Bulletin for 15 years.</i><br><br><b>More on Home Care</b><br></p><ul><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2023/rise-of-companion-care.html" target="_blank" rel="noopener noreferrer">Care Companions: A Watchful Eye and Willing Ear for Older Adults</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2019/home-health-aides.html" target="_blank" rel="noopener noreferrer">Find the Right Home Aide for Your Loved One</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://press.aarp.org/2021-11-18-AARP-Survey-Shows-8-in-10-Older-Adults-Want-to-Age-in-Their-Homes-While-Number-and-Needs-of-Households-Headed-Older-Adults-Grow-Dramatically" target="_blank" rel="noopener noreferrer">AARP Survey: 8 in 10 Older Adults Want to Age at Home</a></span></span></li></ul><div class="Enhancement" > <div class="Enhancement-item"><span class="VideoEnhancement" data-video-disable-history data-embeddedvideo-container> <div class="VideoEnhancement-player"><bsp-brightcoveplayer data-video-player class="BrightcoveVideoPlayer" data-account="3772599298001" data-player="KM9xJAJa4" data-video-id="5754403576001" data-video-title="How In-Home Care Helps — AARP" > <video class="video-js" id="BrightcoveVideoPlayer-5754403576001" data-video-id="5754403576001" data-account="" data-player="KM9xJAJa4" data-embed="default" controls ></video> </bsp-brightcoveplayer> </div> <div class="VideoEnhancement-title">How In-Home Care Helps — AARP</div> </span> </div> </div><p></p></div> </div> </p></span> </div> </div> </div> </div><div class="module clearfix"><script src="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.c85a242a55150cd195e494cd6e5b9c77.gz.js" async=""></script> <link rel="stylesheet" media="all" href="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.bfe6eb5a8301841feef3af4e9bd1e26d.gz.css"> <!-- bypass --> <style> a:focus, a:hover { text-decoration: underline; } h1.article-headline { margin: 0 0 1rem; } </style> <!-- <style> .Enhancement-item .Figure { margin-bottom: 24px; } .RichTextArticleBody-body ul { margin-bottom: 24px; } .RichTextArticleBody-body p{ margin: 12px 0; } .RichTextModule-items { clear: both; display: table; width: 100%; margin-bottom: 12px; } .VideoEnhancement>* { color: var(--primaryTextColor); font-size: 13px; font-weight: 400; line-height: 1.4; font-style: italic; background: #f0efed } @media only screen and (min-width: 768px) { .VideoEnhancement>* { font-size:14px; font-weight: 400; line-height: 1.47 } } .VideoEnhancement-title { padding: 20px } @media only screen and (min-width: 768px) { .VideoEnhancement-title { padding:30px } } .VideoEnhancement-player>* { position: relative; width: 100%; height: 0; padding-bottom: 56.25% } .VideoEnhancement iframe { border: 0; position: absolute; top: 0; left: 0; width: 100%; height: 100% } [data-video-player] { display: block; padding-bottom: 56.25%; height: 0; margin: 0 auto; } [data-video-player][data-aspect-ratio="4x3"] { padding-bottom: 56.25%; } [data-video-player][data-aspect-ratio="16x9"] { padding-bottom: 56.25% } </style> --></div><div class="module clearfix"><div class="module-spacer tout-homefit-750"> <a data-formelementid="CSN-LOCAL-HC-NEWSSK-02272024" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-HC-NEWSSK-02272024"><img class="img-responsive" alt="Explore the free AARP HomeFit Guide" title="Explore the free AARP HomeFit Guide" src="https://cdn-aarp.americantowns.com/img/touts/HomeFit_750x150.png"></a> </div></div></div> <div class="col-md-4 right-rail thin-rhs"><div class="module clearfix"><!--default--> <!-- module_RHS - AARP Events --> <div class="ar-basic-box module-spacer"> <header> <div class="pull-right"> <a href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS"> <img style="width:30px;" src="https://cdn-aarp.americantowns.com/img/template/icons/aarp_event_icon.png" alt="Upcoming AARP Events" /> </a> </div> <h2 class="visible-lg">AARP Events for Washington</h2> <h2 class="hidden-lg">AARP Events for Washington</h2> </header> <div class="wrap"> <div class="ar-listing snippet"> <ul class="list"> <li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-co-virtual-functional-fitness-online-99-10142024-sgnszx3wwws.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-FUNCTIONAL-FITNESS-WITH-BASIC-BODY-MOVEMENTS">Functional Fitness with Basic Body Movements</a></h2> <p class="time">Monday, Oct 7, 2024 at 9:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-nm-tai-ji-quan-moving-for-better-balance-albuquerque-nm-100724-j7nhvzxdkxd.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TAI-JI-QUAN-MOVING-FOR-BETTER-BALANCE">Tai Ji Quan: Moving for Better Balance</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/virtual-aarp-tx-mobility-mondays-houston-tx-100724-f5n2bjqhntc.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TRY-A-LOWIMPACT-WORKOUT-TO-IMPROVE-MOBILITY">Try A Low-Impact Workout to Improve Mobility</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom and Facebook</p> <p class="loc">Online Event</p> </li> </ul> <p><a class="link-red" href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS">View All AARP Events<i class="ml-1 fas fa-chevron-right"></i></a></p> </div> </div> </div> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_53475" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_53475', size:'300x250'}); } </script> </div> </div> <div class="card-tout card-dark membership-tout" style="margin:0 0 30px 0;"> <img class="img-responsive image" title="image of two AARP membership cards" alt="image of two AARP membership cards" src="https://cdn-aarp.americantowns.com/img/tout-two-cards.png"> <div class="title">Only $12 your first year with Automatic Renewal</div> <ul class="list"> <li>Immediate access to your <a href="https://www.aarp.org/benefits-discounts/">member benefits</a></li> <li>Discounts on travel and everyday savings</li> <li>Subscription to AARP The Magazine</li> <li>FREE second membership</li> </ul> <div class="action"> <a class="btn" href="https://appsec.aarp.org/mem/join?campaignid=UAJFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Join AARP</a> <div class="body">Already a member? <a href="https://appsec.aarp.org/mem/renew?campaignid= UARFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Renew</a> or <a href="https://www.aarp.org/benefits-discounts/my-membership/print-your-card/">Print Card</a></div> </div> </div> <style> .membership-tout {padding:16px 20px;} .membership-tout .list li { margin: 0; } </style> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_93505" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_93505', size:'300x250'}); } </script> </div> </div> <div class="module-spacer text-center"> <div class="fb-page" alt="Image of AARP District of Columbia Facebook Page" title="Image of AARP District of Columbia Facebook Page" data-href="https://www.facebook.com/aarpdc" data-tabs="timeline" width="320" height="" data-small-header="false" data-adapt-container-width="true" data-hide-cover="false" data-show-facepile="true" lazy="true"> <blockquote cite="https://www.facebook.com/aarpdc" class="fb-xfbml-parse-ignore"><a href="https://www.facebook.com/aarpdc">Facebook</a></blockquote> </div> </div> <div class="ar-basic-box module-spacer"> <header> <h2>Contact AARP<br />District of Columbia</h2> </header> <div class="wrap"> <div class="ar-quick-list module-spacer"> <ul class="list-unstyled"> <li><i class="list-icon fa fa-envelope" alt="Email icon" title="Email icon" aria-hidden="true"></i><a href="mailto:DCAARP@aarp.org " target="_blank" rel="noopener">DCAARP@aarp.org </a></li> <li><i class="list-icon fa fa-globe" alt="Globe icon" title="Globe icon" aria-hidden="true"></i><a href="https://states.aarp.org/region/washington-dc/" target="_blank" rel="noopener">AARP Washington, DC</a></li> <li><i class="list-icon fa fa-map-marker" alt="Map Marker icon" title="Map Marker icon" aria-hidden="true"></i><a href="https://states.aarp.org/aarp-district-of-columbia-state-office/?intcmp=SNG-LNK-AARPLOCAL-CONTACT-20140101-WASHINGTON-DC" target="_blank" rel="noopener">Contact Us</a></li> </ul> </div> <a href="https://www.facebook.com/aarpdc" target="_blank" rel="noopener" aria-label="Open Facebook"><img alt="Facebook icon" title="Facebook icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/facebook-dreamstale25.png"></a> <a href="https://twitter.com/AARPDC" target="_blank" rel="noopener" aria-label="Open Twitter"><img alt="Twitter icon" title="Twitter icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/x-logo-black.png"></a> </div> </div> </div></div> <div class="col-md-8 left-rail left-bot"></div> <div class="col-md-4 right-rail right-bot thin-rhs"></div> </div> <div class="row oneColumnLayout"> </div> <div class="row oneColumnLayout"> <div class="col-md-12"><!-- script to activate navbar --> <script type="text/javascript"> jQuery(".channelBarMain ul.left li a").click(function() { window.location = jQuery(this).attr('href'); }); </script> </div> </div> ' $scripts_for_layout = '<title>How Mid-Atlantic States Are Expanding Home Care</title> <meta name="page_title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="robots" content="noindex, nofollow"/> <meta content="John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The" name="description"/> <meta content="How, Mid, Atlantic, States, Expanding, Home, Care" name="keywords"/> <link rel="canonical" href="https://states.aarp.org/ltss-in-the-mid-atlantic" /> <meta property="og:url" content="https://vccstaging.local.aarp.org/news/how-midatlantic-states-are-expanding-home-care-2023-12-03.html"/> <meta name="twitter:card" content="summary_large_image"/> <meta name="twitter:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="twitter:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta name="twitter:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> <meta property="og:type" content="article"/> <meta property="og:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta property="og:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta property="og:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }' $title_for_layout = '{local_city_c}, {local_state} Happenings - AARP' $asset_version = '230831' $min = true $nowrapper = false $css = ' :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }' $highlighting = '' $location = '<a href="/washington-dc/?intcmp=CSN-LOCAL-NAV-HOME">Washington, DC</a>' $no_header = false $header_title = '<a href="/washington-dc/happenings/">News Feed</a>' $header_subtitle = '' $isPR = false $navbar = '<nav class="section" role="button" aria-expanded="false" aria-controls="collapse"> <div class="section-toggle">Sections <i class="fas fa-chevron-down"></i></div> <ul class="secondary-menu" id="secondary-menu" role="menu" aria-busy="true"> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/aarp-events/?intcmp=CSN-LOCAL-NAV-OLE" data-formelementid="LOCAL-LNK-CLK-EVENTS">Online & Local Events</a> </li> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/things-to-do/?intcmp=CSN-LOCAL-NAV-TTD" data-formelementid="LOCAL-LNK-CLK-THINGSTODO">Things to Do</a></li> <li role="presentation" class="active"><a role="menuitem" class="menuitem" href="/washington-dc/happenings/?intcmp=CSN-LOCAL-NAV-NF" data-formelementid="LOCAL-LNK-CLK-HAPPENINGS">News Feed</a> </li> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/volunteering/?intcmp=CSN-LOCAL-NAV-VOL" data-formelementid="LOCAL-LNK-CLK-VOLUNTEERING">Volunteering</a> </li> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-NAV-HC" data-formelementid="LOCAL-LNK-CLK-HC">Home & Community</a> </li> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/movies/?intcmp=CSN-LOCAL-NAV-MFG" data-formelementid="LOCAL-LNK-CLK-MOVIESFORGROWNUPS">Movies for Grownups</a> </li> <li role="presentation" class="more nosep " id="submenu-more"> <span role="menuitem" class="menuitem" data-formelementid="LOCAL-LNK-CLK-MORE">More<i class="fas fa-chevron-down"></i></span> <ul class="secondary-submenu animate slide-in" id="secondary-submenu"> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/discounts/?intcmp=CSN-LOCAL-NAV-LO" data-formelementid="LOCAL-LNK-CLK-OFFERS">Local Offers</a></li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/local-resources/?intcmp=CSN-LOCAL-NAV-LR" data-formelementid="LOCAL-LNK-CLK-LOCALRESOURCES">Local Resources</a> </li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/jobs/?intcmp=CSN-LOCAL-NAV-WJ" data-formelementid="LOCAL-LNK-CLK-WORK&JOBS">Work & Jobs</a></li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/events/?intcmp=CSN-LOCAL-NAV-CC" data-formelementid="LOCAL-LNK-CLK-EVENTS">Community Calendar</a></li> <!-- <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/healthy-living/?intcmp=CSN-LOCAL-NAV-HEALTHY_LIVING" data-formelementid="LOCAL-LNK-CLK-HEALTHY_LIVING">Healthy Living</a></li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/arts-entertainment/?intcmp=CSN-LOCAL-NAV-ARTS_ENT" data-formelementid="LOCAL-LNK-CLK-ARTS_ENT">Arts & Entertainment</a></li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/museums/?intcmp=CSN-LOCAL-NAV-MUSEUMS" data-formelementid="LOCAL-LNK-CLK-MUSEUMS">Museums</a></li> --> </ul> </li> </ul> </nav>' $header_custom = '' $breadcrumbs = array( (int) 0 => array( 'title' => 'News Feed', 'slug' => 'happenings' ) ) $row = array( 'title' => 'Back to News Feed', 'slug' => 'happenings' ) $i = (int) 0include - APP/View/Layouts/aarp_2023.ctp, line 242 include - APP/View/Layouts/aarp_2023.ctp, line 242 View::_evaluate() - CORE/Cake/View/View.php, line 971 View::_render() - CORE/Cake/View/View.php, line 933 View::renderLayout() - CORE/Cake/View/View.php, line 546 View::render() - CORE/Cake/View/View.php, line 481 Controller::render() - CORE/Cake/Controller/Controller.php, line 963 AppController::renderPage() - APP/Controller/AppController.php, line 136 BlogsController::display() - APP/Controller/BlogsController.php, line 81 ReflectionMethod::invokeArgs() - [internal], line ?? Controller::invokeAction() - CORE/Cake/Controller/Controller.php, line 491 Dispatcher::_invoke() - CORE/Cake/Routing/Dispatcher.php, line 193 Dispatcher::dispatch() - CORE/Cake/Routing/Dispatcher.php, line 167 [main] - APP/webroot/index.php, line 118
Warning (2): include(/var/www/vhosts/vcc_staging/app/Resource/aarp2_master.bodyTargeting.html) [<a href='http://php.net/function.include'>function.include</a>]: failed to open stream: No such file or directory [APP/View/Layouts/aarp_2023.ctp, line 243]Code Context<?php if (!$nowrapper): // MLW - Spanish wrappers TBD
include (APP . "Resource/aarp2_master.footer.html");
include (APP . "Resource/aarp2_master.bodyTargeting.html");
$viewFile = '/var/www/vhosts/vcc_staging/app/View/Layouts/aarp_2023.ctp' $dataForView = array( 'content_for_layout' => '<div class="row twoColumnLayout"> <div class="col-md-8 left-rail"><div class="module clearfix"><div class="ar-basic-box"> <div> <div class="module-spacer"> <header><h1 class="article-headline">How Mid-Atlantic States Are Expanding Home Care</h1></header> <div class="posted-on"> Posted on 12/03/23 by <b>Ann Hardie</b> </div> </div> <div class="module-spacer"> <span class="blog-content"><p><div class="RichTextArticleBody"> <div class="RichTextArticleBody-body"><p>John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The 55-year-old from Dover, Delaware, goes to work every day, helps his 8-year-old son with basketball drills and watches his beloved Philadelphia Eagles with friends at Buffalo Wild Wings.<br><br>McNeal does so with the assistance of direct-care workers who help him get dressed in the morning, fix his meals and drive him where he needs to go.<br><br>“My life is unique in that I have a significant disability,” says McNeal, director of Delaware’s State Council for Persons with Disabilities. But, he says, it’s “a productive life that is every bit as normal as anybody else’s.”<br><br>Across the country, states such as Delaware are spending a growing percentage of long-term care funding to keep people in their homes and communities instead of institutional settings. That’s according to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023" target="_blank" rel="noopener noreferrer">AARP’s most recent Long-Term Services and Supports State Scorecard</a></span></span>, which uses 50 spending, quality and access indicators to rank each state’s long-term care system.<br><br>The new data shows that for the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid’s long-term care dollars nationally for older people and adults with physical disabilities went to home- and community-based services instead of nursing homes or other facilities.<br></p><p class="cms-textAlign-center"><b>EXPLORE: </b><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/" target="_blank" rel="noopener noreferrer"><b>AARP Long-Term Care Scorecard</b></a></span></span></p><p>“This is a big deal. We are seeing a breaking point,” says Susan Reinhard, senior vice president of the AARP Public Policy Institute, which published the Scorecard in September.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/da/c2/a471a2d346088edaf8c38a8b7a46/midalantic.png" alt="midalantic.png" width="6900" height="5761"/> <figcaption class="Figure-caption">Nicolas Rapp</figcaption> </figure> </div> </div><p>The shift to home- and community-based services comes as demand for such care has increased, fueled in part by a pandemic that took a horrific toll on nursing home residents. Polls have consistently shown that most older Americans want to age in place. A 2021 AARP survey found that more than three-quarters of adults 50-plus say they want to remain in their homes as they grow older.<br><br>But with America’s population of older adults growing, the chasm between the availability of HCBS and access to such services is poised to widen. <br><br>“We’re going to see a dramatic increase in the 80-plus and 85-plus population” as the boomer generation gets older, says Robert Applebaum, a senior research scholar at Miami University’s Scripps Gerontology Center in Ohio. “So the demand for long-term services ... is going to be tremendous.”<br><br><b><u>A person-centered approach</u></b><br><br>In the Mid-Atlantic region, Delaware, the District of Columbia, Maryland, New Jersey and West Virginia have all increased the percentage of their Medicaid dollars going to HCBS for older people and adults with physical disabilities in recent years, the Scorecard shows. One way they are doing that: giving more older adults the power to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">direct their own care</a></span></span>, funded through Medicaid initiatives. (Medicaid, a joint federal-state program for low-income Americans, includes coverage for nursing homes and other long-term care.) <br><br>Enrollment in these <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">“self-directed” care </a></span></span>programs increased by 10 percent or more across 34 states and the District of Columbia in recent years, the Scorecard shows. Such programs give people a greater say over how to spend government dollars on their own care.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/25/1e/2926ddba4cd09d7af135e7604561/1140-inset1-de-john-mcneal.jpg" alt="John McNeal, Director of the State Council for Persons with Disabilities for the State of Delaware, photographed at his office in Dover DE for AARP Bulletin, 7 December 2023. Photo by Mike Morgan." width="655" height="1140" style="height: auto; max-width: 380px;"/> <figcaption class="Figure-caption">John McNeal exits his car. Photo by Mike Morgan.</figcaption> </figure> </div> </div><p>“It’s like the ultimate person-centered approach,” says Lisa Alecxih, who researches long-term care for The Lewin Group, a health care and human services consulting firm. She notes that such programs often have the added benefit of allowing participants to hire family members as caregivers. That’s crucial because there’s a national shortage of direct-care workers.<br><br>Applebaum says his research on self-directed programs has also shown the satisfaction levels were “beyond anything I’ve ever seen as an evaluator.”<br><br>McNeal, the Delaware disability advocate, says that’s certainly true for him. “This is probably the most important program that has come into my life,” he says. “It has allowed me the opportunity to have everything that anybody else in the community has.”<br><br><b><u>Growing demand, workforce crunch</u></b><br><br>Self-directed services are one of many state-level innovations highlighted in the Scorecard as a way states can meet the growing demand for home- and community-based care. In the Mid-Atlantic region, D.C., Virginia and New Jersey posted the highest numbers of people enrolled in self-directed programs relative to their disabled populations.<br><br>Pennsylvania is the only state in the region that did not see an increase, but that could change as Jason Kavulich—who became Pennsylvania’s Secretary of Aging in January 2023—leads the state’s effort to develop a 10-year master plan for aging. “It is our top-most priority to make sure that people can age in place, how they choose, and to make sure that the services that we have really are responsive,” Kavulich says.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/90/ca/722b3834468a82b147701fcee20d/midatlanticranks.png" alt="midatlanticranks.png" width="3166" height="6717" style="height: auto; max-width: 350px;"/> </figure> </div> </div><p>One of the biggest challenges states face in expanding HCBS is the <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">shortage of</a></span></span> <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">direct-care workers</a></span></span> to fill those jobs. The work can be emotionally and physically taxing and usually comes with low pay, poor benefits and limited support and training.<br><br>The Scorecard shows that across the U.S., wages for direct-care workers are lower than in jobs with similar or lower entry requirements. Their median income is about $30,000 a year—approximately $5,000 less than workers in comparable jobs are paid in most states. D.C. has the highest wage gap in the country, with direct-care workers earning $5.03 less per hour than their counterparts in other sectors.<br><br>“I’m in competition with fast-food places. It’s as simple as that,” says 63-year-old Keith Williams of Clarks Green, Pennsylvania, outside Scranton. He was born with arthrogryposis, a combination of conditions that causes joint contractures and weak muscles.<br><br>Through a self-directed program, he hires care workers to help him with everything from showering to eating. He recruits through word of mouth and online postings. When that fails, he hires his sister-in-law.<br><br>It’s not easy, says Williams, the manager of independent living services for the Northeast Pennsylvania Center for Independent Living, a community-based organization staffed in part by people with disabilities. But the control he has over his care has allowed him to have a meaningful life.<br><br>“It’s meant that I’ve been able to live life on my own terms,” he says.<br><br><i>Ann Hardie spent a decade covering aging issues for The Atlanta Journal-Constitution. She has written for the Bulletin for 15 years.</i><br><br><b>More on Home Care</b><br></p><ul><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2023/rise-of-companion-care.html" target="_blank" rel="noopener noreferrer">Care Companions: A Watchful Eye and Willing Ear for Older Adults</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2019/home-health-aides.html" target="_blank" rel="noopener noreferrer">Find the Right Home Aide for Your Loved One</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://press.aarp.org/2021-11-18-AARP-Survey-Shows-8-in-10-Older-Adults-Want-to-Age-in-Their-Homes-While-Number-and-Needs-of-Households-Headed-Older-Adults-Grow-Dramatically" target="_blank" rel="noopener noreferrer">AARP Survey: 8 in 10 Older Adults Want to Age at Home</a></span></span></li></ul><div class="Enhancement" > <div class="Enhancement-item"><span class="VideoEnhancement" data-video-disable-history data-embeddedvideo-container> <div class="VideoEnhancement-player"><bsp-brightcoveplayer data-video-player class="BrightcoveVideoPlayer" data-account="3772599298001" data-player="KM9xJAJa4" data-video-id="5754403576001" data-video-title="How In-Home Care Helps — AARP" > <video class="video-js" id="BrightcoveVideoPlayer-5754403576001" data-video-id="5754403576001" data-account="" data-player="KM9xJAJa4" data-embed="default" controls ></video> </bsp-brightcoveplayer> </div> <div class="VideoEnhancement-title">How In-Home Care Helps — AARP</div> </span> </div> </div><p></p></div> </div> </p></span> </div> </div> </div> </div><div class="module clearfix"><script src="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.c85a242a55150cd195e494cd6e5b9c77.gz.js" async=""></script> <link rel="stylesheet" media="all" href="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.bfe6eb5a8301841feef3af4e9bd1e26d.gz.css"> <!-- bypass --> <style> a:focus, a:hover { text-decoration: underline; } h1.article-headline { margin: 0 0 1rem; } </style> <!-- <style> .Enhancement-item .Figure { margin-bottom: 24px; } .RichTextArticleBody-body ul { margin-bottom: 24px; } .RichTextArticleBody-body p{ margin: 12px 0; } .RichTextModule-items { clear: both; display: table; width: 100%; margin-bottom: 12px; } .VideoEnhancement>* { color: var(--primaryTextColor); font-size: 13px; font-weight: 400; line-height: 1.4; font-style: italic; background: #f0efed } @media only screen and (min-width: 768px) { .VideoEnhancement>* { font-size:14px; font-weight: 400; line-height: 1.47 } } .VideoEnhancement-title { padding: 20px } @media only screen and (min-width: 768px) { .VideoEnhancement-title { padding:30px } } .VideoEnhancement-player>* { position: relative; width: 100%; height: 0; padding-bottom: 56.25% } .VideoEnhancement iframe { border: 0; position: absolute; top: 0; left: 0; width: 100%; height: 100% } [data-video-player] { display: block; padding-bottom: 56.25%; height: 0; margin: 0 auto; } [data-video-player][data-aspect-ratio="4x3"] { padding-bottom: 56.25%; } [data-video-player][data-aspect-ratio="16x9"] { padding-bottom: 56.25% } </style> --></div><div class="module clearfix"><div class="module-spacer tout-homefit-750"> <a data-formelementid="CSN-LOCAL-HC-NEWSSK-02272024" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-HC-NEWSSK-02272024"><img class="img-responsive" alt="Explore the free AARP HomeFit Guide" title="Explore the free AARP HomeFit Guide" src="https://cdn-aarp.americantowns.com/img/touts/HomeFit_750x150.png"></a> </div></div></div> <div class="col-md-4 right-rail thin-rhs"><div class="module clearfix"><!--default--> <!-- module_RHS - AARP Events --> <div class="ar-basic-box module-spacer"> <header> <div class="pull-right"> <a href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS"> <img style="width:30px;" src="https://cdn-aarp.americantowns.com/img/template/icons/aarp_event_icon.png" alt="Upcoming AARP Events" /> </a> </div> <h2 class="visible-lg">AARP Events for Washington</h2> <h2 class="hidden-lg">AARP Events for Washington</h2> </header> <div class="wrap"> <div class="ar-listing snippet"> <ul class="list"> <li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-co-virtual-functional-fitness-online-99-10142024-sgnszx3wwws.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-FUNCTIONAL-FITNESS-WITH-BASIC-BODY-MOVEMENTS">Functional Fitness with Basic Body Movements</a></h2> <p class="time">Monday, Oct 7, 2024 at 9:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-nm-tai-ji-quan-moving-for-better-balance-albuquerque-nm-100724-j7nhvzxdkxd.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TAI-JI-QUAN-MOVING-FOR-BETTER-BALANCE">Tai Ji Quan: Moving for Better Balance</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/virtual-aarp-tx-mobility-mondays-houston-tx-100724-f5n2bjqhntc.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TRY-A-LOWIMPACT-WORKOUT-TO-IMPROVE-MOBILITY">Try A Low-Impact Workout to Improve Mobility</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom and Facebook</p> <p class="loc">Online Event</p> </li> </ul> <p><a class="link-red" href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS">View All AARP Events<i class="ml-1 fas fa-chevron-right"></i></a></p> </div> </div> </div> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_53475" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_53475', size:'300x250'}); } </script> </div> </div> <div class="card-tout card-dark membership-tout" style="margin:0 0 30px 0;"> <img class="img-responsive image" title="image of two AARP membership cards" alt="image of two AARP membership cards" src="https://cdn-aarp.americantowns.com/img/tout-two-cards.png"> <div class="title">Only $12 your first year with Automatic Renewal</div> <ul class="list"> <li>Immediate access to your <a href="https://www.aarp.org/benefits-discounts/">member benefits</a></li> <li>Discounts on travel and everyday savings</li> <li>Subscription to AARP The Magazine</li> <li>FREE second membership</li> </ul> <div class="action"> <a class="btn" href="https://appsec.aarp.org/mem/join?campaignid=UAJFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Join AARP</a> <div class="body">Already a member? <a href="https://appsec.aarp.org/mem/renew?campaignid= UARFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Renew</a> or <a href="https://www.aarp.org/benefits-discounts/my-membership/print-your-card/">Print Card</a></div> </div> </div> <style> .membership-tout {padding:16px 20px;} .membership-tout .list li { margin: 0; } </style> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_93505" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_93505', size:'300x250'}); } </script> </div> </div> <div class="module-spacer text-center"> <div class="fb-page" alt="Image of AARP District of Columbia Facebook Page" title="Image of AARP District of Columbia Facebook Page" data-href="https://www.facebook.com/aarpdc" data-tabs="timeline" width="320" height="" data-small-header="false" data-adapt-container-width="true" data-hide-cover="false" data-show-facepile="true" lazy="true"> <blockquote cite="https://www.facebook.com/aarpdc" class="fb-xfbml-parse-ignore"><a href="https://www.facebook.com/aarpdc">Facebook</a></blockquote> </div> </div> <div class="ar-basic-box module-spacer"> <header> <h2>Contact AARP<br />District of Columbia</h2> </header> <div class="wrap"> <div class="ar-quick-list module-spacer"> <ul class="list-unstyled"> <li><i class="list-icon fa fa-envelope" alt="Email icon" title="Email icon" aria-hidden="true"></i><a href="mailto:DCAARP@aarp.org " target="_blank" rel="noopener">DCAARP@aarp.org </a></li> <li><i class="list-icon fa fa-globe" alt="Globe icon" title="Globe icon" aria-hidden="true"></i><a href="https://states.aarp.org/region/washington-dc/" target="_blank" rel="noopener">AARP Washington, DC</a></li> <li><i class="list-icon fa fa-map-marker" alt="Map Marker icon" title="Map Marker icon" aria-hidden="true"></i><a href="https://states.aarp.org/aarp-district-of-columbia-state-office/?intcmp=SNG-LNK-AARPLOCAL-CONTACT-20140101-WASHINGTON-DC" target="_blank" rel="noopener">Contact Us</a></li> </ul> </div> <a href="https://www.facebook.com/aarpdc" target="_blank" rel="noopener" aria-label="Open Facebook"><img alt="Facebook icon" title="Facebook icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/facebook-dreamstale25.png"></a> <a href="https://twitter.com/AARPDC" target="_blank" rel="noopener" aria-label="Open Twitter"><img alt="Twitter icon" title="Twitter icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/x-logo-black.png"></a> </div> </div> </div></div> <div class="col-md-8 left-rail left-bot"></div> <div class="col-md-4 right-rail right-bot thin-rhs"></div> </div> <div class="row oneColumnLayout"> </div> <div class="row oneColumnLayout"> <div class="col-md-12"><!-- script to activate navbar --> <script type="text/javascript"> jQuery(".channelBarMain ul.left li a").click(function() { window.location = jQuery(this).attr('href'); }); </script> </div> </div> ', 'scripts_for_layout' => '<title>How Mid-Atlantic States Are Expanding Home Care</title> <meta name="page_title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="robots" content="noindex, nofollow"/> <meta content="John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The" name="description"/> <meta content="How, Mid, Atlantic, States, Expanding, Home, Care" name="keywords"/> <link rel="canonical" href="https://states.aarp.org/ltss-in-the-mid-atlantic" /> <meta property="og:url" content="https://vccstaging.local.aarp.org/news/how-midatlantic-states-are-expanding-home-care-2023-12-03.html"/> <meta name="twitter:card" content="summary_large_image"/> <meta name="twitter:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="twitter:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta name="twitter:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> <meta property="og:type" content="article"/> <meta property="og:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta property="og:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta property="og:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }', 'title_for_layout' => '{local_city_c}, {local_state} Happenings - AARP' ) $content_for_layout = '<div class="row twoColumnLayout"> <div class="col-md-8 left-rail"><div class="module clearfix"><div class="ar-basic-box"> <div> <div class="module-spacer"> <header><h1 class="article-headline">How Mid-Atlantic States Are Expanding Home Care</h1></header> <div class="posted-on"> Posted on 12/03/23 by <b>Ann Hardie</b> </div> </div> <div class="module-spacer"> <span class="blog-content"><p><div class="RichTextArticleBody"> <div class="RichTextArticleBody-body"><p>John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The 55-year-old from Dover, Delaware, goes to work every day, helps his 8-year-old son with basketball drills and watches his beloved Philadelphia Eagles with friends at Buffalo Wild Wings.<br><br>McNeal does so with the assistance of direct-care workers who help him get dressed in the morning, fix his meals and drive him where he needs to go.<br><br>“My life is unique in that I have a significant disability,” says McNeal, director of Delaware’s State Council for Persons with Disabilities. But, he says, it’s “a productive life that is every bit as normal as anybody else’s.”<br><br>Across the country, states such as Delaware are spending a growing percentage of long-term care funding to keep people in their homes and communities instead of institutional settings. That’s according to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023" target="_blank" rel="noopener noreferrer">AARP’s most recent Long-Term Services and Supports State Scorecard</a></span></span>, which uses 50 spending, quality and access indicators to rank each state’s long-term care system.<br><br>The new data shows that for the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid’s long-term care dollars nationally for older people and adults with physical disabilities went to home- and community-based services instead of nursing homes or other facilities.<br></p><p class="cms-textAlign-center"><b>EXPLORE: </b><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/" target="_blank" rel="noopener noreferrer"><b>AARP Long-Term Care Scorecard</b></a></span></span></p><p>“This is a big deal. We are seeing a breaking point,” says Susan Reinhard, senior vice president of the AARP Public Policy Institute, which published the Scorecard in September.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/da/c2/a471a2d346088edaf8c38a8b7a46/midalantic.png" alt="midalantic.png" width="6900" height="5761"/> <figcaption class="Figure-caption">Nicolas Rapp</figcaption> </figure> </div> </div><p>The shift to home- and community-based services comes as demand for such care has increased, fueled in part by a pandemic that took a horrific toll on nursing home residents. Polls have consistently shown that most older Americans want to age in place. A 2021 AARP survey found that more than three-quarters of adults 50-plus say they want to remain in their homes as they grow older.<br><br>But with America’s population of older adults growing, the chasm between the availability of HCBS and access to such services is poised to widen. <br><br>“We’re going to see a dramatic increase in the 80-plus and 85-plus population” as the boomer generation gets older, says Robert Applebaum, a senior research scholar at Miami University’s Scripps Gerontology Center in Ohio. “So the demand for long-term services ... is going to be tremendous.”<br><br><b><u>A person-centered approach</u></b><br><br>In the Mid-Atlantic region, Delaware, the District of Columbia, Maryland, New Jersey and West Virginia have all increased the percentage of their Medicaid dollars going to HCBS for older people and adults with physical disabilities in recent years, the Scorecard shows. One way they are doing that: giving more older adults the power to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">direct their own care</a></span></span>, funded through Medicaid initiatives. (Medicaid, a joint federal-state program for low-income Americans, includes coverage for nursing homes and other long-term care.) <br><br>Enrollment in these <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">“self-directed” care </a></span></span>programs increased by 10 percent or more across 34 states and the District of Columbia in recent years, the Scorecard shows. Such programs give people a greater say over how to spend government dollars on their own care.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/25/1e/2926ddba4cd09d7af135e7604561/1140-inset1-de-john-mcneal.jpg" alt="John McNeal, Director of the State Council for Persons with Disabilities for the State of Delaware, photographed at his office in Dover DE for AARP Bulletin, 7 December 2023. Photo by Mike Morgan." width="655" height="1140" style="height: auto; max-width: 380px;"/> <figcaption class="Figure-caption">John McNeal exits his car. Photo by Mike Morgan.</figcaption> </figure> </div> </div><p>“It’s like the ultimate person-centered approach,” says Lisa Alecxih, who researches long-term care for The Lewin Group, a health care and human services consulting firm. She notes that such programs often have the added benefit of allowing participants to hire family members as caregivers. That’s crucial because there’s a national shortage of direct-care workers.<br><br>Applebaum says his research on self-directed programs has also shown the satisfaction levels were “beyond anything I’ve ever seen as an evaluator.”<br><br>McNeal, the Delaware disability advocate, says that’s certainly true for him. “This is probably the most important program that has come into my life,” he says. “It has allowed me the opportunity to have everything that anybody else in the community has.”<br><br><b><u>Growing demand, workforce crunch</u></b><br><br>Self-directed services are one of many state-level innovations highlighted in the Scorecard as a way states can meet the growing demand for home- and community-based care. In the Mid-Atlantic region, D.C., Virginia and New Jersey posted the highest numbers of people enrolled in self-directed programs relative to their disabled populations.<br><br>Pennsylvania is the only state in the region that did not see an increase, but that could change as Jason Kavulich—who became Pennsylvania’s Secretary of Aging in January 2023—leads the state’s effort to develop a 10-year master plan for aging. “It is our top-most priority to make sure that people can age in place, how they choose, and to make sure that the services that we have really are responsive,” Kavulich says.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/90/ca/722b3834468a82b147701fcee20d/midatlanticranks.png" alt="midatlanticranks.png" width="3166" height="6717" style="height: auto; max-width: 350px;"/> </figure> </div> </div><p>One of the biggest challenges states face in expanding HCBS is the <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">shortage of</a></span></span> <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">direct-care workers</a></span></span> to fill those jobs. The work can be emotionally and physically taxing and usually comes with low pay, poor benefits and limited support and training.<br><br>The Scorecard shows that across the U.S., wages for direct-care workers are lower than in jobs with similar or lower entry requirements. Their median income is about $30,000 a year—approximately $5,000 less than workers in comparable jobs are paid in most states. D.C. has the highest wage gap in the country, with direct-care workers earning $5.03 less per hour than their counterparts in other sectors.<br><br>“I’m in competition with fast-food places. It’s as simple as that,” says 63-year-old Keith Williams of Clarks Green, Pennsylvania, outside Scranton. He was born with arthrogryposis, a combination of conditions that causes joint contractures and weak muscles.<br><br>Through a self-directed program, he hires care workers to help him with everything from showering to eating. He recruits through word of mouth and online postings. When that fails, he hires his sister-in-law.<br><br>It’s not easy, says Williams, the manager of independent living services for the Northeast Pennsylvania Center for Independent Living, a community-based organization staffed in part by people with disabilities. But the control he has over his care has allowed him to have a meaningful life.<br><br>“It’s meant that I’ve been able to live life on my own terms,” he says.<br><br><i>Ann Hardie spent a decade covering aging issues for The Atlanta Journal-Constitution. She has written for the Bulletin for 15 years.</i><br><br><b>More on Home Care</b><br></p><ul><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2023/rise-of-companion-care.html" target="_blank" rel="noopener noreferrer">Care Companions: A Watchful Eye and Willing Ear for Older Adults</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2019/home-health-aides.html" target="_blank" rel="noopener noreferrer">Find the Right Home Aide for Your Loved One</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://press.aarp.org/2021-11-18-AARP-Survey-Shows-8-in-10-Older-Adults-Want-to-Age-in-Their-Homes-While-Number-and-Needs-of-Households-Headed-Older-Adults-Grow-Dramatically" target="_blank" rel="noopener noreferrer">AARP Survey: 8 in 10 Older Adults Want to Age at Home</a></span></span></li></ul><div class="Enhancement" > <div class="Enhancement-item"><span class="VideoEnhancement" data-video-disable-history data-embeddedvideo-container> <div class="VideoEnhancement-player"><bsp-brightcoveplayer data-video-player class="BrightcoveVideoPlayer" data-account="3772599298001" data-player="KM9xJAJa4" data-video-id="5754403576001" data-video-title="How In-Home Care Helps — AARP" > <video class="video-js" id="BrightcoveVideoPlayer-5754403576001" data-video-id="5754403576001" data-account="" data-player="KM9xJAJa4" data-embed="default" controls ></video> </bsp-brightcoveplayer> </div> <div class="VideoEnhancement-title">How In-Home Care Helps — AARP</div> </span> </div> </div><p></p></div> </div> </p></span> </div> </div> </div> </div><div class="module clearfix"><script src="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.c85a242a55150cd195e494cd6e5b9c77.gz.js" async=""></script> <link rel="stylesheet" media="all" href="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.bfe6eb5a8301841feef3af4e9bd1e26d.gz.css"> <!-- bypass --> <style> a:focus, a:hover { text-decoration: underline; } h1.article-headline { margin: 0 0 1rem; } </style> <!-- <style> .Enhancement-item .Figure { margin-bottom: 24px; } .RichTextArticleBody-body ul { margin-bottom: 24px; } .RichTextArticleBody-body p{ margin: 12px 0; } .RichTextModule-items { clear: both; display: table; width: 100%; margin-bottom: 12px; } .VideoEnhancement>* { color: var(--primaryTextColor); font-size: 13px; font-weight: 400; line-height: 1.4; font-style: italic; background: #f0efed } @media only screen and (min-width: 768px) { .VideoEnhancement>* { font-size:14px; font-weight: 400; line-height: 1.47 } } .VideoEnhancement-title { padding: 20px } @media only screen and (min-width: 768px) { .VideoEnhancement-title { padding:30px } } .VideoEnhancement-player>* { position: relative; width: 100%; height: 0; padding-bottom: 56.25% } .VideoEnhancement iframe { border: 0; position: absolute; top: 0; left: 0; width: 100%; height: 100% } [data-video-player] { display: block; padding-bottom: 56.25%; height: 0; margin: 0 auto; } [data-video-player][data-aspect-ratio="4x3"] { padding-bottom: 56.25%; } [data-video-player][data-aspect-ratio="16x9"] { padding-bottom: 56.25% } </style> --></div><div class="module clearfix"><div class="module-spacer tout-homefit-750"> <a data-formelementid="CSN-LOCAL-HC-NEWSSK-02272024" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-HC-NEWSSK-02272024"><img class="img-responsive" alt="Explore the free AARP HomeFit Guide" title="Explore the free AARP HomeFit Guide" src="https://cdn-aarp.americantowns.com/img/touts/HomeFit_750x150.png"></a> </div></div></div> <div class="col-md-4 right-rail thin-rhs"><div class="module clearfix"><!--default--> <!-- module_RHS - AARP Events --> <div class="ar-basic-box module-spacer"> <header> <div class="pull-right"> <a href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS"> <img style="width:30px;" src="https://cdn-aarp.americantowns.com/img/template/icons/aarp_event_icon.png" alt="Upcoming AARP Events" /> </a> </div> <h2 class="visible-lg">AARP Events for Washington</h2> <h2 class="hidden-lg">AARP Events for Washington</h2> </header> <div class="wrap"> <div class="ar-listing snippet"> <ul class="list"> <li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-co-virtual-functional-fitness-online-99-10142024-sgnszx3wwws.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-FUNCTIONAL-FITNESS-WITH-BASIC-BODY-MOVEMENTS">Functional Fitness with Basic Body Movements</a></h2> <p class="time">Monday, Oct 7, 2024 at 9:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-nm-tai-ji-quan-moving-for-better-balance-albuquerque-nm-100724-j7nhvzxdkxd.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TAI-JI-QUAN-MOVING-FOR-BETTER-BALANCE">Tai Ji Quan: Moving for Better Balance</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/virtual-aarp-tx-mobility-mondays-houston-tx-100724-f5n2bjqhntc.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TRY-A-LOWIMPACT-WORKOUT-TO-IMPROVE-MOBILITY">Try A Low-Impact Workout to Improve Mobility</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom and Facebook</p> <p class="loc">Online Event</p> </li> </ul> <p><a class="link-red" href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS">View All AARP Events<i class="ml-1 fas fa-chevron-right"></i></a></p> </div> </div> </div> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_53475" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_53475', size:'300x250'}); } </script> </div> </div> <div class="card-tout card-dark membership-tout" style="margin:0 0 30px 0;"> <img class="img-responsive image" title="image of two AARP membership cards" alt="image of two AARP membership cards" src="https://cdn-aarp.americantowns.com/img/tout-two-cards.png"> <div class="title">Only $12 your first year with Automatic Renewal</div> <ul class="list"> <li>Immediate access to your <a href="https://www.aarp.org/benefits-discounts/">member benefits</a></li> <li>Discounts on travel and everyday savings</li> <li>Subscription to AARP The Magazine</li> <li>FREE second membership</li> </ul> <div class="action"> <a class="btn" href="https://appsec.aarp.org/mem/join?campaignid=UAJFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Join AARP</a> <div class="body">Already a member? <a href="https://appsec.aarp.org/mem/renew?campaignid= UARFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Renew</a> or <a href="https://www.aarp.org/benefits-discounts/my-membership/print-your-card/">Print Card</a></div> </div> </div> <style> .membership-tout {padding:16px 20px;} .membership-tout .list li { margin: 0; } </style> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_93505" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_93505', size:'300x250'}); } </script> </div> </div> <div class="module-spacer text-center"> <div class="fb-page" alt="Image of AARP District of Columbia Facebook Page" title="Image of AARP District of Columbia Facebook Page" data-href="https://www.facebook.com/aarpdc" data-tabs="timeline" width="320" height="" data-small-header="false" data-adapt-container-width="true" data-hide-cover="false" data-show-facepile="true" lazy="true"> <blockquote cite="https://www.facebook.com/aarpdc" class="fb-xfbml-parse-ignore"><a href="https://www.facebook.com/aarpdc">Facebook</a></blockquote> </div> </div> <div class="ar-basic-box module-spacer"> <header> <h2>Contact AARP<br />District of Columbia</h2> </header> <div class="wrap"> <div class="ar-quick-list module-spacer"> <ul class="list-unstyled"> <li><i class="list-icon fa fa-envelope" alt="Email icon" title="Email icon" aria-hidden="true"></i><a href="mailto:DCAARP@aarp.org " target="_blank" rel="noopener">DCAARP@aarp.org </a></li> <li><i class="list-icon fa fa-globe" alt="Globe icon" title="Globe icon" aria-hidden="true"></i><a href="https://states.aarp.org/region/washington-dc/" target="_blank" rel="noopener">AARP Washington, DC</a></li> <li><i class="list-icon fa fa-map-marker" alt="Map Marker icon" title="Map Marker icon" aria-hidden="true"></i><a href="https://states.aarp.org/aarp-district-of-columbia-state-office/?intcmp=SNG-LNK-AARPLOCAL-CONTACT-20140101-WASHINGTON-DC" target="_blank" rel="noopener">Contact Us</a></li> </ul> </div> <a href="https://www.facebook.com/aarpdc" target="_blank" rel="noopener" aria-label="Open Facebook"><img alt="Facebook icon" title="Facebook icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/facebook-dreamstale25.png"></a> <a href="https://twitter.com/AARPDC" target="_blank" rel="noopener" aria-label="Open Twitter"><img alt="Twitter icon" title="Twitter icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/x-logo-black.png"></a> </div> </div> </div></div> <div class="col-md-8 left-rail left-bot"></div> <div class="col-md-4 right-rail right-bot thin-rhs"></div> </div> <div class="row oneColumnLayout"> </div> <div class="row oneColumnLayout"> <div class="col-md-12"><!-- script to activate navbar --> <script type="text/javascript"> jQuery(".channelBarMain ul.left li a").click(function() { window.location = jQuery(this).attr('href'); }); </script> </div> </div> ' $scripts_for_layout = '<title>How Mid-Atlantic States Are Expanding Home Care</title> <meta name="page_title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="robots" content="noindex, nofollow"/> <meta content="John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The" name="description"/> <meta content="How, Mid, Atlantic, States, Expanding, Home, Care" name="keywords"/> <link rel="canonical" href="https://states.aarp.org/ltss-in-the-mid-atlantic" /> <meta property="og:url" content="https://vccstaging.local.aarp.org/news/how-midatlantic-states-are-expanding-home-care-2023-12-03.html"/> <meta name="twitter:card" content="summary_large_image"/> <meta name="twitter:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="twitter:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta name="twitter:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> <meta property="og:type" content="article"/> <meta property="og:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta property="og:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta property="og:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }' $title_for_layout = '{local_city_c}, {local_state} Happenings - AARP' $asset_version = '230831' $min = true $nowrapper = false $css = ' :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }' $highlighting = '' $location = '<a href="/washington-dc/?intcmp=CSN-LOCAL-NAV-HOME">Washington, DC</a>' $no_header = false $header_title = '<a href="/washington-dc/happenings/">News Feed</a>' $header_subtitle = '' $isPR = false $navbar = '<nav class="section" role="button" aria-expanded="false" aria-controls="collapse"> <div class="section-toggle">Sections <i class="fas fa-chevron-down"></i></div> <ul class="secondary-menu" id="secondary-menu" role="menu" aria-busy="true"> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/aarp-events/?intcmp=CSN-LOCAL-NAV-OLE" data-formelementid="LOCAL-LNK-CLK-EVENTS">Online & Local Events</a> </li> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/things-to-do/?intcmp=CSN-LOCAL-NAV-TTD" data-formelementid="LOCAL-LNK-CLK-THINGSTODO">Things to Do</a></li> <li role="presentation" class="active"><a role="menuitem" class="menuitem" href="/washington-dc/happenings/?intcmp=CSN-LOCAL-NAV-NF" data-formelementid="LOCAL-LNK-CLK-HAPPENINGS">News Feed</a> </li> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/volunteering/?intcmp=CSN-LOCAL-NAV-VOL" data-formelementid="LOCAL-LNK-CLK-VOLUNTEERING">Volunteering</a> </li> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-NAV-HC" data-formelementid="LOCAL-LNK-CLK-HC">Home & Community</a> </li> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/movies/?intcmp=CSN-LOCAL-NAV-MFG" data-formelementid="LOCAL-LNK-CLK-MOVIESFORGROWNUPS">Movies for Grownups</a> </li> <li role="presentation" class="more nosep " id="submenu-more"> <span role="menuitem" class="menuitem" data-formelementid="LOCAL-LNK-CLK-MORE">More<i class="fas fa-chevron-down"></i></span> <ul class="secondary-submenu animate slide-in" id="secondary-submenu"> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/discounts/?intcmp=CSN-LOCAL-NAV-LO" data-formelementid="LOCAL-LNK-CLK-OFFERS">Local Offers</a></li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/local-resources/?intcmp=CSN-LOCAL-NAV-LR" data-formelementid="LOCAL-LNK-CLK-LOCALRESOURCES">Local Resources</a> </li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/jobs/?intcmp=CSN-LOCAL-NAV-WJ" data-formelementid="LOCAL-LNK-CLK-WORK&JOBS">Work & Jobs</a></li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/events/?intcmp=CSN-LOCAL-NAV-CC" data-formelementid="LOCAL-LNK-CLK-EVENTS">Community Calendar</a></li> <!-- <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/healthy-living/?intcmp=CSN-LOCAL-NAV-HEALTHY_LIVING" data-formelementid="LOCAL-LNK-CLK-HEALTHY_LIVING">Healthy Living</a></li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/arts-entertainment/?intcmp=CSN-LOCAL-NAV-ARTS_ENT" data-formelementid="LOCAL-LNK-CLK-ARTS_ENT">Arts & Entertainment</a></li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/museums/?intcmp=CSN-LOCAL-NAV-MUSEUMS" data-formelementid="LOCAL-LNK-CLK-MUSEUMS">Museums</a></li> --> </ul> </li> </ul> </nav>' $header_custom = '' $breadcrumbs = array( (int) 0 => array( 'title' => 'News Feed', 'slug' => 'happenings' ) ) $row = array( 'title' => 'Back to News Feed', 'slug' => 'happenings' ) $i = (int) 0include - APP/View/Layouts/aarp_2023.ctp, line 243 include - APP/View/Layouts/aarp_2023.ctp, line 243 View::_evaluate() - CORE/Cake/View/View.php, line 971 View::_render() - CORE/Cake/View/View.php, line 933 View::renderLayout() - CORE/Cake/View/View.php, line 546 View::render() - CORE/Cake/View/View.php, line 481 Controller::render() - CORE/Cake/Controller/Controller.php, line 963 AppController::renderPage() - APP/Controller/AppController.php, line 136 BlogsController::display() - APP/Controller/BlogsController.php, line 81 ReflectionMethod::invokeArgs() - [internal], line ?? Controller::invokeAction() - CORE/Cake/Controller/Controller.php, line 491 Dispatcher::_invoke() - CORE/Cake/Routing/Dispatcher.php, line 193 Dispatcher::dispatch() - CORE/Cake/Routing/Dispatcher.php, line 167 [main] - APP/webroot/index.php, line 118
Warning (2): include() [<a href='http://php.net/function.include'>function.include</a>]: Failed opening '/var/www/vhosts/vcc_staging/app/Resource/aarp2_master.bodyTargeting.html' for inclusion (include_path='/var/www/vhosts/vcc_staging/lib:.:/usr/share/pear:/usr/share/php') [APP/View/Layouts/aarp_2023.ctp, line 243]Code Context<?php if (!$nowrapper): // MLW - Spanish wrappers TBD
include (APP . "Resource/aarp2_master.footer.html");
include (APP . "Resource/aarp2_master.bodyTargeting.html");
$viewFile = '/var/www/vhosts/vcc_staging/app/View/Layouts/aarp_2023.ctp' $dataForView = array( 'content_for_layout' => '<div class="row twoColumnLayout"> <div class="col-md-8 left-rail"><div class="module clearfix"><div class="ar-basic-box"> <div> <div class="module-spacer"> <header><h1 class="article-headline">How Mid-Atlantic States Are Expanding Home Care</h1></header> <div class="posted-on"> Posted on 12/03/23 by <b>Ann Hardie</b> </div> </div> <div class="module-spacer"> <span class="blog-content"><p><div class="RichTextArticleBody"> <div class="RichTextArticleBody-body"><p>John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The 55-year-old from Dover, Delaware, goes to work every day, helps his 8-year-old son with basketball drills and watches his beloved Philadelphia Eagles with friends at Buffalo Wild Wings.<br><br>McNeal does so with the assistance of direct-care workers who help him get dressed in the morning, fix his meals and drive him where he needs to go.<br><br>“My life is unique in that I have a significant disability,” says McNeal, director of Delaware’s State Council for Persons with Disabilities. But, he says, it’s “a productive life that is every bit as normal as anybody else’s.”<br><br>Across the country, states such as Delaware are spending a growing percentage of long-term care funding to keep people in their homes and communities instead of institutional settings. That’s according to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023" target="_blank" rel="noopener noreferrer">AARP’s most recent Long-Term Services and Supports State Scorecard</a></span></span>, which uses 50 spending, quality and access indicators to rank each state’s long-term care system.<br><br>The new data shows that for the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid’s long-term care dollars nationally for older people and adults with physical disabilities went to home- and community-based services instead of nursing homes or other facilities.<br></p><p class="cms-textAlign-center"><b>EXPLORE: </b><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/" target="_blank" rel="noopener noreferrer"><b>AARP Long-Term Care Scorecard</b></a></span></span></p><p>“This is a big deal. We are seeing a breaking point,” says Susan Reinhard, senior vice president of the AARP Public Policy Institute, which published the Scorecard in September.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/da/c2/a471a2d346088edaf8c38a8b7a46/midalantic.png" alt="midalantic.png" width="6900" height="5761"/> <figcaption class="Figure-caption">Nicolas Rapp</figcaption> </figure> </div> </div><p>The shift to home- and community-based services comes as demand for such care has increased, fueled in part by a pandemic that took a horrific toll on nursing home residents. Polls have consistently shown that most older Americans want to age in place. A 2021 AARP survey found that more than three-quarters of adults 50-plus say they want to remain in their homes as they grow older.<br><br>But with America’s population of older adults growing, the chasm between the availability of HCBS and access to such services is poised to widen. <br><br>“We’re going to see a dramatic increase in the 80-plus and 85-plus population” as the boomer generation gets older, says Robert Applebaum, a senior research scholar at Miami University’s Scripps Gerontology Center in Ohio. “So the demand for long-term services ... is going to be tremendous.”<br><br><b><u>A person-centered approach</u></b><br><br>In the Mid-Atlantic region, Delaware, the District of Columbia, Maryland, New Jersey and West Virginia have all increased the percentage of their Medicaid dollars going to HCBS for older people and adults with physical disabilities in recent years, the Scorecard shows. One way they are doing that: giving more older adults the power to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">direct their own care</a></span></span>, funded through Medicaid initiatives. (Medicaid, a joint federal-state program for low-income Americans, includes coverage for nursing homes and other long-term care.) <br><br>Enrollment in these <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">“self-directed” care </a></span></span>programs increased by 10 percent or more across 34 states and the District of Columbia in recent years, the Scorecard shows. Such programs give people a greater say over how to spend government dollars on their own care.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/25/1e/2926ddba4cd09d7af135e7604561/1140-inset1-de-john-mcneal.jpg" alt="John McNeal, Director of the State Council for Persons with Disabilities for the State of Delaware, photographed at his office in Dover DE for AARP Bulletin, 7 December 2023. Photo by Mike Morgan." width="655" height="1140" style="height: auto; max-width: 380px;"/> <figcaption class="Figure-caption">John McNeal exits his car. Photo by Mike Morgan.</figcaption> </figure> </div> </div><p>“It’s like the ultimate person-centered approach,” says Lisa Alecxih, who researches long-term care for The Lewin Group, a health care and human services consulting firm. She notes that such programs often have the added benefit of allowing participants to hire family members as caregivers. That’s crucial because there’s a national shortage of direct-care workers.<br><br>Applebaum says his research on self-directed programs has also shown the satisfaction levels were “beyond anything I’ve ever seen as an evaluator.”<br><br>McNeal, the Delaware disability advocate, says that’s certainly true for him. “This is probably the most important program that has come into my life,” he says. “It has allowed me the opportunity to have everything that anybody else in the community has.”<br><br><b><u>Growing demand, workforce crunch</u></b><br><br>Self-directed services are one of many state-level innovations highlighted in the Scorecard as a way states can meet the growing demand for home- and community-based care. In the Mid-Atlantic region, D.C., Virginia and New Jersey posted the highest numbers of people enrolled in self-directed programs relative to their disabled populations.<br><br>Pennsylvania is the only state in the region that did not see an increase, but that could change as Jason Kavulich—who became Pennsylvania’s Secretary of Aging in January 2023—leads the state’s effort to develop a 10-year master plan for aging. “It is our top-most priority to make sure that people can age in place, how they choose, and to make sure that the services that we have really are responsive,” Kavulich says.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/90/ca/722b3834468a82b147701fcee20d/midatlanticranks.png" alt="midatlanticranks.png" width="3166" height="6717" style="height: auto; max-width: 350px;"/> </figure> </div> </div><p>One of the biggest challenges states face in expanding HCBS is the <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">shortage of</a></span></span> <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">direct-care workers</a></span></span> to fill those jobs. The work can be emotionally and physically taxing and usually comes with low pay, poor benefits and limited support and training.<br><br>The Scorecard shows that across the U.S., wages for direct-care workers are lower than in jobs with similar or lower entry requirements. Their median income is about $30,000 a year—approximately $5,000 less than workers in comparable jobs are paid in most states. D.C. has the highest wage gap in the country, with direct-care workers earning $5.03 less per hour than their counterparts in other sectors.<br><br>“I’m in competition with fast-food places. It’s as simple as that,” says 63-year-old Keith Williams of Clarks Green, Pennsylvania, outside Scranton. He was born with arthrogryposis, a combination of conditions that causes joint contractures and weak muscles.<br><br>Through a self-directed program, he hires care workers to help him with everything from showering to eating. He recruits through word of mouth and online postings. When that fails, he hires his sister-in-law.<br><br>It’s not easy, says Williams, the manager of independent living services for the Northeast Pennsylvania Center for Independent Living, a community-based organization staffed in part by people with disabilities. But the control he has over his care has allowed him to have a meaningful life.<br><br>“It’s meant that I’ve been able to live life on my own terms,” he says.<br><br><i>Ann Hardie spent a decade covering aging issues for The Atlanta Journal-Constitution. She has written for the Bulletin for 15 years.</i><br><br><b>More on Home Care</b><br></p><ul><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2023/rise-of-companion-care.html" target="_blank" rel="noopener noreferrer">Care Companions: A Watchful Eye and Willing Ear for Older Adults</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2019/home-health-aides.html" target="_blank" rel="noopener noreferrer">Find the Right Home Aide for Your Loved One</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://press.aarp.org/2021-11-18-AARP-Survey-Shows-8-in-10-Older-Adults-Want-to-Age-in-Their-Homes-While-Number-and-Needs-of-Households-Headed-Older-Adults-Grow-Dramatically" target="_blank" rel="noopener noreferrer">AARP Survey: 8 in 10 Older Adults Want to Age at Home</a></span></span></li></ul><div class="Enhancement" > <div class="Enhancement-item"><span class="VideoEnhancement" data-video-disable-history data-embeddedvideo-container> <div class="VideoEnhancement-player"><bsp-brightcoveplayer data-video-player class="BrightcoveVideoPlayer" data-account="3772599298001" data-player="KM9xJAJa4" data-video-id="5754403576001" data-video-title="How In-Home Care Helps — AARP" > <video class="video-js" id="BrightcoveVideoPlayer-5754403576001" data-video-id="5754403576001" data-account="" data-player="KM9xJAJa4" data-embed="default" controls ></video> </bsp-brightcoveplayer> </div> <div class="VideoEnhancement-title">How In-Home Care Helps — AARP</div> </span> </div> </div><p></p></div> </div> </p></span> </div> </div> </div> </div><div class="module clearfix"><script src="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.c85a242a55150cd195e494cd6e5b9c77.gz.js" async=""></script> <link rel="stylesheet" media="all" href="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.bfe6eb5a8301841feef3af4e9bd1e26d.gz.css"> <!-- bypass --> <style> a:focus, a:hover { text-decoration: underline; } h1.article-headline { margin: 0 0 1rem; } </style> <!-- <style> .Enhancement-item .Figure { margin-bottom: 24px; } .RichTextArticleBody-body ul { margin-bottom: 24px; } .RichTextArticleBody-body p{ margin: 12px 0; } .RichTextModule-items { clear: both; display: table; width: 100%; margin-bottom: 12px; } .VideoEnhancement>* { color: var(--primaryTextColor); font-size: 13px; font-weight: 400; line-height: 1.4; font-style: italic; background: #f0efed } @media only screen and (min-width: 768px) { .VideoEnhancement>* { font-size:14px; font-weight: 400; line-height: 1.47 } } .VideoEnhancement-title { padding: 20px } @media only screen and (min-width: 768px) { .VideoEnhancement-title { padding:30px } } .VideoEnhancement-player>* { position: relative; width: 100%; height: 0; padding-bottom: 56.25% } .VideoEnhancement iframe { border: 0; position: absolute; top: 0; left: 0; width: 100%; height: 100% } [data-video-player] { display: block; padding-bottom: 56.25%; height: 0; margin: 0 auto; } [data-video-player][data-aspect-ratio="4x3"] { padding-bottom: 56.25%; } [data-video-player][data-aspect-ratio="16x9"] { padding-bottom: 56.25% } </style> --></div><div class="module clearfix"><div class="module-spacer tout-homefit-750"> <a data-formelementid="CSN-LOCAL-HC-NEWSSK-02272024" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-HC-NEWSSK-02272024"><img class="img-responsive" alt="Explore the free AARP HomeFit Guide" title="Explore the free AARP HomeFit Guide" src="https://cdn-aarp.americantowns.com/img/touts/HomeFit_750x150.png"></a> </div></div></div> <div class="col-md-4 right-rail thin-rhs"><div class="module clearfix"><!--default--> <!-- module_RHS - AARP Events --> <div class="ar-basic-box module-spacer"> <header> <div class="pull-right"> <a href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS"> <img style="width:30px;" src="https://cdn-aarp.americantowns.com/img/template/icons/aarp_event_icon.png" alt="Upcoming AARP Events" /> </a> </div> <h2 class="visible-lg">AARP Events for Washington</h2> <h2 class="hidden-lg">AARP Events for Washington</h2> </header> <div class="wrap"> <div class="ar-listing snippet"> <ul class="list"> <li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-co-virtual-functional-fitness-online-99-10142024-sgnszx3wwws.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-FUNCTIONAL-FITNESS-WITH-BASIC-BODY-MOVEMENTS">Functional Fitness with Basic Body Movements</a></h2> <p class="time">Monday, Oct 7, 2024 at 9:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-nm-tai-ji-quan-moving-for-better-balance-albuquerque-nm-100724-j7nhvzxdkxd.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TAI-JI-QUAN-MOVING-FOR-BETTER-BALANCE">Tai Ji Quan: Moving for Better Balance</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/virtual-aarp-tx-mobility-mondays-houston-tx-100724-f5n2bjqhntc.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TRY-A-LOWIMPACT-WORKOUT-TO-IMPROVE-MOBILITY">Try A Low-Impact Workout to Improve Mobility</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom and Facebook</p> <p class="loc">Online Event</p> </li> </ul> <p><a class="link-red" href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS">View All AARP Events<i class="ml-1 fas fa-chevron-right"></i></a></p> </div> </div> </div> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_53475" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_53475', size:'300x250'}); } </script> </div> </div> <div class="card-tout card-dark membership-tout" style="margin:0 0 30px 0;"> <img class="img-responsive image" title="image of two AARP membership cards" alt="image of two AARP membership cards" src="https://cdn-aarp.americantowns.com/img/tout-two-cards.png"> <div class="title">Only $12 your first year with Automatic Renewal</div> <ul class="list"> <li>Immediate access to your <a href="https://www.aarp.org/benefits-discounts/">member benefits</a></li> <li>Discounts on travel and everyday savings</li> <li>Subscription to AARP The Magazine</li> <li>FREE second membership</li> </ul> <div class="action"> <a class="btn" href="https://appsec.aarp.org/mem/join?campaignid=UAJFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Join AARP</a> <div class="body">Already a member? <a href="https://appsec.aarp.org/mem/renew?campaignid= UARFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Renew</a> or <a href="https://www.aarp.org/benefits-discounts/my-membership/print-your-card/">Print Card</a></div> </div> </div> <style> .membership-tout {padding:16px 20px;} .membership-tout .list li { margin: 0; } </style> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_93505" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_93505', size:'300x250'}); } </script> </div> </div> <div class="module-spacer text-center"> <div class="fb-page" alt="Image of AARP District of Columbia Facebook Page" title="Image of AARP District of Columbia Facebook Page" data-href="https://www.facebook.com/aarpdc" data-tabs="timeline" width="320" height="" data-small-header="false" data-adapt-container-width="true" data-hide-cover="false" data-show-facepile="true" lazy="true"> <blockquote cite="https://www.facebook.com/aarpdc" class="fb-xfbml-parse-ignore"><a href="https://www.facebook.com/aarpdc">Facebook</a></blockquote> </div> </div> <div class="ar-basic-box module-spacer"> <header> <h2>Contact AARP<br />District of Columbia</h2> </header> <div class="wrap"> <div class="ar-quick-list module-spacer"> <ul class="list-unstyled"> <li><i class="list-icon fa fa-envelope" alt="Email icon" title="Email icon" aria-hidden="true"></i><a href="mailto:DCAARP@aarp.org " target="_blank" rel="noopener">DCAARP@aarp.org </a></li> <li><i class="list-icon fa fa-globe" alt="Globe icon" title="Globe icon" aria-hidden="true"></i><a href="https://states.aarp.org/region/washington-dc/" target="_blank" rel="noopener">AARP Washington, DC</a></li> <li><i class="list-icon fa fa-map-marker" alt="Map Marker icon" title="Map Marker icon" aria-hidden="true"></i><a href="https://states.aarp.org/aarp-district-of-columbia-state-office/?intcmp=SNG-LNK-AARPLOCAL-CONTACT-20140101-WASHINGTON-DC" target="_blank" rel="noopener">Contact Us</a></li> </ul> </div> <a href="https://www.facebook.com/aarpdc" target="_blank" rel="noopener" aria-label="Open Facebook"><img alt="Facebook icon" title="Facebook icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/facebook-dreamstale25.png"></a> <a href="https://twitter.com/AARPDC" target="_blank" rel="noopener" aria-label="Open Twitter"><img alt="Twitter icon" title="Twitter icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/x-logo-black.png"></a> </div> </div> </div></div> <div class="col-md-8 left-rail left-bot"></div> <div class="col-md-4 right-rail right-bot thin-rhs"></div> </div> <div class="row oneColumnLayout"> </div> <div class="row oneColumnLayout"> <div class="col-md-12"><!-- script to activate navbar --> <script type="text/javascript"> jQuery(".channelBarMain ul.left li a").click(function() { window.location = jQuery(this).attr('href'); }); </script> </div> </div> ', 'scripts_for_layout' => '<title>How Mid-Atlantic States Are Expanding Home Care</title> <meta name="page_title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="robots" content="noindex, nofollow"/> <meta content="John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The" name="description"/> <meta content="How, Mid, Atlantic, States, Expanding, Home, Care" name="keywords"/> <link rel="canonical" href="https://states.aarp.org/ltss-in-the-mid-atlantic" /> <meta property="og:url" content="https://vccstaging.local.aarp.org/news/how-midatlantic-states-are-expanding-home-care-2023-12-03.html"/> <meta name="twitter:card" content="summary_large_image"/> <meta name="twitter:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="twitter:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta name="twitter:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> <meta property="og:type" content="article"/> <meta property="og:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta property="og:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta property="og:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }', 'title_for_layout' => '{local_city_c}, {local_state} Happenings - AARP' ) $content_for_layout = '<div class="row twoColumnLayout"> <div class="col-md-8 left-rail"><div class="module clearfix"><div class="ar-basic-box"> <div> <div class="module-spacer"> <header><h1 class="article-headline">How Mid-Atlantic States Are Expanding Home Care</h1></header> <div class="posted-on"> Posted on 12/03/23 by <b>Ann Hardie</b> </div> </div> <div class="module-spacer"> <span class="blog-content"><p><div class="RichTextArticleBody"> <div class="RichTextArticleBody-body"><p>John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The 55-year-old from Dover, Delaware, goes to work every day, helps his 8-year-old son with basketball drills and watches his beloved Philadelphia Eagles with friends at Buffalo Wild Wings.<br><br>McNeal does so with the assistance of direct-care workers who help him get dressed in the morning, fix his meals and drive him where he needs to go.<br><br>“My life is unique in that I have a significant disability,” says McNeal, director of Delaware’s State Council for Persons with Disabilities. But, he says, it’s “a productive life that is every bit as normal as anybody else’s.”<br><br>Across the country, states such as Delaware are spending a growing percentage of long-term care funding to keep people in their homes and communities instead of institutional settings. That’s according to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023" target="_blank" rel="noopener noreferrer">AARP’s most recent Long-Term Services and Supports State Scorecard</a></span></span>, which uses 50 spending, quality and access indicators to rank each state’s long-term care system.<br><br>The new data shows that for the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid’s long-term care dollars nationally for older people and adults with physical disabilities went to home- and community-based services instead of nursing homes or other facilities.<br></p><p class="cms-textAlign-center"><b>EXPLORE: </b><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/" target="_blank" rel="noopener noreferrer"><b>AARP Long-Term Care Scorecard</b></a></span></span></p><p>“This is a big deal. We are seeing a breaking point,” says Susan Reinhard, senior vice president of the AARP Public Policy Institute, which published the Scorecard in September.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/da/c2/a471a2d346088edaf8c38a8b7a46/midalantic.png" alt="midalantic.png" width="6900" height="5761"/> <figcaption class="Figure-caption">Nicolas Rapp</figcaption> </figure> </div> </div><p>The shift to home- and community-based services comes as demand for such care has increased, fueled in part by a pandemic that took a horrific toll on nursing home residents. Polls have consistently shown that most older Americans want to age in place. A 2021 AARP survey found that more than three-quarters of adults 50-plus say they want to remain in their homes as they grow older.<br><br>But with America’s population of older adults growing, the chasm between the availability of HCBS and access to such services is poised to widen. <br><br>“We’re going to see a dramatic increase in the 80-plus and 85-plus population” as the boomer generation gets older, says Robert Applebaum, a senior research scholar at Miami University’s Scripps Gerontology Center in Ohio. “So the demand for long-term services ... is going to be tremendous.”<br><br><b><u>A person-centered approach</u></b><br><br>In the Mid-Atlantic region, Delaware, the District of Columbia, Maryland, New Jersey and West Virginia have all increased the percentage of their Medicaid dollars going to HCBS for older people and adults with physical disabilities in recent years, the Scorecard shows. One way they are doing that: giving more older adults the power to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">direct their own care</a></span></span>, funded through Medicaid initiatives. (Medicaid, a joint federal-state program for low-income Americans, includes coverage for nursing homes and other long-term care.) <br><br>Enrollment in these <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">“self-directed” care </a></span></span>programs increased by 10 percent or more across 34 states and the District of Columbia in recent years, the Scorecard shows. Such programs give people a greater say over how to spend government dollars on their own care.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/25/1e/2926ddba4cd09d7af135e7604561/1140-inset1-de-john-mcneal.jpg" alt="John McNeal, Director of the State Council for Persons with Disabilities for the State of Delaware, photographed at his office in Dover DE for AARP Bulletin, 7 December 2023. Photo by Mike Morgan." width="655" height="1140" style="height: auto; max-width: 380px;"/> <figcaption class="Figure-caption">John McNeal exits his car. Photo by Mike Morgan.</figcaption> </figure> </div> </div><p>“It’s like the ultimate person-centered approach,” says Lisa Alecxih, who researches long-term care for The Lewin Group, a health care and human services consulting firm. She notes that such programs often have the added benefit of allowing participants to hire family members as caregivers. That’s crucial because there’s a national shortage of direct-care workers.<br><br>Applebaum says his research on self-directed programs has also shown the satisfaction levels were “beyond anything I’ve ever seen as an evaluator.”<br><br>McNeal, the Delaware disability advocate, says that’s certainly true for him. “This is probably the most important program that has come into my life,” he says. “It has allowed me the opportunity to have everything that anybody else in the community has.”<br><br><b><u>Growing demand, workforce crunch</u></b><br><br>Self-directed services are one of many state-level innovations highlighted in the Scorecard as a way states can meet the growing demand for home- and community-based care. In the Mid-Atlantic region, D.C., Virginia and New Jersey posted the highest numbers of people enrolled in self-directed programs relative to their disabled populations.<br><br>Pennsylvania is the only state in the region that did not see an increase, but that could change as Jason Kavulich—who became Pennsylvania’s Secretary of Aging in January 2023—leads the state’s effort to develop a 10-year master plan for aging. “It is our top-most priority to make sure that people can age in place, how they choose, and to make sure that the services that we have really are responsive,” Kavulich says.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/90/ca/722b3834468a82b147701fcee20d/midatlanticranks.png" alt="midatlanticranks.png" width="3166" height="6717" style="height: auto; max-width: 350px;"/> </figure> </div> </div><p>One of the biggest challenges states face in expanding HCBS is the <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">shortage of</a></span></span> <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">direct-care workers</a></span></span> to fill those jobs. The work can be emotionally and physically taxing and usually comes with low pay, poor benefits and limited support and training.<br><br>The Scorecard shows that across the U.S., wages for direct-care workers are lower than in jobs with similar or lower entry requirements. Their median income is about $30,000 a year—approximately $5,000 less than workers in comparable jobs are paid in most states. D.C. has the highest wage gap in the country, with direct-care workers earning $5.03 less per hour than their counterparts in other sectors.<br><br>“I’m in competition with fast-food places. It’s as simple as that,” says 63-year-old Keith Williams of Clarks Green, Pennsylvania, outside Scranton. He was born with arthrogryposis, a combination of conditions that causes joint contractures and weak muscles.<br><br>Through a self-directed program, he hires care workers to help him with everything from showering to eating. He recruits through word of mouth and online postings. When that fails, he hires his sister-in-law.<br><br>It’s not easy, says Williams, the manager of independent living services for the Northeast Pennsylvania Center for Independent Living, a community-based organization staffed in part by people with disabilities. But the control he has over his care has allowed him to have a meaningful life.<br><br>“It’s meant that I’ve been able to live life on my own terms,” he says.<br><br><i>Ann Hardie spent a decade covering aging issues for The Atlanta Journal-Constitution. She has written for the Bulletin for 15 years.</i><br><br><b>More on Home Care</b><br></p><ul><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2023/rise-of-companion-care.html" target="_blank" rel="noopener noreferrer">Care Companions: A Watchful Eye and Willing Ear for Older Adults</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2019/home-health-aides.html" target="_blank" rel="noopener noreferrer">Find the Right Home Aide for Your Loved One</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://press.aarp.org/2021-11-18-AARP-Survey-Shows-8-in-10-Older-Adults-Want-to-Age-in-Their-Homes-While-Number-and-Needs-of-Households-Headed-Older-Adults-Grow-Dramatically" target="_blank" rel="noopener noreferrer">AARP Survey: 8 in 10 Older Adults Want to Age at Home</a></span></span></li></ul><div class="Enhancement" > <div class="Enhancement-item"><span class="VideoEnhancement" data-video-disable-history data-embeddedvideo-container> <div class="VideoEnhancement-player"><bsp-brightcoveplayer data-video-player class="BrightcoveVideoPlayer" data-account="3772599298001" data-player="KM9xJAJa4" data-video-id="5754403576001" data-video-title="How In-Home Care Helps — AARP" > <video class="video-js" id="BrightcoveVideoPlayer-5754403576001" data-video-id="5754403576001" data-account="" data-player="KM9xJAJa4" data-embed="default" controls ></video> </bsp-brightcoveplayer> </div> <div class="VideoEnhancement-title">How In-Home Care Helps — AARP</div> </span> </div> </div><p></p></div> </div> </p></span> </div> </div> </div> </div><div class="module clearfix"><script src="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.c85a242a55150cd195e494cd6e5b9c77.gz.js" async=""></script> <link rel="stylesheet" media="all" href="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.bfe6eb5a8301841feef3af4e9bd1e26d.gz.css"> <!-- bypass --> <style> a:focus, a:hover { text-decoration: underline; } h1.article-headline { margin: 0 0 1rem; } </style> <!-- <style> .Enhancement-item .Figure { margin-bottom: 24px; } .RichTextArticleBody-body ul { margin-bottom: 24px; } .RichTextArticleBody-body p{ margin: 12px 0; } .RichTextModule-items { clear: both; display: table; width: 100%; margin-bottom: 12px; } .VideoEnhancement>* { color: var(--primaryTextColor); font-size: 13px; font-weight: 400; line-height: 1.4; font-style: italic; background: #f0efed } @media only screen and (min-width: 768px) { .VideoEnhancement>* { font-size:14px; font-weight: 400; line-height: 1.47 } } .VideoEnhancement-title { padding: 20px } @media only screen and (min-width: 768px) { .VideoEnhancement-title { padding:30px } } .VideoEnhancement-player>* { position: relative; width: 100%; height: 0; padding-bottom: 56.25% } .VideoEnhancement iframe { border: 0; position: absolute; top: 0; left: 0; width: 100%; height: 100% } [data-video-player] { display: block; padding-bottom: 56.25%; height: 0; margin: 0 auto; } [data-video-player][data-aspect-ratio="4x3"] { padding-bottom: 56.25%; } [data-video-player][data-aspect-ratio="16x9"] { padding-bottom: 56.25% } </style> --></div><div class="module clearfix"><div class="module-spacer tout-homefit-750"> <a data-formelementid="CSN-LOCAL-HC-NEWSSK-02272024" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-HC-NEWSSK-02272024"><img class="img-responsive" alt="Explore the free AARP HomeFit Guide" title="Explore the free AARP HomeFit Guide" src="https://cdn-aarp.americantowns.com/img/touts/HomeFit_750x150.png"></a> </div></div></div> <div class="col-md-4 right-rail thin-rhs"><div class="module clearfix"><!--default--> <!-- module_RHS - AARP Events --> <div class="ar-basic-box module-spacer"> <header> <div class="pull-right"> <a href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS"> <img style="width:30px;" src="https://cdn-aarp.americantowns.com/img/template/icons/aarp_event_icon.png" alt="Upcoming AARP Events" /> </a> </div> <h2 class="visible-lg">AARP Events for Washington</h2> <h2 class="hidden-lg">AARP Events for Washington</h2> </header> <div class="wrap"> <div class="ar-listing snippet"> <ul class="list"> <li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-co-virtual-functional-fitness-online-99-10142024-sgnszx3wwws.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-FUNCTIONAL-FITNESS-WITH-BASIC-BODY-MOVEMENTS">Functional Fitness with Basic Body Movements</a></h2> <p class="time">Monday, Oct 7, 2024 at 9:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-nm-tai-ji-quan-moving-for-better-balance-albuquerque-nm-100724-j7nhvzxdkxd.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TAI-JI-QUAN-MOVING-FOR-BETTER-BALANCE">Tai Ji Quan: Moving for Better Balance</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/virtual-aarp-tx-mobility-mondays-houston-tx-100724-f5n2bjqhntc.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TRY-A-LOWIMPACT-WORKOUT-TO-IMPROVE-MOBILITY">Try A Low-Impact Workout to Improve Mobility</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom and Facebook</p> <p class="loc">Online Event</p> </li> </ul> <p><a class="link-red" href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS">View All AARP Events<i class="ml-1 fas fa-chevron-right"></i></a></p> </div> </div> </div> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_53475" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_53475', size:'300x250'}); } </script> </div> </div> <div class="card-tout card-dark membership-tout" style="margin:0 0 30px 0;"> <img class="img-responsive image" title="image of two AARP membership cards" alt="image of two AARP membership cards" src="https://cdn-aarp.americantowns.com/img/tout-two-cards.png"> <div class="title">Only $12 your first year with Automatic Renewal</div> <ul class="list"> <li>Immediate access to your <a href="https://www.aarp.org/benefits-discounts/">member benefits</a></li> <li>Discounts on travel and everyday savings</li> <li>Subscription to AARP The Magazine</li> <li>FREE second membership</li> </ul> <div class="action"> <a class="btn" href="https://appsec.aarp.org/mem/join?campaignid=UAJFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Join AARP</a> <div class="body">Already a member? <a href="https://appsec.aarp.org/mem/renew?campaignid= UARFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Renew</a> or <a href="https://www.aarp.org/benefits-discounts/my-membership/print-your-card/">Print Card</a></div> </div> </div> <style> .membership-tout {padding:16px 20px;} .membership-tout .list li { margin: 0; } </style> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_93505" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_93505', size:'300x250'}); } </script> </div> </div> <div class="module-spacer text-center"> <div class="fb-page" alt="Image of AARP District of Columbia Facebook Page" title="Image of AARP District of Columbia Facebook Page" data-href="https://www.facebook.com/aarpdc" data-tabs="timeline" width="320" height="" data-small-header="false" data-adapt-container-width="true" data-hide-cover="false" data-show-facepile="true" lazy="true"> <blockquote cite="https://www.facebook.com/aarpdc" class="fb-xfbml-parse-ignore"><a href="https://www.facebook.com/aarpdc">Facebook</a></blockquote> </div> </div> <div class="ar-basic-box module-spacer"> <header> <h2>Contact AARP<br />District of Columbia</h2> </header> <div class="wrap"> <div class="ar-quick-list module-spacer"> <ul class="list-unstyled"> <li><i class="list-icon fa fa-envelope" alt="Email icon" title="Email icon" aria-hidden="true"></i><a href="mailto:DCAARP@aarp.org " target="_blank" rel="noopener">DCAARP@aarp.org </a></li> <li><i class="list-icon fa fa-globe" alt="Globe icon" title="Globe icon" aria-hidden="true"></i><a href="https://states.aarp.org/region/washington-dc/" target="_blank" rel="noopener">AARP Washington, DC</a></li> <li><i class="list-icon fa fa-map-marker" alt="Map Marker icon" title="Map Marker icon" aria-hidden="true"></i><a href="https://states.aarp.org/aarp-district-of-columbia-state-office/?intcmp=SNG-LNK-AARPLOCAL-CONTACT-20140101-WASHINGTON-DC" target="_blank" rel="noopener">Contact Us</a></li> </ul> </div> <a href="https://www.facebook.com/aarpdc" target="_blank" rel="noopener" aria-label="Open Facebook"><img alt="Facebook icon" title="Facebook icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/facebook-dreamstale25.png"></a> <a href="https://twitter.com/AARPDC" target="_blank" rel="noopener" aria-label="Open Twitter"><img alt="Twitter icon" title="Twitter icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/x-logo-black.png"></a> </div> </div> </div></div> <div class="col-md-8 left-rail left-bot"></div> <div class="col-md-4 right-rail right-bot thin-rhs"></div> </div> <div class="row oneColumnLayout"> </div> <div class="row oneColumnLayout"> <div class="col-md-12"><!-- script to activate navbar --> <script type="text/javascript"> jQuery(".channelBarMain ul.left li a").click(function() { window.location = jQuery(this).attr('href'); }); </script> </div> </div> ' $scripts_for_layout = '<title>How Mid-Atlantic States Are Expanding Home Care</title> <meta name="page_title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="robots" content="noindex, nofollow"/> <meta content="John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The" name="description"/> <meta content="How, Mid, Atlantic, States, Expanding, Home, Care" name="keywords"/> <link rel="canonical" href="https://states.aarp.org/ltss-in-the-mid-atlantic" /> <meta property="og:url" content="https://vccstaging.local.aarp.org/news/how-midatlantic-states-are-expanding-home-care-2023-12-03.html"/> <meta name="twitter:card" content="summary_large_image"/> <meta name="twitter:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="twitter:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta name="twitter:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> <meta property="og:type" content="article"/> <meta property="og:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta property="og:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta property="og:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }' $title_for_layout = '{local_city_c}, {local_state} Happenings - AARP' $asset_version = '230831' $min = true $nowrapper = false $css = ' :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }' $highlighting = '' $location = '<a href="/washington-dc/?intcmp=CSN-LOCAL-NAV-HOME">Washington, DC</a>' $no_header = false $header_title = '<a href="/washington-dc/happenings/">News Feed</a>' $header_subtitle = '' $isPR = false $navbar = '<nav class="section" role="button" aria-expanded="false" aria-controls="collapse"> <div class="section-toggle">Sections <i class="fas fa-chevron-down"></i></div> <ul class="secondary-menu" id="secondary-menu" role="menu" aria-busy="true"> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/aarp-events/?intcmp=CSN-LOCAL-NAV-OLE" data-formelementid="LOCAL-LNK-CLK-EVENTS">Online & Local Events</a> </li> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/things-to-do/?intcmp=CSN-LOCAL-NAV-TTD" data-formelementid="LOCAL-LNK-CLK-THINGSTODO">Things to Do</a></li> <li role="presentation" class="active"><a role="menuitem" class="menuitem" href="/washington-dc/happenings/?intcmp=CSN-LOCAL-NAV-NF" data-formelementid="LOCAL-LNK-CLK-HAPPENINGS">News Feed</a> </li> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/volunteering/?intcmp=CSN-LOCAL-NAV-VOL" data-formelementid="LOCAL-LNK-CLK-VOLUNTEERING">Volunteering</a> </li> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-NAV-HC" data-formelementid="LOCAL-LNK-CLK-HC">Home & Community</a> </li> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/movies/?intcmp=CSN-LOCAL-NAV-MFG" data-formelementid="LOCAL-LNK-CLK-MOVIESFORGROWNUPS">Movies for Grownups</a> </li> <li role="presentation" class="more nosep " id="submenu-more"> <span role="menuitem" class="menuitem" data-formelementid="LOCAL-LNK-CLK-MORE">More<i class="fas fa-chevron-down"></i></span> <ul class="secondary-submenu animate slide-in" id="secondary-submenu"> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/discounts/?intcmp=CSN-LOCAL-NAV-LO" data-formelementid="LOCAL-LNK-CLK-OFFERS">Local Offers</a></li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/local-resources/?intcmp=CSN-LOCAL-NAV-LR" data-formelementid="LOCAL-LNK-CLK-LOCALRESOURCES">Local Resources</a> </li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/jobs/?intcmp=CSN-LOCAL-NAV-WJ" data-formelementid="LOCAL-LNK-CLK-WORK&JOBS">Work & Jobs</a></li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/events/?intcmp=CSN-LOCAL-NAV-CC" data-formelementid="LOCAL-LNK-CLK-EVENTS">Community Calendar</a></li> <!-- <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/healthy-living/?intcmp=CSN-LOCAL-NAV-HEALTHY_LIVING" data-formelementid="LOCAL-LNK-CLK-HEALTHY_LIVING">Healthy Living</a></li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/arts-entertainment/?intcmp=CSN-LOCAL-NAV-ARTS_ENT" data-formelementid="LOCAL-LNK-CLK-ARTS_ENT">Arts & Entertainment</a></li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/museums/?intcmp=CSN-LOCAL-NAV-MUSEUMS" data-formelementid="LOCAL-LNK-CLK-MUSEUMS">Museums</a></li> --> </ul> </li> </ul> </nav>' $header_custom = '' $breadcrumbs = array( (int) 0 => array( 'title' => 'News Feed', 'slug' => 'happenings' ) ) $row = array( 'title' => 'Back to News Feed', 'slug' => 'happenings' ) $i = (int) 0include - APP/View/Layouts/aarp_2023.ctp, line 243 include - APP/View/Layouts/aarp_2023.ctp, line 243 View::_evaluate() - CORE/Cake/View/View.php, line 971 View::_render() - CORE/Cake/View/View.php, line 933 View::renderLayout() - CORE/Cake/View/View.php, line 546 View::render() - CORE/Cake/View/View.php, line 481 Controller::render() - CORE/Cake/Controller/Controller.php, line 963 AppController::renderPage() - APP/Controller/AppController.php, line 136 BlogsController::display() - APP/Controller/BlogsController.php, line 81 ReflectionMethod::invokeArgs() - [internal], line ?? Controller::invokeAction() - CORE/Cake/Controller/Controller.php, line 491 Dispatcher::_invoke() - CORE/Cake/Routing/Dispatcher.php, line 193 Dispatcher::dispatch() - CORE/Cake/Routing/Dispatcher.php, line 167 [main] - APP/webroot/index.php, line 118
Warning (2): include(/var/www/vhosts/vcc_staging/app/Resource/aarp2_master.resource.footer.root.html) [<a href='http://php.net/function.include'>function.include</a>]: failed to open stream: No such file or directory [APP/View/Layouts/aarp_2023.ctp, line 244]Code Contextinclude (APP . "Resource/aarp2_master.footer.html");
include (APP . "Resource/aarp2_master.bodyTargeting.html");
include (APP . "Resource/aarp2_master.resource.footer.root.html");
$viewFile = '/var/www/vhosts/vcc_staging/app/View/Layouts/aarp_2023.ctp' $dataForView = array( 'content_for_layout' => '<div class="row twoColumnLayout"> <div class="col-md-8 left-rail"><div class="module clearfix"><div class="ar-basic-box"> <div> <div class="module-spacer"> <header><h1 class="article-headline">How Mid-Atlantic States Are Expanding Home Care</h1></header> <div class="posted-on"> Posted on 12/03/23 by <b>Ann Hardie</b> </div> </div> <div class="module-spacer"> <span class="blog-content"><p><div class="RichTextArticleBody"> <div class="RichTextArticleBody-body"><p>John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The 55-year-old from Dover, Delaware, goes to work every day, helps his 8-year-old son with basketball drills and watches his beloved Philadelphia Eagles with friends at Buffalo Wild Wings.<br><br>McNeal does so with the assistance of direct-care workers who help him get dressed in the morning, fix his meals and drive him where he needs to go.<br><br>“My life is unique in that I have a significant disability,” says McNeal, director of Delaware’s State Council for Persons with Disabilities. But, he says, it’s “a productive life that is every bit as normal as anybody else’s.”<br><br>Across the country, states such as Delaware are spending a growing percentage of long-term care funding to keep people in their homes and communities instead of institutional settings. That’s according to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023" target="_blank" rel="noopener noreferrer">AARP’s most recent Long-Term Services and Supports State Scorecard</a></span></span>, which uses 50 spending, quality and access indicators to rank each state’s long-term care system.<br><br>The new data shows that for the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid’s long-term care dollars nationally for older people and adults with physical disabilities went to home- and community-based services instead of nursing homes or other facilities.<br></p><p class="cms-textAlign-center"><b>EXPLORE: </b><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/" target="_blank" rel="noopener noreferrer"><b>AARP Long-Term Care Scorecard</b></a></span></span></p><p>“This is a big deal. We are seeing a breaking point,” says Susan Reinhard, senior vice president of the AARP Public Policy Institute, which published the Scorecard in September.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/da/c2/a471a2d346088edaf8c38a8b7a46/midalantic.png" alt="midalantic.png" width="6900" height="5761"/> <figcaption class="Figure-caption">Nicolas Rapp</figcaption> </figure> </div> </div><p>The shift to home- and community-based services comes as demand for such care has increased, fueled in part by a pandemic that took a horrific toll on nursing home residents. Polls have consistently shown that most older Americans want to age in place. A 2021 AARP survey found that more than three-quarters of adults 50-plus say they want to remain in their homes as they grow older.<br><br>But with America’s population of older adults growing, the chasm between the availability of HCBS and access to such services is poised to widen. <br><br>“We’re going to see a dramatic increase in the 80-plus and 85-plus population” as the boomer generation gets older, says Robert Applebaum, a senior research scholar at Miami University’s Scripps Gerontology Center in Ohio. “So the demand for long-term services ... is going to be tremendous.”<br><br><b><u>A person-centered approach</u></b><br><br>In the Mid-Atlantic region, Delaware, the District of Columbia, Maryland, New Jersey and West Virginia have all increased the percentage of their Medicaid dollars going to HCBS for older people and adults with physical disabilities in recent years, the Scorecard shows. One way they are doing that: giving more older adults the power to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">direct their own care</a></span></span>, funded through Medicaid initiatives. (Medicaid, a joint federal-state program for low-income Americans, includes coverage for nursing homes and other long-term care.) <br><br>Enrollment in these <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">“self-directed” care </a></span></span>programs increased by 10 percent or more across 34 states and the District of Columbia in recent years, the Scorecard shows. Such programs give people a greater say over how to spend government dollars on their own care.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/25/1e/2926ddba4cd09d7af135e7604561/1140-inset1-de-john-mcneal.jpg" alt="John McNeal, Director of the State Council for Persons with Disabilities for the State of Delaware, photographed at his office in Dover DE for AARP Bulletin, 7 December 2023. Photo by Mike Morgan." width="655" height="1140" style="height: auto; max-width: 380px;"/> <figcaption class="Figure-caption">John McNeal exits his car. Photo by Mike Morgan.</figcaption> </figure> </div> </div><p>“It’s like the ultimate person-centered approach,” says Lisa Alecxih, who researches long-term care for The Lewin Group, a health care and human services consulting firm. She notes that such programs often have the added benefit of allowing participants to hire family members as caregivers. That’s crucial because there’s a national shortage of direct-care workers.<br><br>Applebaum says his research on self-directed programs has also shown the satisfaction levels were “beyond anything I’ve ever seen as an evaluator.”<br><br>McNeal, the Delaware disability advocate, says that’s certainly true for him. “This is probably the most important program that has come into my life,” he says. “It has allowed me the opportunity to have everything that anybody else in the community has.”<br><br><b><u>Growing demand, workforce crunch</u></b><br><br>Self-directed services are one of many state-level innovations highlighted in the Scorecard as a way states can meet the growing demand for home- and community-based care. In the Mid-Atlantic region, D.C., Virginia and New Jersey posted the highest numbers of people enrolled in self-directed programs relative to their disabled populations.<br><br>Pennsylvania is the only state in the region that did not see an increase, but that could change as Jason Kavulich—who became Pennsylvania’s Secretary of Aging in January 2023—leads the state’s effort to develop a 10-year master plan for aging. “It is our top-most priority to make sure that people can age in place, how they choose, and to make sure that the services that we have really are responsive,” Kavulich says.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/90/ca/722b3834468a82b147701fcee20d/midatlanticranks.png" alt="midatlanticranks.png" width="3166" height="6717" style="height: auto; max-width: 350px;"/> </figure> </div> </div><p>One of the biggest challenges states face in expanding HCBS is the <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">shortage of</a></span></span> <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">direct-care workers</a></span></span> to fill those jobs. The work can be emotionally and physically taxing and usually comes with low pay, poor benefits and limited support and training.<br><br>The Scorecard shows that across the U.S., wages for direct-care workers are lower than in jobs with similar or lower entry requirements. Their median income is about $30,000 a year—approximately $5,000 less than workers in comparable jobs are paid in most states. D.C. has the highest wage gap in the country, with direct-care workers earning $5.03 less per hour than their counterparts in other sectors.<br><br>“I’m in competition with fast-food places. It’s as simple as that,” says 63-year-old Keith Williams of Clarks Green, Pennsylvania, outside Scranton. He was born with arthrogryposis, a combination of conditions that causes joint contractures and weak muscles.<br><br>Through a self-directed program, he hires care workers to help him with everything from showering to eating. He recruits through word of mouth and online postings. When that fails, he hires his sister-in-law.<br><br>It’s not easy, says Williams, the manager of independent living services for the Northeast Pennsylvania Center for Independent Living, a community-based organization staffed in part by people with disabilities. But the control he has over his care has allowed him to have a meaningful life.<br><br>“It’s meant that I’ve been able to live life on my own terms,” he says.<br><br><i>Ann Hardie spent a decade covering aging issues for The Atlanta Journal-Constitution. She has written for the Bulletin for 15 years.</i><br><br><b>More on Home Care</b><br></p><ul><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2023/rise-of-companion-care.html" target="_blank" rel="noopener noreferrer">Care Companions: A Watchful Eye and Willing Ear for Older Adults</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2019/home-health-aides.html" target="_blank" rel="noopener noreferrer">Find the Right Home Aide for Your Loved One</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://press.aarp.org/2021-11-18-AARP-Survey-Shows-8-in-10-Older-Adults-Want-to-Age-in-Their-Homes-While-Number-and-Needs-of-Households-Headed-Older-Adults-Grow-Dramatically" target="_blank" rel="noopener noreferrer">AARP Survey: 8 in 10 Older Adults Want to Age at Home</a></span></span></li></ul><div class="Enhancement" > <div class="Enhancement-item"><span class="VideoEnhancement" data-video-disable-history data-embeddedvideo-container> <div class="VideoEnhancement-player"><bsp-brightcoveplayer data-video-player class="BrightcoveVideoPlayer" data-account="3772599298001" data-player="KM9xJAJa4" data-video-id="5754403576001" data-video-title="How In-Home Care Helps — AARP" > <video class="video-js" id="BrightcoveVideoPlayer-5754403576001" data-video-id="5754403576001" data-account="" data-player="KM9xJAJa4" data-embed="default" controls ></video> </bsp-brightcoveplayer> </div> <div class="VideoEnhancement-title">How In-Home Care Helps — AARP</div> </span> </div> </div><p></p></div> </div> </p></span> </div> </div> </div> </div><div class="module clearfix"><script src="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.c85a242a55150cd195e494cd6e5b9c77.gz.js" async=""></script> <link rel="stylesheet" media="all" href="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.bfe6eb5a8301841feef3af4e9bd1e26d.gz.css"> <!-- bypass --> <style> a:focus, a:hover { text-decoration: underline; } h1.article-headline { margin: 0 0 1rem; } </style> <!-- <style> .Enhancement-item .Figure { margin-bottom: 24px; } .RichTextArticleBody-body ul { margin-bottom: 24px; } .RichTextArticleBody-body p{ margin: 12px 0; } .RichTextModule-items { clear: both; display: table; width: 100%; margin-bottom: 12px; } .VideoEnhancement>* { color: var(--primaryTextColor); font-size: 13px; font-weight: 400; line-height: 1.4; font-style: italic; background: #f0efed } @media only screen and (min-width: 768px) { .VideoEnhancement>* { font-size:14px; font-weight: 400; line-height: 1.47 } } .VideoEnhancement-title { padding: 20px } @media only screen and (min-width: 768px) { .VideoEnhancement-title { padding:30px } } .VideoEnhancement-player>* { position: relative; width: 100%; height: 0; padding-bottom: 56.25% } .VideoEnhancement iframe { border: 0; position: absolute; top: 0; left: 0; width: 100%; height: 100% } [data-video-player] { display: block; padding-bottom: 56.25%; height: 0; margin: 0 auto; } [data-video-player][data-aspect-ratio="4x3"] { padding-bottom: 56.25%; } [data-video-player][data-aspect-ratio="16x9"] { padding-bottom: 56.25% } </style> --></div><div class="module clearfix"><div class="module-spacer tout-homefit-750"> <a data-formelementid="CSN-LOCAL-HC-NEWSSK-02272024" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-HC-NEWSSK-02272024"><img class="img-responsive" alt="Explore the free AARP HomeFit Guide" title="Explore the free AARP HomeFit Guide" src="https://cdn-aarp.americantowns.com/img/touts/HomeFit_750x150.png"></a> </div></div></div> <div class="col-md-4 right-rail thin-rhs"><div class="module clearfix"><!--default--> <!-- module_RHS - AARP Events --> <div class="ar-basic-box module-spacer"> <header> <div class="pull-right"> <a href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS"> <img style="width:30px;" src="https://cdn-aarp.americantowns.com/img/template/icons/aarp_event_icon.png" alt="Upcoming AARP Events" /> </a> </div> <h2 class="visible-lg">AARP Events for Washington</h2> <h2 class="hidden-lg">AARP Events for Washington</h2> </header> <div class="wrap"> <div class="ar-listing snippet"> <ul class="list"> <li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-co-virtual-functional-fitness-online-99-10142024-sgnszx3wwws.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-FUNCTIONAL-FITNESS-WITH-BASIC-BODY-MOVEMENTS">Functional Fitness with Basic Body Movements</a></h2> <p class="time">Monday, Oct 7, 2024 at 9:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-nm-tai-ji-quan-moving-for-better-balance-albuquerque-nm-100724-j7nhvzxdkxd.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TAI-JI-QUAN-MOVING-FOR-BETTER-BALANCE">Tai Ji Quan: Moving for Better Balance</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/virtual-aarp-tx-mobility-mondays-houston-tx-100724-f5n2bjqhntc.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TRY-A-LOWIMPACT-WORKOUT-TO-IMPROVE-MOBILITY">Try A Low-Impact Workout to Improve Mobility</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom and Facebook</p> <p class="loc">Online Event</p> </li> </ul> <p><a class="link-red" href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS">View All AARP Events<i class="ml-1 fas fa-chevron-right"></i></a></p> </div> </div> </div> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_53475" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_53475', size:'300x250'}); } </script> </div> </div> <div class="card-tout card-dark membership-tout" style="margin:0 0 30px 0;"> <img class="img-responsive image" title="image of two AARP membership cards" alt="image of two AARP membership cards" src="https://cdn-aarp.americantowns.com/img/tout-two-cards.png"> <div class="title">Only $12 your first year with Automatic Renewal</div> <ul class="list"> <li>Immediate access to your <a href="https://www.aarp.org/benefits-discounts/">member benefits</a></li> <li>Discounts on travel and everyday savings</li> <li>Subscription to AARP The Magazine</li> <li>FREE second membership</li> </ul> <div class="action"> <a class="btn" href="https://appsec.aarp.org/mem/join?campaignid=UAJFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Join AARP</a> <div class="body">Already a member? <a href="https://appsec.aarp.org/mem/renew?campaignid= UARFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Renew</a> or <a href="https://www.aarp.org/benefits-discounts/my-membership/print-your-card/">Print Card</a></div> </div> </div> <style> .membership-tout {padding:16px 20px;} .membership-tout .list li { margin: 0; } </style> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_93505" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_93505', size:'300x250'}); } </script> </div> </div> <div class="module-spacer text-center"> <div class="fb-page" alt="Image of AARP District of Columbia Facebook Page" title="Image of AARP District of Columbia Facebook Page" data-href="https://www.facebook.com/aarpdc" data-tabs="timeline" width="320" height="" data-small-header="false" data-adapt-container-width="true" data-hide-cover="false" data-show-facepile="true" lazy="true"> <blockquote cite="https://www.facebook.com/aarpdc" class="fb-xfbml-parse-ignore"><a href="https://www.facebook.com/aarpdc">Facebook</a></blockquote> </div> </div> <div class="ar-basic-box module-spacer"> <header> <h2>Contact AARP<br />District of Columbia</h2> </header> <div class="wrap"> <div class="ar-quick-list module-spacer"> <ul class="list-unstyled"> <li><i class="list-icon fa fa-envelope" alt="Email icon" title="Email icon" aria-hidden="true"></i><a href="mailto:DCAARP@aarp.org " target="_blank" rel="noopener">DCAARP@aarp.org </a></li> <li><i class="list-icon fa fa-globe" alt="Globe icon" title="Globe icon" aria-hidden="true"></i><a href="https://states.aarp.org/region/washington-dc/" target="_blank" rel="noopener">AARP Washington, DC</a></li> <li><i class="list-icon fa fa-map-marker" alt="Map Marker icon" title="Map Marker icon" aria-hidden="true"></i><a href="https://states.aarp.org/aarp-district-of-columbia-state-office/?intcmp=SNG-LNK-AARPLOCAL-CONTACT-20140101-WASHINGTON-DC" target="_blank" rel="noopener">Contact Us</a></li> </ul> </div> <a href="https://www.facebook.com/aarpdc" target="_blank" rel="noopener" aria-label="Open Facebook"><img alt="Facebook icon" title="Facebook icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/facebook-dreamstale25.png"></a> <a href="https://twitter.com/AARPDC" target="_blank" rel="noopener" aria-label="Open Twitter"><img alt="Twitter icon" title="Twitter icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/x-logo-black.png"></a> </div> </div> </div></div> <div class="col-md-8 left-rail left-bot"></div> <div class="col-md-4 right-rail right-bot thin-rhs"></div> </div> <div class="row oneColumnLayout"> </div> <div class="row oneColumnLayout"> <div class="col-md-12"><!-- script to activate navbar --> <script type="text/javascript"> jQuery(".channelBarMain ul.left li a").click(function() { window.location = jQuery(this).attr('href'); }); </script> </div> </div> ', 'scripts_for_layout' => '<title>How Mid-Atlantic States Are Expanding Home Care</title> <meta name="page_title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="robots" content="noindex, nofollow"/> <meta content="John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The" name="description"/> <meta content="How, Mid, Atlantic, States, Expanding, Home, Care" name="keywords"/> <link rel="canonical" href="https://states.aarp.org/ltss-in-the-mid-atlantic" /> <meta property="og:url" content="https://vccstaging.local.aarp.org/news/how-midatlantic-states-are-expanding-home-care-2023-12-03.html"/> <meta name="twitter:card" content="summary_large_image"/> <meta name="twitter:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="twitter:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta name="twitter:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> <meta property="og:type" content="article"/> <meta property="og:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta property="og:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta property="og:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }', 'title_for_layout' => '{local_city_c}, {local_state} Happenings - AARP' ) $content_for_layout = '<div class="row twoColumnLayout"> <div class="col-md-8 left-rail"><div class="module clearfix"><div class="ar-basic-box"> <div> <div class="module-spacer"> <header><h1 class="article-headline">How Mid-Atlantic States Are Expanding Home Care</h1></header> <div class="posted-on"> Posted on 12/03/23 by <b>Ann Hardie</b> </div> </div> <div class="module-spacer"> <span class="blog-content"><p><div class="RichTextArticleBody"> <div class="RichTextArticleBody-body"><p>John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The 55-year-old from Dover, Delaware, goes to work every day, helps his 8-year-old son with basketball drills and watches his beloved Philadelphia Eagles with friends at Buffalo Wild Wings.<br><br>McNeal does so with the assistance of direct-care workers who help him get dressed in the morning, fix his meals and drive him where he needs to go.<br><br>“My life is unique in that I have a significant disability,” says McNeal, director of Delaware’s State Council for Persons with Disabilities. But, he says, it’s “a productive life that is every bit as normal as anybody else’s.”<br><br>Across the country, states such as Delaware are spending a growing percentage of long-term care funding to keep people in their homes and communities instead of institutional settings. That’s according to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023" target="_blank" rel="noopener noreferrer">AARP’s most recent Long-Term Services and Supports State Scorecard</a></span></span>, which uses 50 spending, quality and access indicators to rank each state’s long-term care system.<br><br>The new data shows that for the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid’s long-term care dollars nationally for older people and adults with physical disabilities went to home- and community-based services instead of nursing homes or other facilities.<br></p><p class="cms-textAlign-center"><b>EXPLORE: </b><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/" target="_blank" rel="noopener noreferrer"><b>AARP Long-Term Care Scorecard</b></a></span></span></p><p>“This is a big deal. We are seeing a breaking point,” says Susan Reinhard, senior vice president of the AARP Public Policy Institute, which published the Scorecard in September.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/da/c2/a471a2d346088edaf8c38a8b7a46/midalantic.png" alt="midalantic.png" width="6900" height="5761"/> <figcaption class="Figure-caption">Nicolas Rapp</figcaption> </figure> </div> </div><p>The shift to home- and community-based services comes as demand for such care has increased, fueled in part by a pandemic that took a horrific toll on nursing home residents. Polls have consistently shown that most older Americans want to age in place. A 2021 AARP survey found that more than three-quarters of adults 50-plus say they want to remain in their homes as they grow older.<br><br>But with America’s population of older adults growing, the chasm between the availability of HCBS and access to such services is poised to widen. <br><br>“We’re going to see a dramatic increase in the 80-plus and 85-plus population” as the boomer generation gets older, says Robert Applebaum, a senior research scholar at Miami University’s Scripps Gerontology Center in Ohio. “So the demand for long-term services ... is going to be tremendous.”<br><br><b><u>A person-centered approach</u></b><br><br>In the Mid-Atlantic region, Delaware, the District of Columbia, Maryland, New Jersey and West Virginia have all increased the percentage of their Medicaid dollars going to HCBS for older people and adults with physical disabilities in recent years, the Scorecard shows. One way they are doing that: giving more older adults the power to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">direct their own care</a></span></span>, funded through Medicaid initiatives. (Medicaid, a joint federal-state program for low-income Americans, includes coverage for nursing homes and other long-term care.) <br><br>Enrollment in these <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">“self-directed” care </a></span></span>programs increased by 10 percent or more across 34 states and the District of Columbia in recent years, the Scorecard shows. Such programs give people a greater say over how to spend government dollars on their own care.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/25/1e/2926ddba4cd09d7af135e7604561/1140-inset1-de-john-mcneal.jpg" alt="John McNeal, Director of the State Council for Persons with Disabilities for the State of Delaware, photographed at his office in Dover DE for AARP Bulletin, 7 December 2023. Photo by Mike Morgan." width="655" height="1140" style="height: auto; max-width: 380px;"/> <figcaption class="Figure-caption">John McNeal exits his car. Photo by Mike Morgan.</figcaption> </figure> </div> </div><p>“It’s like the ultimate person-centered approach,” says Lisa Alecxih, who researches long-term care for The Lewin Group, a health care and human services consulting firm. She notes that such programs often have the added benefit of allowing participants to hire family members as caregivers. That’s crucial because there’s a national shortage of direct-care workers.<br><br>Applebaum says his research on self-directed programs has also shown the satisfaction levels were “beyond anything I’ve ever seen as an evaluator.”<br><br>McNeal, the Delaware disability advocate, says that’s certainly true for him. “This is probably the most important program that has come into my life,” he says. “It has allowed me the opportunity to have everything that anybody else in the community has.”<br><br><b><u>Growing demand, workforce crunch</u></b><br><br>Self-directed services are one of many state-level innovations highlighted in the Scorecard as a way states can meet the growing demand for home- and community-based care. In the Mid-Atlantic region, D.C., Virginia and New Jersey posted the highest numbers of people enrolled in self-directed programs relative to their disabled populations.<br><br>Pennsylvania is the only state in the region that did not see an increase, but that could change as Jason Kavulich—who became Pennsylvania’s Secretary of Aging in January 2023—leads the state’s effort to develop a 10-year master plan for aging. “It is our top-most priority to make sure that people can age in place, how they choose, and to make sure that the services that we have really are responsive,” Kavulich says.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/90/ca/722b3834468a82b147701fcee20d/midatlanticranks.png" alt="midatlanticranks.png" width="3166" height="6717" style="height: auto; max-width: 350px;"/> </figure> </div> </div><p>One of the biggest challenges states face in expanding HCBS is the <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">shortage of</a></span></span> <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">direct-care workers</a></span></span> to fill those jobs. The work can be emotionally and physically taxing and usually comes with low pay, poor benefits and limited support and training.<br><br>The Scorecard shows that across the U.S., wages for direct-care workers are lower than in jobs with similar or lower entry requirements. Their median income is about $30,000 a year—approximately $5,000 less than workers in comparable jobs are paid in most states. D.C. has the highest wage gap in the country, with direct-care workers earning $5.03 less per hour than their counterparts in other sectors.<br><br>“I’m in competition with fast-food places. It’s as simple as that,” says 63-year-old Keith Williams of Clarks Green, Pennsylvania, outside Scranton. He was born with arthrogryposis, a combination of conditions that causes joint contractures and weak muscles.<br><br>Through a self-directed program, he hires care workers to help him with everything from showering to eating. He recruits through word of mouth and online postings. When that fails, he hires his sister-in-law.<br><br>It’s not easy, says Williams, the manager of independent living services for the Northeast Pennsylvania Center for Independent Living, a community-based organization staffed in part by people with disabilities. But the control he has over his care has allowed him to have a meaningful life.<br><br>“It’s meant that I’ve been able to live life on my own terms,” he says.<br><br><i>Ann Hardie spent a decade covering aging issues for The Atlanta Journal-Constitution. She has written for the Bulletin for 15 years.</i><br><br><b>More on Home Care</b><br></p><ul><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2023/rise-of-companion-care.html" target="_blank" rel="noopener noreferrer">Care Companions: A Watchful Eye and Willing Ear for Older Adults</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2019/home-health-aides.html" target="_blank" rel="noopener noreferrer">Find the Right Home Aide for Your Loved One</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://press.aarp.org/2021-11-18-AARP-Survey-Shows-8-in-10-Older-Adults-Want-to-Age-in-Their-Homes-While-Number-and-Needs-of-Households-Headed-Older-Adults-Grow-Dramatically" target="_blank" rel="noopener noreferrer">AARP Survey: 8 in 10 Older Adults Want to Age at Home</a></span></span></li></ul><div class="Enhancement" > <div class="Enhancement-item"><span class="VideoEnhancement" data-video-disable-history data-embeddedvideo-container> <div class="VideoEnhancement-player"><bsp-brightcoveplayer data-video-player class="BrightcoveVideoPlayer" data-account="3772599298001" data-player="KM9xJAJa4" data-video-id="5754403576001" data-video-title="How In-Home Care Helps — AARP" > <video class="video-js" id="BrightcoveVideoPlayer-5754403576001" data-video-id="5754403576001" data-account="" data-player="KM9xJAJa4" data-embed="default" controls ></video> </bsp-brightcoveplayer> </div> <div class="VideoEnhancement-title">How In-Home Care Helps — AARP</div> </span> </div> </div><p></p></div> </div> </p></span> </div> </div> </div> </div><div class="module clearfix"><script src="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.c85a242a55150cd195e494cd6e5b9c77.gz.js" async=""></script> <link rel="stylesheet" media="all" href="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.bfe6eb5a8301841feef3af4e9bd1e26d.gz.css"> <!-- bypass --> <style> a:focus, a:hover { text-decoration: underline; } h1.article-headline { margin: 0 0 1rem; } </style> <!-- <style> .Enhancement-item .Figure { margin-bottom: 24px; } .RichTextArticleBody-body ul { margin-bottom: 24px; } .RichTextArticleBody-body p{ margin: 12px 0; } .RichTextModule-items { clear: both; display: table; width: 100%; margin-bottom: 12px; } .VideoEnhancement>* { color: var(--primaryTextColor); font-size: 13px; font-weight: 400; line-height: 1.4; font-style: italic; background: #f0efed } @media only screen and (min-width: 768px) { .VideoEnhancement>* { font-size:14px; font-weight: 400; line-height: 1.47 } } .VideoEnhancement-title { padding: 20px } @media only screen and (min-width: 768px) { .VideoEnhancement-title { padding:30px } } .VideoEnhancement-player>* { position: relative; width: 100%; height: 0; padding-bottom: 56.25% } .VideoEnhancement iframe { border: 0; position: absolute; top: 0; left: 0; width: 100%; height: 100% } [data-video-player] { display: block; padding-bottom: 56.25%; height: 0; margin: 0 auto; } [data-video-player][data-aspect-ratio="4x3"] { padding-bottom: 56.25%; } [data-video-player][data-aspect-ratio="16x9"] { padding-bottom: 56.25% } </style> --></div><div class="module clearfix"><div class="module-spacer tout-homefit-750"> <a data-formelementid="CSN-LOCAL-HC-NEWSSK-02272024" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-HC-NEWSSK-02272024"><img class="img-responsive" alt="Explore the free AARP HomeFit Guide" title="Explore the free AARP HomeFit Guide" src="https://cdn-aarp.americantowns.com/img/touts/HomeFit_750x150.png"></a> </div></div></div> <div class="col-md-4 right-rail thin-rhs"><div class="module clearfix"><!--default--> <!-- module_RHS - AARP Events --> <div class="ar-basic-box module-spacer"> <header> <div class="pull-right"> <a href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS"> <img style="width:30px;" src="https://cdn-aarp.americantowns.com/img/template/icons/aarp_event_icon.png" alt="Upcoming AARP Events" /> </a> </div> <h2 class="visible-lg">AARP Events for Washington</h2> <h2 class="hidden-lg">AARP Events for Washington</h2> </header> <div class="wrap"> <div class="ar-listing snippet"> <ul class="list"> <li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-co-virtual-functional-fitness-online-99-10142024-sgnszx3wwws.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-FUNCTIONAL-FITNESS-WITH-BASIC-BODY-MOVEMENTS">Functional Fitness with Basic Body Movements</a></h2> <p class="time">Monday, Oct 7, 2024 at 9:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-nm-tai-ji-quan-moving-for-better-balance-albuquerque-nm-100724-j7nhvzxdkxd.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TAI-JI-QUAN-MOVING-FOR-BETTER-BALANCE">Tai Ji Quan: Moving for Better Balance</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/virtual-aarp-tx-mobility-mondays-houston-tx-100724-f5n2bjqhntc.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TRY-A-LOWIMPACT-WORKOUT-TO-IMPROVE-MOBILITY">Try A Low-Impact Workout to Improve Mobility</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom and Facebook</p> <p class="loc">Online Event</p> </li> </ul> <p><a class="link-red" href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS">View All AARP Events<i class="ml-1 fas fa-chevron-right"></i></a></p> </div> </div> </div> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_53475" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_53475', size:'300x250'}); } </script> </div> </div> <div class="card-tout card-dark membership-tout" style="margin:0 0 30px 0;"> <img class="img-responsive image" title="image of two AARP membership cards" alt="image of two AARP membership cards" src="https://cdn-aarp.americantowns.com/img/tout-two-cards.png"> <div class="title">Only $12 your first year with Automatic Renewal</div> <ul class="list"> <li>Immediate access to your <a href="https://www.aarp.org/benefits-discounts/">member benefits</a></li> <li>Discounts on travel and everyday savings</li> <li>Subscription to AARP The Magazine</li> <li>FREE second membership</li> </ul> <div class="action"> <a class="btn" href="https://appsec.aarp.org/mem/join?campaignid=UAJFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Join AARP</a> <div class="body">Already a member? <a href="https://appsec.aarp.org/mem/renew?campaignid= UARFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Renew</a> or <a href="https://www.aarp.org/benefits-discounts/my-membership/print-your-card/">Print Card</a></div> </div> </div> <style> .membership-tout {padding:16px 20px;} .membership-tout .list li { margin: 0; } </style> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_93505" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_93505', size:'300x250'}); } </script> </div> </div> <div class="module-spacer text-center"> <div class="fb-page" alt="Image of AARP District of Columbia Facebook Page" title="Image of AARP District of Columbia Facebook Page" data-href="https://www.facebook.com/aarpdc" data-tabs="timeline" width="320" height="" data-small-header="false" data-adapt-container-width="true" data-hide-cover="false" data-show-facepile="true" lazy="true"> <blockquote cite="https://www.facebook.com/aarpdc" class="fb-xfbml-parse-ignore"><a href="https://www.facebook.com/aarpdc">Facebook</a></blockquote> </div> </div> <div class="ar-basic-box module-spacer"> <header> <h2>Contact AARP<br />District of Columbia</h2> </header> <div class="wrap"> <div class="ar-quick-list module-spacer"> <ul class="list-unstyled"> <li><i class="list-icon fa fa-envelope" alt="Email icon" title="Email icon" aria-hidden="true"></i><a href="mailto:DCAARP@aarp.org " target="_blank" rel="noopener">DCAARP@aarp.org </a></li> <li><i class="list-icon fa fa-globe" alt="Globe icon" title="Globe icon" aria-hidden="true"></i><a href="https://states.aarp.org/region/washington-dc/" target="_blank" rel="noopener">AARP Washington, DC</a></li> <li><i class="list-icon fa fa-map-marker" alt="Map Marker icon" title="Map Marker icon" aria-hidden="true"></i><a href="https://states.aarp.org/aarp-district-of-columbia-state-office/?intcmp=SNG-LNK-AARPLOCAL-CONTACT-20140101-WASHINGTON-DC" target="_blank" rel="noopener">Contact Us</a></li> </ul> </div> <a href="https://www.facebook.com/aarpdc" target="_blank" rel="noopener" aria-label="Open Facebook"><img alt="Facebook icon" title="Facebook icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/facebook-dreamstale25.png"></a> <a href="https://twitter.com/AARPDC" target="_blank" rel="noopener" aria-label="Open Twitter"><img alt="Twitter icon" title="Twitter icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/x-logo-black.png"></a> </div> </div> </div></div> <div class="col-md-8 left-rail left-bot"></div> <div class="col-md-4 right-rail right-bot thin-rhs"></div> </div> <div class="row oneColumnLayout"> </div> <div class="row oneColumnLayout"> <div class="col-md-12"><!-- script to activate navbar --> <script type="text/javascript"> jQuery(".channelBarMain ul.left li a").click(function() { window.location = jQuery(this).attr('href'); }); </script> </div> </div> ' $scripts_for_layout = '<title>How Mid-Atlantic States Are Expanding Home Care</title> <meta name="page_title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="robots" content="noindex, nofollow"/> <meta content="John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The" name="description"/> <meta content="How, Mid, Atlantic, States, Expanding, Home, Care" name="keywords"/> <link rel="canonical" href="https://states.aarp.org/ltss-in-the-mid-atlantic" /> <meta property="og:url" content="https://vccstaging.local.aarp.org/news/how-midatlantic-states-are-expanding-home-care-2023-12-03.html"/> <meta name="twitter:card" content="summary_large_image"/> <meta name="twitter:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="twitter:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta name="twitter:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> <meta property="og:type" content="article"/> <meta property="og:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta property="og:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta property="og:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }' $title_for_layout = '{local_city_c}, {local_state} Happenings - AARP' $asset_version = '230831' $min = true $nowrapper = false $css = ' :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }' $highlighting = '' $location = '<a href="/washington-dc/?intcmp=CSN-LOCAL-NAV-HOME">Washington, DC</a>' $no_header = false $header_title = '<a href="/washington-dc/happenings/">News Feed</a>' $header_subtitle = '' $isPR = false $navbar = '<nav class="section" role="button" aria-expanded="false" aria-controls="collapse"> <div class="section-toggle">Sections <i class="fas fa-chevron-down"></i></div> <ul class="secondary-menu" id="secondary-menu" role="menu" aria-busy="true"> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/aarp-events/?intcmp=CSN-LOCAL-NAV-OLE" data-formelementid="LOCAL-LNK-CLK-EVENTS">Online & Local Events</a> </li> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/things-to-do/?intcmp=CSN-LOCAL-NAV-TTD" data-formelementid="LOCAL-LNK-CLK-THINGSTODO">Things to Do</a></li> <li role="presentation" class="active"><a role="menuitem" class="menuitem" href="/washington-dc/happenings/?intcmp=CSN-LOCAL-NAV-NF" data-formelementid="LOCAL-LNK-CLK-HAPPENINGS">News Feed</a> </li> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/volunteering/?intcmp=CSN-LOCAL-NAV-VOL" data-formelementid="LOCAL-LNK-CLK-VOLUNTEERING">Volunteering</a> </li> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-NAV-HC" data-formelementid="LOCAL-LNK-CLK-HC">Home & Community</a> </li> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/movies/?intcmp=CSN-LOCAL-NAV-MFG" data-formelementid="LOCAL-LNK-CLK-MOVIESFORGROWNUPS">Movies for Grownups</a> </li> <li role="presentation" class="more nosep " id="submenu-more"> <span role="menuitem" class="menuitem" data-formelementid="LOCAL-LNK-CLK-MORE">More<i class="fas fa-chevron-down"></i></span> <ul class="secondary-submenu animate slide-in" id="secondary-submenu"> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/discounts/?intcmp=CSN-LOCAL-NAV-LO" data-formelementid="LOCAL-LNK-CLK-OFFERS">Local Offers</a></li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/local-resources/?intcmp=CSN-LOCAL-NAV-LR" data-formelementid="LOCAL-LNK-CLK-LOCALRESOURCES">Local Resources</a> </li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/jobs/?intcmp=CSN-LOCAL-NAV-WJ" data-formelementid="LOCAL-LNK-CLK-WORK&JOBS">Work & Jobs</a></li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/events/?intcmp=CSN-LOCAL-NAV-CC" data-formelementid="LOCAL-LNK-CLK-EVENTS">Community Calendar</a></li> <!-- <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/healthy-living/?intcmp=CSN-LOCAL-NAV-HEALTHY_LIVING" data-formelementid="LOCAL-LNK-CLK-HEALTHY_LIVING">Healthy Living</a></li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/arts-entertainment/?intcmp=CSN-LOCAL-NAV-ARTS_ENT" data-formelementid="LOCAL-LNK-CLK-ARTS_ENT">Arts & Entertainment</a></li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/museums/?intcmp=CSN-LOCAL-NAV-MUSEUMS" data-formelementid="LOCAL-LNK-CLK-MUSEUMS">Museums</a></li> --> </ul> </li> </ul> </nav>' $header_custom = '' $breadcrumbs = array( (int) 0 => array( 'title' => 'News Feed', 'slug' => 'happenings' ) ) $row = array( 'title' => 'Back to News Feed', 'slug' => 'happenings' ) $i = (int) 0include - APP/View/Layouts/aarp_2023.ctp, line 244 include - APP/View/Layouts/aarp_2023.ctp, line 244 View::_evaluate() - CORE/Cake/View/View.php, line 971 View::_render() - CORE/Cake/View/View.php, line 933 View::renderLayout() - CORE/Cake/View/View.php, line 546 View::render() - CORE/Cake/View/View.php, line 481 Controller::render() - CORE/Cake/Controller/Controller.php, line 963 AppController::renderPage() - APP/Controller/AppController.php, line 136 BlogsController::display() - APP/Controller/BlogsController.php, line 81 ReflectionMethod::invokeArgs() - [internal], line ?? Controller::invokeAction() - CORE/Cake/Controller/Controller.php, line 491 Dispatcher::_invoke() - CORE/Cake/Routing/Dispatcher.php, line 193 Dispatcher::dispatch() - CORE/Cake/Routing/Dispatcher.php, line 167 [main] - APP/webroot/index.php, line 118
Warning (2): include() [<a href='http://php.net/function.include'>function.include</a>]: Failed opening '/var/www/vhosts/vcc_staging/app/Resource/aarp2_master.resource.footer.root.html' for inclusion (include_path='/var/www/vhosts/vcc_staging/lib:.:/usr/share/pear:/usr/share/php') [APP/View/Layouts/aarp_2023.ctp, line 244]Code Contextinclude (APP . "Resource/aarp2_master.footer.html");
include (APP . "Resource/aarp2_master.bodyTargeting.html");
include (APP . "Resource/aarp2_master.resource.footer.root.html");
$viewFile = '/var/www/vhosts/vcc_staging/app/View/Layouts/aarp_2023.ctp' $dataForView = array( 'content_for_layout' => '<div class="row twoColumnLayout"> <div class="col-md-8 left-rail"><div class="module clearfix"><div class="ar-basic-box"> <div> <div class="module-spacer"> <header><h1 class="article-headline">How Mid-Atlantic States Are Expanding Home Care</h1></header> <div class="posted-on"> Posted on 12/03/23 by <b>Ann Hardie</b> </div> </div> <div class="module-spacer"> <span class="blog-content"><p><div class="RichTextArticleBody"> <div class="RichTextArticleBody-body"><p>John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The 55-year-old from Dover, Delaware, goes to work every day, helps his 8-year-old son with basketball drills and watches his beloved Philadelphia Eagles with friends at Buffalo Wild Wings.<br><br>McNeal does so with the assistance of direct-care workers who help him get dressed in the morning, fix his meals and drive him where he needs to go.<br><br>“My life is unique in that I have a significant disability,” says McNeal, director of Delaware’s State Council for Persons with Disabilities. But, he says, it’s “a productive life that is every bit as normal as anybody else’s.”<br><br>Across the country, states such as Delaware are spending a growing percentage of long-term care funding to keep people in their homes and communities instead of institutional settings. That’s according to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023" target="_blank" rel="noopener noreferrer">AARP’s most recent Long-Term Services and Supports State Scorecard</a></span></span>, which uses 50 spending, quality and access indicators to rank each state’s long-term care system.<br><br>The new data shows that for the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid’s long-term care dollars nationally for older people and adults with physical disabilities went to home- and community-based services instead of nursing homes or other facilities.<br></p><p class="cms-textAlign-center"><b>EXPLORE: </b><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/" target="_blank" rel="noopener noreferrer"><b>AARP Long-Term Care Scorecard</b></a></span></span></p><p>“This is a big deal. We are seeing a breaking point,” says Susan Reinhard, senior vice president of the AARP Public Policy Institute, which published the Scorecard in September.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/da/c2/a471a2d346088edaf8c38a8b7a46/midalantic.png" alt="midalantic.png" width="6900" height="5761"/> <figcaption class="Figure-caption">Nicolas Rapp</figcaption> </figure> </div> </div><p>The shift to home- and community-based services comes as demand for such care has increased, fueled in part by a pandemic that took a horrific toll on nursing home residents. Polls have consistently shown that most older Americans want to age in place. A 2021 AARP survey found that more than three-quarters of adults 50-plus say they want to remain in their homes as they grow older.<br><br>But with America’s population of older adults growing, the chasm between the availability of HCBS and access to such services is poised to widen. <br><br>“We’re going to see a dramatic increase in the 80-plus and 85-plus population” as the boomer generation gets older, says Robert Applebaum, a senior research scholar at Miami University’s Scripps Gerontology Center in Ohio. “So the demand for long-term services ... is going to be tremendous.”<br><br><b><u>A person-centered approach</u></b><br><br>In the Mid-Atlantic region, Delaware, the District of Columbia, Maryland, New Jersey and West Virginia have all increased the percentage of their Medicaid dollars going to HCBS for older people and adults with physical disabilities in recent years, the Scorecard shows. One way they are doing that: giving more older adults the power to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">direct their own care</a></span></span>, funded through Medicaid initiatives. (Medicaid, a joint federal-state program for low-income Americans, includes coverage for nursing homes and other long-term care.) <br><br>Enrollment in these <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">“self-directed” care </a></span></span>programs increased by 10 percent or more across 34 states and the District of Columbia in recent years, the Scorecard shows. Such programs give people a greater say over how to spend government dollars on their own care.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/25/1e/2926ddba4cd09d7af135e7604561/1140-inset1-de-john-mcneal.jpg" alt="John McNeal, Director of the State Council for Persons with Disabilities for the State of Delaware, photographed at his office in Dover DE for AARP Bulletin, 7 December 2023. Photo by Mike Morgan." width="655" height="1140" style="height: auto; max-width: 380px;"/> <figcaption class="Figure-caption">John McNeal exits his car. Photo by Mike Morgan.</figcaption> </figure> </div> </div><p>“It’s like the ultimate person-centered approach,” says Lisa Alecxih, who researches long-term care for The Lewin Group, a health care and human services consulting firm. She notes that such programs often have the added benefit of allowing participants to hire family members as caregivers. That’s crucial because there’s a national shortage of direct-care workers.<br><br>Applebaum says his research on self-directed programs has also shown the satisfaction levels were “beyond anything I’ve ever seen as an evaluator.”<br><br>McNeal, the Delaware disability advocate, says that’s certainly true for him. “This is probably the most important program that has come into my life,” he says. “It has allowed me the opportunity to have everything that anybody else in the community has.”<br><br><b><u>Growing demand, workforce crunch</u></b><br><br>Self-directed services are one of many state-level innovations highlighted in the Scorecard as a way states can meet the growing demand for home- and community-based care. In the Mid-Atlantic region, D.C., Virginia and New Jersey posted the highest numbers of people enrolled in self-directed programs relative to their disabled populations.<br><br>Pennsylvania is the only state in the region that did not see an increase, but that could change as Jason Kavulich—who became Pennsylvania’s Secretary of Aging in January 2023—leads the state’s effort to develop a 10-year master plan for aging. “It is our top-most priority to make sure that people can age in place, how they choose, and to make sure that the services that we have really are responsive,” Kavulich says.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/90/ca/722b3834468a82b147701fcee20d/midatlanticranks.png" alt="midatlanticranks.png" width="3166" height="6717" style="height: auto; max-width: 350px;"/> </figure> </div> </div><p>One of the biggest challenges states face in expanding HCBS is the <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">shortage of</a></span></span> <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">direct-care workers</a></span></span> to fill those jobs. The work can be emotionally and physically taxing and usually comes with low pay, poor benefits and limited support and training.<br><br>The Scorecard shows that across the U.S., wages for direct-care workers are lower than in jobs with similar or lower entry requirements. Their median income is about $30,000 a year—approximately $5,000 less than workers in comparable jobs are paid in most states. D.C. has the highest wage gap in the country, with direct-care workers earning $5.03 less per hour than their counterparts in other sectors.<br><br>“I’m in competition with fast-food places. It’s as simple as that,” says 63-year-old Keith Williams of Clarks Green, Pennsylvania, outside Scranton. He was born with arthrogryposis, a combination of conditions that causes joint contractures and weak muscles.<br><br>Through a self-directed program, he hires care workers to help him with everything from showering to eating. He recruits through word of mouth and online postings. When that fails, he hires his sister-in-law.<br><br>It’s not easy, says Williams, the manager of independent living services for the Northeast Pennsylvania Center for Independent Living, a community-based organization staffed in part by people with disabilities. But the control he has over his care has allowed him to have a meaningful life.<br><br>“It’s meant that I’ve been able to live life on my own terms,” he says.<br><br><i>Ann Hardie spent a decade covering aging issues for The Atlanta Journal-Constitution. She has written for the Bulletin for 15 years.</i><br><br><b>More on Home Care</b><br></p><ul><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2023/rise-of-companion-care.html" target="_blank" rel="noopener noreferrer">Care Companions: A Watchful Eye and Willing Ear for Older Adults</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2019/home-health-aides.html" target="_blank" rel="noopener noreferrer">Find the Right Home Aide for Your Loved One</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://press.aarp.org/2021-11-18-AARP-Survey-Shows-8-in-10-Older-Adults-Want-to-Age-in-Their-Homes-While-Number-and-Needs-of-Households-Headed-Older-Adults-Grow-Dramatically" target="_blank" rel="noopener noreferrer">AARP Survey: 8 in 10 Older Adults Want to Age at Home</a></span></span></li></ul><div class="Enhancement" > <div class="Enhancement-item"><span class="VideoEnhancement" data-video-disable-history data-embeddedvideo-container> <div class="VideoEnhancement-player"><bsp-brightcoveplayer data-video-player class="BrightcoveVideoPlayer" data-account="3772599298001" data-player="KM9xJAJa4" data-video-id="5754403576001" data-video-title="How In-Home Care Helps — AARP" > <video class="video-js" id="BrightcoveVideoPlayer-5754403576001" data-video-id="5754403576001" data-account="" data-player="KM9xJAJa4" data-embed="default" controls ></video> </bsp-brightcoveplayer> </div> <div class="VideoEnhancement-title">How In-Home Care Helps — AARP</div> </span> </div> </div><p></p></div> </div> </p></span> </div> </div> </div> </div><div class="module clearfix"><script src="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.c85a242a55150cd195e494cd6e5b9c77.gz.js" async=""></script> <link rel="stylesheet" media="all" href="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.bfe6eb5a8301841feef3af4e9bd1e26d.gz.css"> <!-- bypass --> <style> a:focus, a:hover { text-decoration: underline; } h1.article-headline { margin: 0 0 1rem; } </style> <!-- <style> .Enhancement-item .Figure { margin-bottom: 24px; } .RichTextArticleBody-body ul { margin-bottom: 24px; } .RichTextArticleBody-body p{ margin: 12px 0; } .RichTextModule-items { clear: both; display: table; width: 100%; margin-bottom: 12px; } .VideoEnhancement>* { color: var(--primaryTextColor); font-size: 13px; font-weight: 400; line-height: 1.4; font-style: italic; background: #f0efed } @media only screen and (min-width: 768px) { .VideoEnhancement>* { font-size:14px; font-weight: 400; line-height: 1.47 } } .VideoEnhancement-title { padding: 20px } @media only screen and (min-width: 768px) { .VideoEnhancement-title { padding:30px } } .VideoEnhancement-player>* { position: relative; width: 100%; height: 0; padding-bottom: 56.25% } .VideoEnhancement iframe { border: 0; position: absolute; top: 0; left: 0; width: 100%; height: 100% } [data-video-player] { display: block; padding-bottom: 56.25%; height: 0; margin: 0 auto; } [data-video-player][data-aspect-ratio="4x3"] { padding-bottom: 56.25%; } [data-video-player][data-aspect-ratio="16x9"] { padding-bottom: 56.25% } </style> --></div><div class="module clearfix"><div class="module-spacer tout-homefit-750"> <a data-formelementid="CSN-LOCAL-HC-NEWSSK-02272024" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-HC-NEWSSK-02272024"><img class="img-responsive" alt="Explore the free AARP HomeFit Guide" title="Explore the free AARP HomeFit Guide" src="https://cdn-aarp.americantowns.com/img/touts/HomeFit_750x150.png"></a> </div></div></div> <div class="col-md-4 right-rail thin-rhs"><div class="module clearfix"><!--default--> <!-- module_RHS - AARP Events --> <div class="ar-basic-box module-spacer"> <header> <div class="pull-right"> <a href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS"> <img style="width:30px;" src="https://cdn-aarp.americantowns.com/img/template/icons/aarp_event_icon.png" alt="Upcoming AARP Events" /> </a> </div> <h2 class="visible-lg">AARP Events for Washington</h2> <h2 class="hidden-lg">AARP Events for Washington</h2> </header> <div class="wrap"> <div class="ar-listing snippet"> <ul class="list"> <li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-co-virtual-functional-fitness-online-99-10142024-sgnszx3wwws.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-FUNCTIONAL-FITNESS-WITH-BASIC-BODY-MOVEMENTS">Functional Fitness with Basic Body Movements</a></h2> <p class="time">Monday, Oct 7, 2024 at 9:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-nm-tai-ji-quan-moving-for-better-balance-albuquerque-nm-100724-j7nhvzxdkxd.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TAI-JI-QUAN-MOVING-FOR-BETTER-BALANCE">Tai Ji Quan: Moving for Better Balance</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/virtual-aarp-tx-mobility-mondays-houston-tx-100724-f5n2bjqhntc.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TRY-A-LOWIMPACT-WORKOUT-TO-IMPROVE-MOBILITY">Try A Low-Impact Workout to Improve Mobility</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom and Facebook</p> <p class="loc">Online Event</p> </li> </ul> <p><a class="link-red" href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS">View All AARP Events<i class="ml-1 fas fa-chevron-right"></i></a></p> </div> </div> </div> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_53475" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_53475', size:'300x250'}); } </script> </div> </div> <div class="card-tout card-dark membership-tout" style="margin:0 0 30px 0;"> <img class="img-responsive image" title="image of two AARP membership cards" alt="image of two AARP membership cards" src="https://cdn-aarp.americantowns.com/img/tout-two-cards.png"> <div class="title">Only $12 your first year with Automatic Renewal</div> <ul class="list"> <li>Immediate access to your <a href="https://www.aarp.org/benefits-discounts/">member benefits</a></li> <li>Discounts on travel and everyday savings</li> <li>Subscription to AARP The Magazine</li> <li>FREE second membership</li> </ul> <div class="action"> <a class="btn" href="https://appsec.aarp.org/mem/join?campaignid=UAJFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Join AARP</a> <div class="body">Already a member? <a href="https://appsec.aarp.org/mem/renew?campaignid= UARFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Renew</a> or <a href="https://www.aarp.org/benefits-discounts/my-membership/print-your-card/">Print Card</a></div> </div> </div> <style> .membership-tout {padding:16px 20px;} .membership-tout .list li { margin: 0; } </style> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_93505" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_93505', size:'300x250'}); } </script> </div> </div> <div class="module-spacer text-center"> <div class="fb-page" alt="Image of AARP District of Columbia Facebook Page" title="Image of AARP District of Columbia Facebook Page" data-href="https://www.facebook.com/aarpdc" data-tabs="timeline" width="320" height="" data-small-header="false" data-adapt-container-width="true" data-hide-cover="false" data-show-facepile="true" lazy="true"> <blockquote cite="https://www.facebook.com/aarpdc" class="fb-xfbml-parse-ignore"><a href="https://www.facebook.com/aarpdc">Facebook</a></blockquote> </div> </div> <div class="ar-basic-box module-spacer"> <header> <h2>Contact AARP<br />District of Columbia</h2> </header> <div class="wrap"> <div class="ar-quick-list module-spacer"> <ul class="list-unstyled"> <li><i class="list-icon fa fa-envelope" alt="Email icon" title="Email icon" aria-hidden="true"></i><a href="mailto:DCAARP@aarp.org " target="_blank" rel="noopener">DCAARP@aarp.org </a></li> <li><i class="list-icon fa fa-globe" alt="Globe icon" title="Globe icon" aria-hidden="true"></i><a href="https://states.aarp.org/region/washington-dc/" target="_blank" rel="noopener">AARP Washington, DC</a></li> <li><i class="list-icon fa fa-map-marker" alt="Map Marker icon" title="Map Marker icon" aria-hidden="true"></i><a href="https://states.aarp.org/aarp-district-of-columbia-state-office/?intcmp=SNG-LNK-AARPLOCAL-CONTACT-20140101-WASHINGTON-DC" target="_blank" rel="noopener">Contact Us</a></li> </ul> </div> <a href="https://www.facebook.com/aarpdc" target="_blank" rel="noopener" aria-label="Open Facebook"><img alt="Facebook icon" title="Facebook icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/facebook-dreamstale25.png"></a> <a href="https://twitter.com/AARPDC" target="_blank" rel="noopener" aria-label="Open Twitter"><img alt="Twitter icon" title="Twitter icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/x-logo-black.png"></a> </div> </div> </div></div> <div class="col-md-8 left-rail left-bot"></div> <div class="col-md-4 right-rail right-bot thin-rhs"></div> </div> <div class="row oneColumnLayout"> </div> <div class="row oneColumnLayout"> <div class="col-md-12"><!-- script to activate navbar --> <script type="text/javascript"> jQuery(".channelBarMain ul.left li a").click(function() { window.location = jQuery(this).attr('href'); }); </script> </div> </div> ', 'scripts_for_layout' => '<title>How Mid-Atlantic States Are Expanding Home Care</title> <meta name="page_title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="robots" content="noindex, nofollow"/> <meta content="John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The" name="description"/> <meta content="How, Mid, Atlantic, States, Expanding, Home, Care" name="keywords"/> <link rel="canonical" href="https://states.aarp.org/ltss-in-the-mid-atlantic" /> <meta property="og:url" content="https://vccstaging.local.aarp.org/news/how-midatlantic-states-are-expanding-home-care-2023-12-03.html"/> <meta name="twitter:card" content="summary_large_image"/> <meta name="twitter:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="twitter:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta name="twitter:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> <meta property="og:type" content="article"/> <meta property="og:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta property="og:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta property="og:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }', 'title_for_layout' => '{local_city_c}, {local_state} Happenings - AARP' ) $content_for_layout = '<div class="row twoColumnLayout"> <div class="col-md-8 left-rail"><div class="module clearfix"><div class="ar-basic-box"> <div> <div class="module-spacer"> <header><h1 class="article-headline">How Mid-Atlantic States Are Expanding Home Care</h1></header> <div class="posted-on"> Posted on 12/03/23 by <b>Ann Hardie</b> </div> </div> <div class="module-spacer"> <span class="blog-content"><p><div class="RichTextArticleBody"> <div class="RichTextArticleBody-body"><p>John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The 55-year-old from Dover, Delaware, goes to work every day, helps his 8-year-old son with basketball drills and watches his beloved Philadelphia Eagles with friends at Buffalo Wild Wings.<br><br>McNeal does so with the assistance of direct-care workers who help him get dressed in the morning, fix his meals and drive him where he needs to go.<br><br>“My life is unique in that I have a significant disability,” says McNeal, director of Delaware’s State Council for Persons with Disabilities. But, he says, it’s “a productive life that is every bit as normal as anybody else’s.”<br><br>Across the country, states such as Delaware are spending a growing percentage of long-term care funding to keep people in their homes and communities instead of institutional settings. That’s according to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023" target="_blank" rel="noopener noreferrer">AARP’s most recent Long-Term Services and Supports State Scorecard</a></span></span>, which uses 50 spending, quality and access indicators to rank each state’s long-term care system.<br><br>The new data shows that for the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid’s long-term care dollars nationally for older people and adults with physical disabilities went to home- and community-based services instead of nursing homes or other facilities.<br></p><p class="cms-textAlign-center"><b>EXPLORE: </b><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/" target="_blank" rel="noopener noreferrer"><b>AARP Long-Term Care Scorecard</b></a></span></span></p><p>“This is a big deal. We are seeing a breaking point,” says Susan Reinhard, senior vice president of the AARP Public Policy Institute, which published the Scorecard in September.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/da/c2/a471a2d346088edaf8c38a8b7a46/midalantic.png" alt="midalantic.png" width="6900" height="5761"/> <figcaption class="Figure-caption">Nicolas Rapp</figcaption> </figure> </div> </div><p>The shift to home- and community-based services comes as demand for such care has increased, fueled in part by a pandemic that took a horrific toll on nursing home residents. Polls have consistently shown that most older Americans want to age in place. A 2021 AARP survey found that more than three-quarters of adults 50-plus say they want to remain in their homes as they grow older.<br><br>But with America’s population of older adults growing, the chasm between the availability of HCBS and access to such services is poised to widen. <br><br>“We’re going to see a dramatic increase in the 80-plus and 85-plus population” as the boomer generation gets older, says Robert Applebaum, a senior research scholar at Miami University’s Scripps Gerontology Center in Ohio. “So the demand for long-term services ... is going to be tremendous.”<br><br><b><u>A person-centered approach</u></b><br><br>In the Mid-Atlantic region, Delaware, the District of Columbia, Maryland, New Jersey and West Virginia have all increased the percentage of their Medicaid dollars going to HCBS for older people and adults with physical disabilities in recent years, the Scorecard shows. One way they are doing that: giving more older adults the power to <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">direct their own care</a></span></span>, funded through Medicaid initiatives. (Medicaid, a joint federal-state program for low-income Americans, includes coverage for nursing homes and other long-term care.) <br><br>Enrollment in these <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/self-directed-program-enrollment" target="_blank" rel="noopener noreferrer">“self-directed” care </a></span></span>programs increased by 10 percent or more across 34 states and the District of Columbia in recent years, the Scorecard shows. Such programs give people a greater say over how to spend government dollars on their own care.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/25/1e/2926ddba4cd09d7af135e7604561/1140-inset1-de-john-mcneal.jpg" alt="John McNeal, Director of the State Council for Persons with Disabilities for the State of Delaware, photographed at his office in Dover DE for AARP Bulletin, 7 December 2023. Photo by Mike Morgan." width="655" height="1140" style="height: auto; max-width: 380px;"/> <figcaption class="Figure-caption">John McNeal exits his car. Photo by Mike Morgan.</figcaption> </figure> </div> </div><p>“It’s like the ultimate person-centered approach,” says Lisa Alecxih, who researches long-term care for The Lewin Group, a health care and human services consulting firm. She notes that such programs often have the added benefit of allowing participants to hire family members as caregivers. That’s crucial because there’s a national shortage of direct-care workers.<br><br>Applebaum says his research on self-directed programs has also shown the satisfaction levels were “beyond anything I’ve ever seen as an evaluator.”<br><br>McNeal, the Delaware disability advocate, says that’s certainly true for him. “This is probably the most important program that has come into my life,” he says. “It has allowed me the opportunity to have everything that anybody else in the community has.”<br><br><b><u>Growing demand, workforce crunch</u></b><br><br>Self-directed services are one of many state-level innovations highlighted in the Scorecard as a way states can meet the growing demand for home- and community-based care. In the Mid-Atlantic region, D.C., Virginia and New Jersey posted the highest numbers of people enrolled in self-directed programs relative to their disabled populations.<br><br>Pennsylvania is the only state in the region that did not see an increase, but that could change as Jason Kavulich—who became Pennsylvania’s Secretary of Aging in January 2023—leads the state’s effort to develop a 10-year master plan for aging. “It is our top-most priority to make sure that people can age in place, how they choose, and to make sure that the services that we have really are responsive,” Kavulich says.</p><div class="Enhancement" > <div class="Enhancement-item"><figure class="Figure" data-alignment="left"> <img src="https://aarp-states.brightspotcdn.com/90/ca/722b3834468a82b147701fcee20d/midatlanticranks.png" alt="midatlanticranks.png" width="3166" height="6717" style="height: auto; max-width: 350px;"/> </figure> </div> </div><p>One of the biggest challenges states face in expanding HCBS is the <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">shortage of</a></span></span> <span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/basics/info-2022/in-home-caregiver-shortage.html" target="_blank" rel="noopener noreferrer">direct-care workers</a></span></span> to fill those jobs. The work can be emotionally and physically taxing and usually comes with low pay, poor benefits and limited support and training.<br><br>The Scorecard shows that across the U.S., wages for direct-care workers are lower than in jobs with similar or lower entry requirements. Their median income is about $30,000 a year—approximately $5,000 less than workers in comparable jobs are paid in most states. D.C. has the highest wage gap in the country, with direct-care workers earning $5.03 less per hour than their counterparts in other sectors.<br><br>“I’m in competition with fast-food places. It’s as simple as that,” says 63-year-old Keith Williams of Clarks Green, Pennsylvania, outside Scranton. He was born with arthrogryposis, a combination of conditions that causes joint contractures and weak muscles.<br><br>Through a self-directed program, he hires care workers to help him with everything from showering to eating. He recruits through word of mouth and online postings. When that fails, he hires his sister-in-law.<br><br>It’s not easy, says Williams, the manager of independent living services for the Northeast Pennsylvania Center for Independent Living, a community-based organization staffed in part by people with disabilities. But the control he has over his care has allowed him to have a meaningful life.<br><br>“It’s meant that I’ve been able to live life on my own terms,” he says.<br><br><i>Ann Hardie spent a decade covering aging issues for The Atlanta Journal-Constitution. She has written for the Bulletin for 15 years.</i><br><br><b>More on Home Care</b><br></p><ul><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2023/rise-of-companion-care.html" target="_blank" rel="noopener noreferrer">Care Companions: A Watchful Eye and Willing Ear for Older Adults</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://www.aarp.org/caregiving/home-care/info-2019/home-health-aides.html" target="_blank" rel="noopener noreferrer">Find the Right Home Aide for Your Loved One</a></span></span></li><li><span class="Enhancement" ><span class="Enhancement-item"><a class="Link" href="https://press.aarp.org/2021-11-18-AARP-Survey-Shows-8-in-10-Older-Adults-Want-to-Age-in-Their-Homes-While-Number-and-Needs-of-Households-Headed-Older-Adults-Grow-Dramatically" target="_blank" rel="noopener noreferrer">AARP Survey: 8 in 10 Older Adults Want to Age at Home</a></span></span></li></ul><div class="Enhancement" > <div class="Enhancement-item"><span class="VideoEnhancement" data-video-disable-history data-embeddedvideo-container> <div class="VideoEnhancement-player"><bsp-brightcoveplayer data-video-player class="BrightcoveVideoPlayer" data-account="3772599298001" data-player="KM9xJAJa4" data-video-id="5754403576001" data-video-title="How In-Home Care Helps — AARP" > <video class="video-js" id="BrightcoveVideoPlayer-5754403576001" data-video-id="5754403576001" data-account="" data-player="KM9xJAJa4" data-embed="default" controls ></video> </bsp-brightcoveplayer> </div> <div class="VideoEnhancement-title">How In-Home Care Helps — AARP</div> </span> </div> </div><p></p></div> </div> </p></span> </div> </div> </div> </div><div class="module clearfix"><script src="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.c85a242a55150cd195e494cd6e5b9c77.gz.js" async=""></script> <link rel="stylesheet" media="all" href="https://aarp-states.brightspotcdn.com/resource/00000168-dd17-d487-a96e-df5fe3ee0000/styleguide/All.min.bfe6eb5a8301841feef3af4e9bd1e26d.gz.css"> <!-- bypass --> <style> a:focus, a:hover { text-decoration: underline; } h1.article-headline { margin: 0 0 1rem; } </style> <!-- <style> .Enhancement-item .Figure { margin-bottom: 24px; } .RichTextArticleBody-body ul { margin-bottom: 24px; } .RichTextArticleBody-body p{ margin: 12px 0; } .RichTextModule-items { clear: both; display: table; width: 100%; margin-bottom: 12px; } .VideoEnhancement>* { color: var(--primaryTextColor); font-size: 13px; font-weight: 400; line-height: 1.4; font-style: italic; background: #f0efed } @media only screen and (min-width: 768px) { .VideoEnhancement>* { font-size:14px; font-weight: 400; line-height: 1.47 } } .VideoEnhancement-title { padding: 20px } @media only screen and (min-width: 768px) { .VideoEnhancement-title { padding:30px } } .VideoEnhancement-player>* { position: relative; width: 100%; height: 0; padding-bottom: 56.25% } .VideoEnhancement iframe { border: 0; position: absolute; top: 0; left: 0; width: 100%; height: 100% } [data-video-player] { display: block; padding-bottom: 56.25%; height: 0; margin: 0 auto; } [data-video-player][data-aspect-ratio="4x3"] { padding-bottom: 56.25%; } [data-video-player][data-aspect-ratio="16x9"] { padding-bottom: 56.25% } </style> --></div><div class="module clearfix"><div class="module-spacer tout-homefit-750"> <a data-formelementid="CSN-LOCAL-HC-NEWSSK-02272024" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-HC-NEWSSK-02272024"><img class="img-responsive" alt="Explore the free AARP HomeFit Guide" title="Explore the free AARP HomeFit Guide" src="https://cdn-aarp.americantowns.com/img/touts/HomeFit_750x150.png"></a> </div></div></div> <div class="col-md-4 right-rail thin-rhs"><div class="module clearfix"><!--default--> <!-- module_RHS - AARP Events --> <div class="ar-basic-box module-spacer"> <header> <div class="pull-right"> <a href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS"> <img style="width:30px;" src="https://cdn-aarp.americantowns.com/img/template/icons/aarp_event_icon.png" alt="Upcoming AARP Events" /> </a> </div> <h2 class="visible-lg">AARP Events for Washington</h2> <h2 class="hidden-lg">AARP Events for Washington</h2> </header> <div class="wrap"> <div class="ar-listing snippet"> <ul class="list"> <li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-co-virtual-functional-fitness-online-99-10142024-sgnszx3wwws.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-FUNCTIONAL-FITNESS-WITH-BASIC-BODY-MOVEMENTS">Functional Fitness with Basic Body Movements</a></h2> <p class="time">Monday, Oct 7, 2024 at 9:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/aarp-nm-tai-ji-quan-moving-for-better-balance-albuquerque-nm-100724-j7nhvzxdkxd.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TAI-JI-QUAN-MOVING-FOR-BETTER-BALANCE">Tai Ji Quan: Moving for Better Balance</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom</p> <p class="loc">Online Event</p> </li><li class="item" data-pageindex="1"> <h2 class="title"><a href="/aarp-event/virtual-aarp-tx-mobility-mondays-houston-tx-100724-f5n2bjqhntc.html" data-formelementid="LOCAL-BTN-CLK-EVENTS-TRY-A-LOWIMPACT-WORKOUT-TO-IMPROVE-MOBILITY">Try A Low-Impact Workout to Improve Mobility</a></h2> <p class="time">Monday, Oct 7, 2024 at 11:00 a.m. ET</p> <p class="venue">Zoom and Facebook</p> <p class="loc">Online Event</p> </li> </ul> <p><a class="link-red" href="/washington-dc/aarp-events/" data-formelementid="LOCAL-BTN-CLK-SEEALL-EVENTS">View All AARP Events<i class="ml-1 fas fa-chevron-right"></i></a></p> </div> </div> </div> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_53475" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_53475', size:'300x250'}); } </script> </div> </div> <div class="card-tout card-dark membership-tout" style="margin:0 0 30px 0;"> <img class="img-responsive image" title="image of two AARP membership cards" alt="image of two AARP membership cards" src="https://cdn-aarp.americantowns.com/img/tout-two-cards.png"> <div class="title">Only $12 your first year with Automatic Renewal</div> <ul class="list"> <li>Immediate access to your <a href="https://www.aarp.org/benefits-discounts/">member benefits</a></li> <li>Discounts on travel and everyday savings</li> <li>Subscription to AARP The Magazine</li> <li>FREE second membership</li> </ul> <div class="action"> <a class="btn" href="https://appsec.aarp.org/mem/join?campaignid=UAJFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Join AARP</a> <div class="body">Already a member? <a href="https://appsec.aarp.org/mem/renew?campaignid= UARFT3&intcmp=LNK-CSN-AARPLOCAL-JRTOUT-RR-A-WASHINGTON-DC">Renew</a> or <a href="https://www.aarp.org/benefits-discounts/my-membership/print-your-card/">Print Card</a></div> </div> </div> <style> .membership-tout {padding:16px 20px;} .membership-tout .list li { margin: 0; } </style> <div aria-hidden="true" class="aarpe-ad-wrapper"> <div class="aarpe-ad en clearfix" id="300x250_93505" data-adsize="300x250"> <script type="text/javascript"> if(typeof AARP.ads !== 'undefined'){ AARP.ads.slots({ id:'300x250_93505', size:'300x250'}); } </script> </div> </div> <div class="module-spacer text-center"> <div class="fb-page" alt="Image of AARP District of Columbia Facebook Page" title="Image of AARP District of Columbia Facebook Page" data-href="https://www.facebook.com/aarpdc" data-tabs="timeline" width="320" height="" data-small-header="false" data-adapt-container-width="true" data-hide-cover="false" data-show-facepile="true" lazy="true"> <blockquote cite="https://www.facebook.com/aarpdc" class="fb-xfbml-parse-ignore"><a href="https://www.facebook.com/aarpdc">Facebook</a></blockquote> </div> </div> <div class="ar-basic-box module-spacer"> <header> <h2>Contact AARP<br />District of Columbia</h2> </header> <div class="wrap"> <div class="ar-quick-list module-spacer"> <ul class="list-unstyled"> <li><i class="list-icon fa fa-envelope" alt="Email icon" title="Email icon" aria-hidden="true"></i><a href="mailto:DCAARP@aarp.org " target="_blank" rel="noopener">DCAARP@aarp.org </a></li> <li><i class="list-icon fa fa-globe" alt="Globe icon" title="Globe icon" aria-hidden="true"></i><a href="https://states.aarp.org/region/washington-dc/" target="_blank" rel="noopener">AARP Washington, DC</a></li> <li><i class="list-icon fa fa-map-marker" alt="Map Marker icon" title="Map Marker icon" aria-hidden="true"></i><a href="https://states.aarp.org/aarp-district-of-columbia-state-office/?intcmp=SNG-LNK-AARPLOCAL-CONTACT-20140101-WASHINGTON-DC" target="_blank" rel="noopener">Contact Us</a></li> </ul> </div> <a href="https://www.facebook.com/aarpdc" target="_blank" rel="noopener" aria-label="Open Facebook"><img alt="Facebook icon" title="Facebook icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/facebook-dreamstale25.png"></a> <a href="https://twitter.com/AARPDC" target="_blank" rel="noopener" aria-label="Open Twitter"><img alt="Twitter icon" title="Twitter icon" src="https://cdn-aarp.americantowns.com/img/responsive/icons/48/x-logo-black.png"></a> </div> </div> </div></div> <div class="col-md-8 left-rail left-bot"></div> <div class="col-md-4 right-rail right-bot thin-rhs"></div> </div> <div class="row oneColumnLayout"> </div> <div class="row oneColumnLayout"> <div class="col-md-12"><!-- script to activate navbar --> <script type="text/javascript"> jQuery(".channelBarMain ul.left li a").click(function() { window.location = jQuery(this).attr('href'); }); </script> </div> </div> ' $scripts_for_layout = '<title>How Mid-Atlantic States Are Expanding Home Care</title> <meta name="page_title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="robots" content="noindex, nofollow"/> <meta content="John McNeal, who was paralyzed from the neck down after a motorcycle accident in 1990, likes to brag about his “extraordinarily ordinary” life. The" name="description"/> <meta content="How, Mid, Atlantic, States, Expanding, Home, Care" name="keywords"/> <link rel="canonical" href="https://states.aarp.org/ltss-in-the-mid-atlantic" /> <meta property="og:url" content="https://vccstaging.local.aarp.org/news/how-midatlantic-states-are-expanding-home-care-2023-12-03.html"/> <meta name="twitter:card" content="summary_large_image"/> <meta name="twitter:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta name="twitter:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta name="twitter:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> <meta property="og:type" content="article"/> <meta property="og:title" content="How Mid-Atlantic States Are Expanding Home Care"/> <meta property="og:description" content="For the first time since AARP began publishing the Scorecard in 2011, more than half of Medicaid long-term care dollars nationwide for older adults and people"/> <meta property="og:image" content="https://aarp-states.brightspotcdn.com/dims4/default/74caf2e/2147483647/strip/true/crop/1019x655+61+0/resize/420x270!/quality/90/?url=http%3A%2F%2Faarp-brightspot.s3.amazonaws.com%2Fstates%2F05%2F9c%2F3970b8294cb282b79c6e35bafa9d%2F1140-hero-de-john-mcneal.jpg"/> :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }' $title_for_layout = '{local_city_c}, {local_state} Happenings - AARP' $asset_version = '230831' $min = true $nowrapper = false $css = ' :root { --primaryColor: #ff1e3c; --primaryTextColor: #2a2a2a; --linkTextColor: #1f66bd; --linkHoverColor: #1f66bd; --secondaryTextColor: #000000; --secondaryColor2: #000000; --secondaryColor3: #000000; --secondaryColor4: #000000; --secondaryColor5: #000000; --black: #000000; --white: #ffffff; --grey: #f0efed; --gridGutters: 30px; --modulePadding: 60px; --pageWidth: 86.11%; --maxPageWidth: 1240px; --horizontalAlignment: center; --fontFamily: 'Roboto', sans-serif; --headerBackgroundColor:#000000; --headerTextColor:#FFFFFF; --headerHeight:50px; --footerbackgroundColor:#000000; --footerTextColor:#918883; }' $highlighting = '' $location = '<a href="/washington-dc/?intcmp=CSN-LOCAL-NAV-HOME">Washington, DC</a>' $no_header = false $header_title = '<a href="/washington-dc/happenings/">News Feed</a>' $header_subtitle = '' $isPR = false $navbar = '<nav class="section" role="button" aria-expanded="false" aria-controls="collapse"> <div class="section-toggle">Sections <i class="fas fa-chevron-down"></i></div> <ul class="secondary-menu" id="secondary-menu" role="menu" aria-busy="true"> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/aarp-events/?intcmp=CSN-LOCAL-NAV-OLE" data-formelementid="LOCAL-LNK-CLK-EVENTS">Online & Local Events</a> </li> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/things-to-do/?intcmp=CSN-LOCAL-NAV-TTD" data-formelementid="LOCAL-LNK-CLK-THINGSTODO">Things to Do</a></li> <li role="presentation" class="active"><a role="menuitem" class="menuitem" href="/washington-dc/happenings/?intcmp=CSN-LOCAL-NAV-NF" data-formelementid="LOCAL-LNK-CLK-HAPPENINGS">News Feed</a> </li> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/volunteering/?intcmp=CSN-LOCAL-NAV-VOL" data-formelementid="LOCAL-LNK-CLK-VOLUNTEERING">Volunteering</a> </li> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/home-and-community/?intcmp=CSN-LOCAL-NAV-HC" data-formelementid="LOCAL-LNK-CLK-HC">Home & Community</a> </li> <li role="presentation" class=""><a role="menuitem" class="menuitem" href="/washington-dc/movies/?intcmp=CSN-LOCAL-NAV-MFG" data-formelementid="LOCAL-LNK-CLK-MOVIESFORGROWNUPS">Movies for Grownups</a> </li> <li role="presentation" class="more nosep " id="submenu-more"> <span role="menuitem" class="menuitem" data-formelementid="LOCAL-LNK-CLK-MORE">More<i class="fas fa-chevron-down"></i></span> <ul class="secondary-submenu animate slide-in" id="secondary-submenu"> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/discounts/?intcmp=CSN-LOCAL-NAV-LO" data-formelementid="LOCAL-LNK-CLK-OFFERS">Local Offers</a></li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/local-resources/?intcmp=CSN-LOCAL-NAV-LR" data-formelementid="LOCAL-LNK-CLK-LOCALRESOURCES">Local Resources</a> </li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/jobs/?intcmp=CSN-LOCAL-NAV-WJ" data-formelementid="LOCAL-LNK-CLK-WORK&JOBS">Work & Jobs</a></li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/events/?intcmp=CSN-LOCAL-NAV-CC" data-formelementid="LOCAL-LNK-CLK-EVENTS">Community Calendar</a></li> <!-- <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/healthy-living/?intcmp=CSN-LOCAL-NAV-HEALTHY_LIVING" data-formelementid="LOCAL-LNK-CLK-HEALTHY_LIVING">Healthy Living</a></li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/arts-entertainment/?intcmp=CSN-LOCAL-NAV-ARTS_ENT" data-formelementid="LOCAL-LNK-CLK-ARTS_ENT">Arts & Entertainment</a></li> <li role="presentation"><a role="menuitem" class="menuitem " href="/washington-dc/museums/?intcmp=CSN-LOCAL-NAV-MUSEUMS" data-formelementid="LOCAL-LNK-CLK-MUSEUMS">Museums</a></li> --> </ul> </li> </ul> </nav>' $header_custom = '' $breadcrumbs = array( (int) 0 => array( 'title' => 'News Feed', 'slug' => 'happenings' ) ) $row = array( 'title' => 'Back to News Feed', 'slug' => 'happenings' ) $i = (int) 0include - APP/View/Layouts/aarp_2023.ctp, line 244 include - APP/View/Layouts/aarp_2023.ctp, line 244 View::_evaluate() - CORE/Cake/View/View.php, line 971 View::_render() - CORE/Cake/View/View.php, line 933 View::renderLayout() - CORE/Cake/View/View.php, line 546 View::render() - CORE/Cake/View/View.php, line 481 Controller::render() - CORE/Cake/Controller/Controller.php, line 963 AppController::renderPage() - APP/Controller/AppController.php, line 136 BlogsController::display() - APP/Controller/BlogsController.php, line 81 ReflectionMethod::invokeArgs() - [internal], line ?? Controller::invokeAction() - CORE/Cake/Controller/Controller.php, line 491 Dispatcher::_invoke() - CORE/Cake/Routing/Dispatcher.php, line 193 Dispatcher::dispatch() - CORE/Cake/Routing/Dispatcher.php, line 167 [main] - APP/webroot/index.php, line 118