Meals on Wheels volunteer Sig Phillipoff delivers lunch to Paula Spart recently at her South Bend apartment. Spart is grateful for the service, which is helping her live independently despite a disability. Tribune Photo/MICHAEL CATERINA
Meals on Wheels volunteer Sig Phillipoff delivers lunch to Paula Spart recently at her South Bend apartment. Spart is grateful for the service, which is helping her live independently despite a disability. Tribune Photo/MICHAEL CATERINA
Paula Spart, who lives alone in her South Bend apartment, has a disability that poses many challenges, so she’s grateful for the Meals on Wheels volunteer who brings her a hot lunch every day.

It’s one of the non-medical home care services that are helping Spart live independently for as long as possible.

Many of her fellow Hoosiers aren’t so fortunate. Indiana ranks 51st, or dead last, in “Long Term Services and Supports” for the elderly and disabled and their caregivers, according to a report compiled and released earlier last year by AARP, formerly known as the American Association for Retired Persons. The “scorecard” is part of the organization’s growing efforts to advocate for more nursing home alternatives.

Indiana simply hasn’t kept pace with the rest of the nation on this issue, which will only grow more critical in coming years as baby boomers age, said Bob Applebaum, professor of gerontology at Miami University in Ohio.

“Indiana is a state that continues to spend a large proportion of its Medicaid dollars on the institutional side, rather than on the home- and community-based side,” said Applebaum, who served on a board that advised the AARP on how to gather and analyze data for the report.

That’s driving Indiana’s poor performance in two of the scorecard’s four categories, “affordability and access,” and “choice of setting.”

“What we’ve seen is a lot of states, including Ohio, were in the same category as Indiana but have really changed dramatically,” he said. “Indiana has changed some but it still remains well below the national average. Indiana has been very slow to shift (away from nursing homes).”

Indiana governors and the General Assembly have combined to maintain that policy direction, Applebaum said. In Ohio, the nursing home industry has lobbied hard against change, and has donated generously to General Assembly members’ campaign funds, he said. He didn’t know whether that’s also happened in Indiana, but he would “bet” that it has, Applebaum said.

Despite having an older population than it had a decade ago, Ohio nursing homes have fewer residents today, he said.

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