Scorecard for long-term care services and supports puts Ky. 42nd

AARP's Long-term Services and Supports Scorecard places Kentucky in the next-to-lowest tier. 

By Melissa Patrick

Kentucky Health News

The American Association of Retired Persons' latest Long-term Services and Supports Scorecard, three years after the Covid-19 pandemic, ranks Kentucky 42nd in the nation. That put the state in the next-to-lowest tier, but that was a move up from the the last report, when it was in the bottom tier.  

A state's score is determined by 50 indicators grouped in five dimensions, including affordability and access, choice of setting and providers, safety and quality, support for family caregivers and community integration. Among the 26 indicators with a trend, Kentucky saw "significant improvement" among eight of them, little or no change in 17 of them and a "significant decline" in one of them. 

That was in the "home care cost" indicator in this category, which measures the median annual home-care private-pay cost as a percentage of median household income for people 65 and older. Kentucky's percentage increased to 93%, from 77% last year.

The scorecard ranked Kentucky 42nd for affordability and access, which looks at indicators of whether consumers can easily find and afford services, with a "meaningfully available safety net" for those who can't afford services. 

In the "choice of setting and providers" category, Kentucky ranked 37th, placing it in the bottom tier for this measure. The indicators in this category look at whether the state has a person- and family-centered approach that allows for consumer choice and control of services. This measure also looks at whether the workforce is well-trained and adequately paid, whether home and community-based services are widely provided and whether provider choice fosters equity. 

In this category, Kentucky had the fourth highest average hourly wage shortfall for direct-care workers, with a shortfall of $1.75 less per hour than those of other occupations with comparable or lesser entry requirements across all states.

The state ranked 45th in the "safety and quality" category, which looks at whether consumers are treated with respect and whether they honor their wishes. It also looks at whether residential facilities and other care settings are adequately staffed and are prepared for emergencies and whether its policies and systems prevent disparities in quality and outcomes. 

The report ranked Kentucky 38th for "support for family caregivers," looking at measures that determine whether caregivers are getting the supports they need to continue their essential roles. 

The state ranked 40th for "community integration," which looks at whether consumers have access to services that facilitate long-term services and supports , including affordable housing, age-friendly, livable and drive-equitable communities. In this category, Kentucky was among one of the sixth lowest states when it came to transportation convenience, safety and options. 

The report's executive summary says AARP's "intention is to identify strengths and weaknesses in state systems to spark and inform the development of actionable solutions at the local, state, and national levels— solutions that respond in meaningful ways to individual preferences and family choices and care needs as well as to new pressures and challenges."