AARP: The Importance of Self-Directed Long-Term Services and Supports Programs
Self-directed long-term services and supports (LTSS) allow individuals to choose how, when, and from whom they receive care, with over two million older adults and people with disabilities utilizing this model as of 2026. Data from the 2026 Self-Direction National Inventory shows significant enrollment growth across states—ranging up to a 1,100 percent increase in Florida—as well as expanding adoption in all Veterans Affairs Medical Centers for over 12,000 veterans. State agencies generally consider self-directed care to be cost-effective compared to traditional agency models, often costing 20 to 30 percent less per participant while helping address direct-care workforce shortages, particularly in rural areas where participants frequently hire family and friends.
