HCBS

The Centers for Medicaid & Medicare Services released a report that profiled the 10 states with the greatest change in Long-Term Services and Support (LTSS) system balancing. The report highlights characteristics of the 10 states and compares their change in LTSS system balancing with other states and provides a national overview on LTSS system balancing. State profiles consist of characteristics and strategies states utilized in their progress towards rebalancing their LTSS systems.

CMS released an informational bulletin that provides guidance regarding new constructions and the HCBS heightened scrutiny process. The 2014 Medicaid HCBS regulation’s settings regulation requires an in-depth assessment, called heightened scrutiny, for certain providers that are presumed to be institutional. This guidance provides clarification and flexibility to states, including an overview of three potential scenarios for how newly constructed settings could receive Federal funding

This report discusses how HHS can help rural service providers cope with the challenges of meeting the demand for home and community-based services in rural areas. Specifically, GAO recommends the consolidation of information regarding promising practices to allow local officials and rural service providers to more readily access this information.

While faced with new challenges, reduced budgets, and growing populations requiring more services, states are stronger than ever, and the work they do is more effective than ever in reaching individuals and addressing their needs. The National Home and Community Based Services (HCBS) Conference 2018 highlights these achievements, allowing states to share best practices, present unique partnerships, and recognize the work of their peers.

This annual report outlines Medicaid expenditures for all LTSS, including institutional services and HCBS, by service category and state. This report covers trends in total LTSS expenditures, LTSS as a Percentage of Total Medicaid Spending, HCBS as a Percentage of Total Medicaid LTSS, and more.

This paper examines whether there is evidence that MLTSS programs increase access to home and community-based services (HCBS). One theory states that MLTSS programs may reduce costs associated with the use of institutional services, thereby allowing states to expand HCBS services and reduce waiting lists. This brief uses this theory and examines changes in a state's HCBS waiting list as one way to measure access to HCBS.

This paper from AARP’s Public Policy Institute discusses the potential implications of the expanded use of telehealth from the lens of older adults and family caregivers. It discusses the hope that telehealth may help address rising healthcare costs, enable older adults to stay in their homes longer, and relieve pressure for family caregivers. It also emphasizes the importance of keeping older adults and their families at the center of telehealth expansion efforts and continuing research.

This report describes key considerations and policy decisions that states should consider as they work to implement EVV systems in accordance with the mandate included in the 21st Century Cures Act. The paper also examines different approaches that states may wish to use to establish EVV within their HCBS programs, and discusses some of the benefits and challenges associated with each approach. Lastly, it includes case studies of four states with existing EVV systems.

This brief uses a series of interviews to explore the ways that Medicaid health plans can work to meet the nutritional needs of low-income older adults. Best practices identified include hiring staff with strong nutrition experience, using assessments to create targeted interventions, adapting effective programs from other populations, and utilizing community resources. This paper is particularly optimistic about the potential of Medicaid partnerships with community-based organizations.

This report from AARP's Public Policy Institute is part of a series of papers focusing on innovative strategies. It explores the benefits of self-directed care and looks at best practices used in Texas, Iowa, Wisconsin, and Florida. The report also provides a toolkit for educational and training purposes to help states improve and expand upon their self-directed LTSS programs.