ADAPT
OUR HOMES NOT NURSING HOMES
TEN WORST STATES SURVEY 2002/2003
LOUISIANA - THE WORST IN THE NATION
Periodically ADAPT ranks how the states are doing in providing options for people with disabilities and older Americans to live and receive support services in the community. View
the ADAPT Press Release
Looking at the states provision of long term services and supports, our analysis for this ranking weighed various long term care factors based both on published data and on the evaluation of people with disabilities (old and young).
ADAPT used three sources of information to rank the states:
The MEDSTAT Group Inc data on Medicaid long term care expenditure in Federal Fiscal Year 2001; (May,2002)
The State of the States in Developmental Disabilities: 2002 Study Summary; (June 2002)
Advocate's assessment of the states services.(September 2002)
The rankings below are ADAPT's analysis of the above information:
Ten Worst Ranking 
- Louisiana (worst nationally)
- Mississippi
- Washington, DC
- Illinois
- Indiana
- Tennessee
- Nevada
- New Jersey
- Ohio
- Georgia
The next ten worst states: Alabama, Florida, Pennsylvania, Texas, Kentucky, Delaware, Virginia, Maryland, Arkansas and
Missouri.
LOUISIANA - FY 2001 THE WORST IN THE COUNTRY BACKGROUND INFORMATION
Louisiana spends 90.3% of Medicaid Long Term Care (LTC) dollars on nursing homes and ICF-MR facilities;
This funding bias exists:
- 30 years after the passage of Section 504
- 12 years after the passage of the ADA
- 2 years after the Supreme Court's Olmstead decision
 THE NUMBERS:
Nursing Homes: 69% on facilities for people with disabilities, old and young
ICF-MR: 21.3% on facilities for people with developmental disabilities
Community spending: 9.7% (Medicaid waivers, Home Health)
Total Louisiana Medicaid LTC spending: $1.68 billion
- Louisiana Medicaid spending on nursing homes: $1.16 billion
- Louisiana Medicaid spending on ICF-MR: $ 355.27 million
- Louisiana Medicaid total spending on Community: $ 163.43 million
State's ratio of nursing home beds per capita exceeds national average by more than 50%. This means Louisiana has more beds than it needs (20% are empty).
The states ratio of ICF-MR beds is three times the national average.
Louisiana Medicaid per capita spending nursing homes: $259.43 (over 70% higher than national average)
National Medicaid per capita spending nursing homes: $150.04
Louisiana Medicaid per capita spending on ICF-MR: $79.57 (over 115% higher than national average)
National Medicaid per capita spending on ICF-MR: $36.35
Louisiana Medicaid per capita spending on Community: $36.60 (Less than 1/2 the national average)
National Medicaid per capita spending on Community: $77.99
Access to Long Term Care is uncoordinated across programs. Louisiana's system is fragmented and difficult for people to access.
Attendant wages average $5.56 - only 7% have health benefits.
ADAPT'S TEN WORST STATES SUMMARY BACKGROUND
LOUISIANA:
90.3% of long term care spending goes for nursing homes and other institutions. Spends less than 1/2 the national average per capita on community services. 5th highest spending per capita on nursing home services. 3rd highest spending per capita for ICF-MR facilities for people with developmental disabilities.
MISSISSIPPI:
90.7% of long term care spending goes for nursing homes and other institutions. 47th in community fiscal effort for persons with developmental disabilities. 23rd in per capita spending on nursing homes.
WASHINGTON DC:
94% of long term care spending goes for nursing homes and other institutions. 5th lowest spending per capita on community services. 4th highest spending per capita on nursing homes. The highest per capita spending on ICF-MR facilities.
ILLINOIS:
85.6% of long term care spending goes for nursing homes and other institutions. 6th lowest spending per capita on community spending. 42nd in community fiscal effort for persons with developmental disabilities.
INDIANA:
85.3% of long term care spending goes for nursing homes and other institutions. 7th lowest spending per capita on community services. 34th in community fiscal effort for person with developmental disabilities.
TENNESSEE:
84.6% of long term care spending goes for nursing homes and other institutions. 8th lowest spending per capita on community services. 39th in community fiscal effort for persons with developmental disabilities.
NEVADA:
74.7% of long term care spending goes for nursing homes and other institutions. 2nd lowest spending per capita on community services. Lowest in the nation community fiscal effort for persons with developmental disabilities.
NEW JERSEY:
81.9% of long term care spending goes for nursing homes and other institutions. 6th highest spending per capita on nursing homes. 41st in community fiscal effort for persons with developmental disabilities.
OHIO:
85.1% of long term care spending goes for nursing homes and other institutions. 6th highest spending per capita on ICF-MR facilities. 12th highest spending per capita on nursing homes.
GEORGIA:
79.4% of long term care spending goes for nursing homes and other institutions. 4th lowest spending per capita on community services. 50th in community effort for persons with developmental disabilities.
Dear Advocates for Home and Community Services:
These are the "Ten Worst States."
Use this information to reform the long term service and support system. Hold a press conference to highlight the poor job these states are doing, and issue a challenge to state officials to improve the community service system. COMMUNITY FIRST!
In addition to the "Ten Worst" we listed the next 10 states that, though not making the "Worst" list, are also particularly bad in providing residents community services.
Though being in the worst category is nothing to be proud of, it gives your state the opportunity to commit to using 2002/2003 as a year to improve community services.
If you have any question please contact us at 512/442-0252.
For an Institution Free America,
The ADAPT Collective
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