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This opinion piece was submitted to the Tallahassee Democrat for publication.

Florida’s At the Bottom

By Betsy Tabac

Florida has achieved a new distinction but not a coveted one. The AARP Public Policy Institute reports that Florida is #51, at the very bottom, compared to all the states and the District of Columbia, in care it provides for frail, poor and middle class old people. This finding is reported in AARP’s just released Long-Term Services and Supports State Scorecard, 2020.

The report talks about long-term support and services (LTSS), the very services many older adults need to stay in their homes safely and with dignity as they age. LTSS consist of “day-to-day help needed by people with long-term conditions, disabilities, or frailty. It can include personal care (bathing, dressing, toileting); complex care (medications, wound care); help with housekeeping, transportation, paying bills, and meals; and other ongoing social services.” LTSS also include supportive services provided to family members and other unpaid caregivers.

The report covers five “dimensions” or aspects of LTSS elder-care, researches each state on multiple features within each dimension and then uses the data to compare states to each other.

The first dimension is the affordability and accessibility of LTSS services. The second is choice of setting and provider; third is quality of life and quality of care; fourth is support for family caregivers and last is effective transitions. To access the report, go to

The sorry state of LTSS in Florida is exemplified by an action the Florida legislature took during the last session. One of the tools the state has to monitor its provision of services to elders and other adults with disabilities is a report by the Florida Department of Elder Affairs called Statewide Analysis, Assessed Prioritized Consumer List, Totals by Assessed Rank Level and Program. This is the waiting list of Floridians eligible for, needing, wanting and waiting to receive various home and community-based LTSS services so they do not have to go to nursing homes. A report from April 2020 showed there were 79,258 people in Florida on that waiting list. In Leon and surrounding counties there were more than 25,000 people on the list. Most will die before receiving any state-supported LTSS services.

In keeping with the state’s disregard of frail elders, the legislature passed a law to ensure that this list will be much shorter. Instead of showing the thousands and thousands of Floridians waiting for services, the report will show only those who have the highest priority, about .02% of the total eligible residents. The full scope of need will no longer be available to advocates or the general public.

Florida has the worst track record of all the states in providing LTSS support for its elderly. It’s ironic that, even though Florida is a magnet for retirees, it is not a good state in which to be old, frail, poor or even middle class.

Betsy Tabac is president of Neighbor to Neighbor in the Nenes whose mission is to help elders in Indianhead/Lehigh stay in their homes as long as possible as they age.