Wyoming ranked just outside the bottom 10 on a recent AARP report ranking states for their services and support to older adults. The Wyoming-specific scorecard with an explanation can be seen here.
“The scorecard shows we have plenty of room for investment in more service lines inside the category of home and community-based services,” says AARP Wyoming State Director Sam Shumway. “Our geography and sparse population centers make delivering HCBS difficult in Wyoming, but we know offering more options for home health saves state dollars while treating residents in their home communities.”
Wyoming scored low for a lack of public investment in specific supplies of home and community-based services measured by the scorecard. Wyoming ranked 42nd in the nation for adult day services supply. The Scorecard estimates that the state has only about 13 adult day services slots per 1,000 people over the age of 65, compared to the national average of 54. Wyoming also ranked 35th in assisted living and residential care units per 1,000 population ages 75 and over.
Wyoming also ranked low in LTSS worker wage competitiveness – specifically what is the average wage shortfall that those who work in direct patient services for older adults and the disabled receive when compared to other entry-level jobs. According to the scorecard, Wyoming’s direct care workers make $3.38 per hour less than other entry-level jobs. A lack of available Programs for the All-Inclusive Care for the Elderly (PACE) also hurt Wyoming’s overall score. In previous years, there was a PACE program in Cheyenne, which closed in 2020.
Wyoming showed well when it came to nursing home costs, ranking fourth in the nation with a median nursing home cost of 170% of the state’s median income. Nursing homes in Wyoming also had the nation’s eighth-best percentage of long stay nursing home residents hospitalized within a six-month period. However, high nursing home staff turnover (the nation’s ninth worst) and low nursing home staffing levels (11th worst in the nation) impacted the rankings.
One other component that hurt Wyoming’s rankings is being addressed. Wyoming was scored low due to the lack of an Aging and Disability Resource Center (ADRC) when the data was pulled. Wyoming has since started an ADRC, which allows citizens to call one number to find services available to older adults and those with disabilities in their area. Wyoming’s ADRC is run through the state’s 2-1-1 program, and those interested in finding home health, home-delivered meals, and other services in their area are encouraged to call 2-1-1.
The Wyoming Department of Health has also recently presented on expanding reimbursement for adult day services and an 1115 waiver to provide more in the way of home services. Wyoming’s legislators will have the opportunity to fund those projects during the 2024 Legislative Session, which begins in February.
State Rankings:
- Tier One: 1: Minnesota; 2: Washington state; 3: District of Columbia; 4: Massachusetts; 5: Colorado.
- Tier Two: 6: New York; 7: Oregon; 8: Hawaii; 9: Vermont; 10: New Jersey; 11: California; 12: Rhode Island; 13: Connecticut; 14: Maryland; 15: Wisconsin; 16: Maine.
- Tier Three: 17: Delaware; 18: Nebraska; 19: North Dakota; 20: New Mexico; 21: Pennsylvania; 22: Arizona; 23: Iowa; 24: New Hampshire; 25: Illinois; 26: Alaska; 27: Indiana; 28: Virginia; 29: Utah; 30: Kansas; 31: Michigan; 32: Ohio; 33: Montana; 34: Texas; 35: Idaho.
- Tier Four: 36: South Dakota; 37: Arkansas; 38: Missouri; 39: Georgia; 40: Wyoming; 41: North Carolina; 42: Kentucky; 43: Florida: 44: Nevada; 45: Louisiana; 46: Oklahoma.
- Tier Five: 47: Tennessee; 48: Mississippi; 49: South Carolina; 50: Alabama; 51: West Virginia.
Recommendations
Key recommendations from the report and AARP to strengthen support for long-term care and aging at home:
o Prioritizing support for the 48 million family caregivers, the backbone of the long-term care system, providing over $600 billion in unpaid care, such as with paid leave, tax credits, and other mechanisms to address health and financial needs.
o Investing in all aspects of Home and Community-Based Services infrastructure, such as increasing support and training for home health aides and home visits, supporting the ability to access and use medical devices and equipment, and updating key Medicaid regulations and payment models.
o Bolstering the nursing home and in-home care workforce with improved recruitment and training, increasing pay, and expanding the ability of trained nurses, aides, community health workers, and other paraprofessionals to take on some aspects of care. States can choose to enact and enforce staffing and related care standards.
o Expanding the use of innovative, effective models for nursing homes can improve both quality of care and quality of life, such as with smaller facilities and private rooms.
o Addressing inequities by making investments that close the staggering gaps in access to quality care and facilities and staffing shortages.
o Building multisector plans for aging, coalitions, and age-friendly health systems, and consider the wider needs to allow individuals to live independently in their homes and communities, such as having affordable and accessible housing and transportation, improved community design, and comprehensive emergency preparedness plans.
o Advancing innovation in cities, counties, and states by supporting comprehensive state- and community-wide aging plans and piloting new approaches and programs, like Green House® Nursing Homes and presumptive eligibility, that can then be scaled.
o Ensuring every state in the nation has a sound emergency preparedness plan to support nursing home residents, in particular, in times of crisis – including natural disaster.