Massachusetts Long-Term Care

In response to a congressional request, GAO reviewed Massachusetts' long-term care programs for elderly and disabled persons, focusing on state and federal programs and their fiscal year (FY) 1992 funding. GAO found that: (1) in FY 1992, the federal government and Massachusetts spent about $3.3 billion on long-term care for all persons, with the state paying a little more than one-half of the funding; (2) Medicaid accounted for 60 percent of all funding, with numerous federal and state programs providing the rest of the funding; (3) the programs spent about two-thirds of the funding on long-term care in institutional settings; (4) Medicaid provided 80 percent of the $2.2 billion spent on long-term institutional care and about 33 percent of the $1 billion spent on home- and community-based long-term care; (5) home- and community-based long-term care programs covered persons and services not eligible for Medicaid; (6) the programs had differing eligibility requirements and objectives; (7) one Massachusetts agency provided most of the long-term care services to the elderly; and (8) the nonelderly disabled were served by different Massachusetts agencies depending on their age, which could result in disruption of appropriate care delivery.