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CLS Blog: Long Term Services and Support for Older Adults

Aging and Disabilities

CLS Blog: Long Term Services and Support for Older Adults

May is Older Americans month. This series explores new and growing movements and ideas that help older adults maintain their independence and autonomy throughout later life. We will be exploring alternatives to guardianship, and home and community based services and supports.

Although average life expectancy differs based upon factors attributed to social and environmental health, on average, people in the United States are living longer lives. U.S. Census statistics predict that between the years 2012 and 2050, the population aged 65 and over is expected to double in size (Ortman, Jennifer M, et al).

While Americas are living longer lives, research demonstrates that individuals are also living longer with chronic illness (Lindgren, Bjorn). Consequently, higher rates of chronic illness result in an increased need for healthcare services.

Recent history has demonstrated a societal shift in preference toward aging in the community as opposed to a nursing home. Long Term Services and Supports, LTSS, is an umbrella term used to describe resources that assist individuals with disabilities in maintaining their independence. LTSS provides assistance with a range of daily tasks such as meal preparation, medication management, grocery shopping, transportation, and personal care needs. These services aim to assist individuals with aging safely, in the location of their choice, for as long as possible.

In Pennsylvania, LTSS is provided through “waiver” programs; these programs provide the services necessary to make aging in place possible for individuals with disabilities. These waiver programs allow individuals who are assessed as clinically eligible for nursing home level of care, to receive services in their own home. Waiver programs provide tailored services for a diversified spectrum of needs, catering to individuals with physical and intellectual disabilities, disabling chronic conditions, and behavioral health needs.

Funding for LTSS is provided by Medicaid, a national health coverage program for low-income Americans. Recent research conducted by AARP found home and community based care to be more cost effective than care provided in a nursing facility. On average, a years’ worth of care in a nursing facility costs $92,000; thirty hours of weekly home and community based services, over the course of one year, averages 1/3 the price of nursing facility care (Nguyen, Vivian).

In order to qualify for LTSS, an individual must be determined to be both clinically and financially eligible for care. To begin the process of applying for a waiver program, it is best to contact MAXIMUS, the Pennsylvania Independent Enrollment Broker, at 1 (877) 550 4227 or your local Area Agency on Aging.

If you are experiencing problems with accessing services and supports needed to maintain your independence, Community Legal Services (CLS) can help! The Aging and Disabilities Unit at CLS is equipped with resources needed to advocate for you and your healthcare. Please contact Community Legal Services if you have been denied an application for waiver services, have received a reduction in service hours, or have experienced challenges or dissatisfaction when interacting with a home care provider or service coordination agency.

Ortman, Jennifer M, et al. “An Aging Nation: The Older Population in the United States.” United States Census Bureau, May 2014,

Lindgren, Bjorn. “The Rise in Life Expectancy, Health Trends among the Elderly, and the Demand for Health and Social Care.” National Institute for Economic Research, vol. 142, Mar. 2016.

Nguyen, Vivian. “Long-Term Support and Services.” AARP Fact Sheet, Mar. 2017, Sheet Long-Term Support and Services.pdf.