Currently, our understanding of the population that needs and uses long-term services and supports (LTSS) is largely derived from studies of people age 65 and older. However, nearly half of all individuals with functional needs are adults younger than 65. This younger population has a wide variety of disabilities and LTSS needs.

In 2018, LTQA, with support from the Commonwealth Fund and in partnership with Brandeis University’s Community Living Policy Center (CLPC), launched a multi-year initiative to fill the data void on LTSS needs of working-age adults (i.e., ages 18-64) with disabilities. Based on earlier work (Environmental Scan, White Paper), LTQA in 2022 completed two state pilots testing a strategy for obtaining better and more current information through a state-level data collection and survey initiative. LTQA partnered with Washington State and Texas to add supplemental questions on LTSS need and receipt to the 2021 Behavioral Risk Factor Surveillance System (BRFSS), a national survey led by the Centers for Disease Control and Prevention (CDC) and administered by states.



The Community Living Policy Center works to improve policies and practices that keep people with disabilities in the community.


The Commonwealth Fund supports independent research on health care issues and makes grants to promote better access, improved quality, and greater efficiency in health care, particularly for society’s most vulnerable, including people of color, people with low income, and those who are uninsured.