It is nearly impossible for most individuals and policymakers to fully
understand California’s long term care system. Programs, eligibility,
and funding are confusing, leaving most people perplexed. Funding streams
and program rules reside within a framework of interacting federal,
state, and local responsibilities. How does one make sense of what is
needed and what is available? Where are the gaps in services and funding?
How equitable is the distribution of funding and services? What are
the federal, state and local level responsibilities for long term care?
What is the balance of institutional and home-and-community based care
in each community?
This Long Term Care County Data Book is one effort that we hope begins
to help answer these questions by putting the pieces of the long term
care puzzle together in the larger context of demographics and trends.
Funding for this project was provided through a one-time $100,000 Long
Term Care Innovation Grant from the California Department of Aging.
The goal of this project was to identify the most complete and accurate
statewide sources of county-level data and to compile this information
as a resource for decision-makers and others. County level data has
never before been assembled and displayed in such a comprehensive manner.
Formatted into two pages for each county, this Long Term Care County
Data Book provides relevant data on both home-and-community-based, and
facility-based long term care programs, as well as Census 2000 demographic
findings, area wage rates, and housing and transportation data. Key
indicators show how each county ranks compared to all other counties
in California and help to identify emerging long term care issues and
Numerous state departments and agencies are responsible for long term
care programs and services. There is no one department or agency that
uniformly collects and reports all long term care data, although the
Office of Statewide Health Planning and Development maintains comprehensive
county-level Medi-Cal data across many, but not all, provider types.
We obtained information about current long term care programs from readily
available primary data sources and reports. We discovered that there
was sometimes much data but little analytical information. Much of our
data was available by county, but there were significant gaps where
information was not available, data was incomplete, or was not available
by county. The reader should refer to the Data Sources section of the
data book to understand sources and constraints of the data for each
element. For example, several counties show an expenditure for nursing
home facility but display zero (0) persons served. This is because census
count is reported at a point in time (December 31) but expenditures
are displayed as an annual cost. If the facility had no resident on
that date, the persons served would show zero.
Despite our best efforts to capture the best data source, fairly present
the information, and double-check and compare our data, questions will
invariably arise as to how and what data is displayed or how it should
be interpreted. This is exactly the kind of dialogue that we hope the
Long Term Care County Data Book will stimulate. We hope that the information
will be so valuable or the desire to improve it so strong that this
will become an ongoing effort. It is our hope that this document will
stimulate insights that will be useful not only to planners and providers
of services, but also to those who are responsible for making important
policy decisions impacting long term care at the local, state, and national
levels: county agencies and boards of supervisors; state and national
legislators; state agencies; area agencies on aging; adult day health
care planning councils, other agencies and associations interested in
long term care issues, as well as the media and others.
Last, we hope that this document will help to make sense out of the
pieces of the long term care puzzle and to create a sense of urgency
to reform the current fragmented system into one that makes sense to
Californians today and for future generations.
The California Association for Adult Day Services (CAADS) thanks Governor
Gray Davis, the California Legislature, and Lynda Terry, Director of
the California Department of Aging, for providing funding for the Long
Term Care Data Book through a Long Term Care Innovation Grant.
CAADS also thanks all those individuals, organizations, and departments
who provided this long term care data and offered insights and suggestions,
including those individuals and legislative staff who attended several
admisory committee meetings.
CAADS gratefully acknowledges the contributions of the
following individuals who made this Long Term Care Data Book possible:
CAADS Associate Director of Policy & Research
Katrina Middleton and Karen Aschenbrenner
Community Services Planning Council
CAADS Executive Director
© Copyright 2002 by California Association for
Adult Day Services. All Rights Reserved