HCBS

On March 12, the Centers for Medicare & Medicaid Services (CMS) released a report describing best practices in implementing the Money Follows the Person (MFP) Demonstration. Since its authorization in the Deficit Reduction Act of 2005 (P.L. 109-171), the MFP Demonstration has provided nearly $6 billion to 43 states and the District of Columbia to improve access to home and community-based services (HCBS) for Medicaid-eligible individuals and helped more than 107,128 long-term residents transition from institutions to the community. Developed in collaboration with states, providers, and MFP participants, this report identifies effective state strategies for implementing the key components of the MFP Demonstration...

Justice in Aging has released a fact sheet focusing on Medicaid-funded assisted living facilities and their compliance with federal laws. This resource equips residents and their representatives with advocacy tools to ensure facilities follow the law and treat residents appropriately. Although this guide focuses on assisted living, the relevant federal laws cover any similar residential setting reimbursed through Medicaid HCBS. Accordingly, this guide’s advice generally applies also to HCBS-funded facilities for persons with disabilities, such as group homes and adult residential facilities...

Much innovation in the LTSS system has originated at local levels and later reached the national level after testing and support from the government, foundations and others. A new paper reviews five innovative LTSS programs to explore how they were successfully scaled up and implemented in more places. This report builds on the widely accepted model for understanding the expansion of an innovation developed by sociologist E.M. Rogers, who coined the phrase “early adopter.” Its five recommendations adapt Rogers’s framework to selecting and promoting LTSS innovations.

Late yesterday CMS released a State Medicaid Director Letter (SMDL 22-003) providing guidance for the first-ever HCBS Quality Measure Set, the first of two planned guidance documents from CMS. The HCBS Quality Measure Set is included in the SMD, starting on page 14. The list of measures includes the NQF number (if applicable), measure steward, and data collection method, as well as information on whether each measure addresses section 1915(c) waiver assurances and/or can be used to assess access, LTSS rebalancing, and/or community integration and HCBS settings requirements.

“Aging in place" refers to living independently, safely, and comfortably in one’s home for as long as possible. In order to do so, home modifications and additional support are often needed to ensure that older adults are safe and have their needs met over the course of their aging. During January and February 2022, the University of Michigan National Poll on Healthy Aging asked a national sample of adults age 50–80 about their perspectives on aging in place and how they feel about home modifications and available social supports.

The majority of individuals who need long-term services and supports (LTSS) in the United States rely on unpaid assistance from family and friends. The economic value of the unpaid care they provide is estimated to be over $470 billion annually. Unmet needs and waiting lists for Medicaid Home and Community Based Services (HCBS) place significant strain on individuals with disabilities and their families. This report explores how increasing access to HCBS services can reduce out-of-pocket costs for families and strengthen employment and financial wellbeing of family caregivers.

On Thursday, October 21, 2021 CMS launched a new “one-stop shop” for state Medicaid agencies and stakeholders on Medicaid.gov to advance transparency and innovation for home and community-based services. Through this new webpage, state Medicaid agencies and stakeholders can access information about states’ plans to enhance, expand, and strengthen home and community-based services across the country using new Medicaid funding made available by the American Rescue Plan Act of 2021 (ARP).

States received approval for temporary changes to their HCBS programs from CMS, within the Department of Health and Human Services to enable states to limit in-person contact to reduce the spread of COVID-19. This GAO report describes the temporary changes to Medicaid HCBS programs and examines CMS’s monitoring and evaluation of the effects of those changes.

The GAO released a report on the impacts of the 2013 regulation that revised the domestic service employment and companionship services under the Fair Labor Standards Act (FLSA). This rule, which became effective in 2015, had the effect of extending minimum wage and overtime protections to a broader range of home care workers, many of whom provide Medicaid-funded home and community based services (HCBS).

On July 31, Governor Tom Wolf of Pennsylvania announced, by an executive order, an overhaul of the state services and systems to protect the most vulnerable Pennsylvanians. The executive order establishes an Office of Advocacy and Reform, Child Advocate, and Council on Reform. The executive order also lists responsibilities of the state agencies and the Governor’s Office of Performance through Excellence.