This report is divided into two main parts. First, in the background section we provide an overview of long-term care programs in the state of Pennsylvania. The focus is generally on efforts to provide home and community-based alternatives to institutional care for people with mental retardation or developmental disability (MR/DD) and for disabled elderly. We define long-term care discuss the setting, financing, and some of the demographic trends facing the system, and then we address workforce issues.
In the second part, we introduce and discuss several policy options related to expanding community-based long-term care. For each recommendation, we discuss the rationale and potential costs and benefits. The recommendations range from specific policy changes to adoption of broad principles. Some refer to existing programs that could be expanded and others to initiatives that have been tried in other parts of the country.