Summary: GAO examined how publicly funded programs assess the need for home and community-based long-term care for the elderly with disabilities. This care is provided to persons living at home who, because of a chronic condition or illness, cannot care for themselves. Services ranges from skilled nursing to assistance with day-to-day activities, such as bathing and housekeeping. Under the Medicaid program, 49 states have obtained waivers to provide home and community-based services to low-income elderly persons who would otherwise need institutional care paid for by Medicaid. These states are responsible for developing a care plan tailored to a client's specific needs. A well-designed assessment instrument helps identify all appropriate needs--increasing the likelihood that important aspects of the client's situation will not be overlooked in care planning. Standardized administration of the assessment instrument increases the likelihood that the needs of all clients will be determined in the same way. This report provides information on the (1) comprehensiveness of assessment instruments, (2) uniformity of their administration, and (3) training for staff who do the assessments.
