TOTAL LONG TERM CARE SPENDING FY 2004 NATIONAL TOTAL $89.32 BILLION.  Institutional spending 64.5% $57.60 billion Community Based Spending 35.5% $31.72 billion Institutional services are nursing homes and ICF's MR. Community services are Personal Care Waivers & Home Health. This list is in order from best to worst RANKING OF STATES INSTITUTIONAL COMMUNITY Oregon 29.50% 70.50% New Mexico 32.40% 67.60% Alaska 39.90% 62.10% Vermont 42.30% 57.70% Minnesota 44.10% 55.90% Washington 45.30% 54.70% Wyoming 46.60% 53.40% Colorado 51.50% 48.50% Maine 53.10% 46.90% Kansas 53.10% 46.90% California 55.40% 44.60% New York 56.60% 43.40% Rhode Island 57.90% 42.10% Utah 58.70% 41.30% Idaho 59.20% 40.80% Wisconsin 60.60% 39.40% West Virginia 61.20% 38.80% North Carolina 61.20% 38.80% New Hampshire 61.80% 38.20% Maryland 62.30% 37.70% Connecticut 62.60% 37.40% South Dakota 63.00% 37.00% Oklahoma 63.20% 36.80% Hawaii 63.70% 36.30% Texas 64.00% 36.00% Montana 64.20% 35.80% Missouri 64.50% 35.50% Massachusetts 64.60% 35.40% Nebraska 68.20% 31.80% Virginia 68.30% 31.70% New Jersey 68.40% 31.60% iowa 68.90% 31.10% South Carolina 69.40% 30.60% Nevada 69.90% 30.10% Kentucky 70.30% 28.70% Delaware 71.00% 29.00% Michigan 71.80% 28.20% Indiana 73.30% 26.70% Illinois 73.40% 26.60% Florida 74.00% 26.00% Alabama 74.60% 25.40% Arizona 74.90% 25.10% Georgia 75.20% 24.80% North Dakota 77.50% 22.50% Louisiana 77.60% 23.40% Pennsylvania 77.70% 22.30% Ohio 78.40% 21.60% Arkansas 78.50% 21.50% Tennsssee 82.70% 17.30% Washington D.C. 88.30% 11.70% Mississippi 94.80% 5.20% Maryland ranks 29th overall nationally in institutional vs. community based services spending Data from Medstack