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State Long-term Care Programs: Balancing Cost, Quality, and Access

Projecting Service Need


Lisa Maria B. Alecxih, M.P.A., Vice President, Center on Long-term Care, The Lewin Group, Inc., Falls Church, VA.

Lisa Maria Alecxih presented a new tool that may be used by States to estimate the number of individuals eligible for home and community services under alternative criteria for age, level of disability, and income as a percent of the poverty level. The numbers estimated are for non-institutionalized populations. The model uses national data from the Survey of Income and Program Participation and State level data on age, income and broad measures of disability.

Because the disability measures are very broad they may not be consistent with a State's eligibility criteria for home and community based services waivers. To estimate the cost of a program the number of people already being served must be determined compared to the total who are potentially eligible, as well as a likely participation rate for new eligibles and how much each new eligible will cost.

Additional Resource

Tumlinson A, Ramchand R, Mendelson D. Toolkit: the essential elements of cost estimation. Washington (DC): Center for Health Care Strategies; 2001 Sep.

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