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AARP report finds Iowa lacking in services for older and disabled residents

Vollis Simpson
Posted at 3:00 PM, Oct 11, 2023

A new report from AARP says the services available to older and disabled Iowans are “painfully inadequate.”

The report, which looks at long-term care options throughout the United States, says major gaps in service exist in Iowa.

“AARP’s scorecard shows that home- and community-based care options are severely lacking and too expensive for most Iowans,” said Brad Anderson, AARP Iowa’s state director. “We need to re-think our approach to long-term care in Iowa and give Iowans what they want, which is access to quality, affordable care in the comfort of their own home.”

AARP’s Iowa “scorecard” highlights the specific areas judged to be the most problematic in Iowa:

State funding for home-based care — State funding for care that’s intended to help older and disabled Iowans is weighted too heavily toward institutional care, with too few public dollars allocated for home-based care. The report shows that Iowa ranks 38th in Medicaid spending on home-based care. AARP says that reflects the fact that Iowa, unlike other states, still spends a significant majority of state Medicaid dollars on institutions, such as nursing homes, rather than improving the state’s network of home- and community-based services.

The cost of home-based care – The report contends that home-based care, where it is available in Iowa, is too expensive. Iowa ranks near the bottom, 46th among the 50 states and the District of Columbia, in terms of affordability of home-based care.

Inadequate adult day services — Iowa also ranks in the bottom half of states when it comes to providing adult day services for seniors. Individuals who can benefit from support services but don’t need full-time institutional care can often remain in their homes longer is adult day services are an option in their community. The services can allow family caregivers to remain in the workforce while still caring for a loved one.

No access to Green House residences – Iowans have little or no access to so-called Green House facilities modeled after traditional residential houses. Green Houses are smaller than nursing homes, with a dozen or fewer residents, and are intended to duplicate the feel of a private residence. Since the inception of the Green House model by the nonprofit Green House Project 20 years ago, nearly 400 such homes have been built in 32 states.

The AARP report also found that Iowa has significantly more nursing home residents with “low care needs” than most other states – suggesting that some Iowans now receiving institutional care might be better served, and at a lower cost, in their own homes, if home- and community-based services were available.

To view the full AARP scorecard with state-by-state information, visit

Iowa Capital Dispatch is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Iowa Capital Dispatch maintains editorial independence. Contact Editor Kathie Obradovich for questions: Follow Iowa Capital Dispatch on Facebook and Twitter.

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