Long Term Care County Data Book

Introduction

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 trends.

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.

Acknowledgements

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:

Project Director
Kathy Daigle

CAADS Associate Director of Policy & Research
Gigi Baniqued

Data Management
Katrina Middleton and Karen Aschenbrenner
Community Services Planning Council

Sincerely,

Lydia Missaelides
CAADS Executive Director

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