HCBS

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 2017 highlights these achievements, allowing states to share best practices, present unique partnerships, and recognize the work of their peers.

During calendar year 2015, ADvancing States engaged in a collaboration with the DentaQuest Foundation to identify and promote effective oral health interventions for older adults and people with physical disabilities. This initiative involved collaborating with partners from the dental, aging, and disability fields in order to increase knowledge regarding issues and challenges related to dental services for older adults and people with disabilities.

UnitedHealthcare Community & State released a White Paper unveiling a proposed quality framework for MLTSS programs. The framework, developed by UnitedHealthcare's National Advisory Board, extends beyond traditional clinical measures to measure the quality of the "services and supports" delivered in MTLSS, which is often most important for those accessing MLTSS benefits.

The Kaiser Commission of Medicaid and the Uninsured published an issue brief on the system design of Medicaid's current home and community-based (HCBS) programs.

The National Center for Health Statistics' Long-Term Care Statistics Branch released a report on variation in residential care community nurse and aide staffing levels in the United States. This report presents national and state estimates of staffing levels in residential care communities for registered nurses, licensed practical or vocational nurses, and aides in the United States for 2014.

Mathematica Policy Research submitted several reports on proposed methods for developing and testing risk and reliability. The important contribution for this work is the development of a risk adjustment methodology that can be applied to Medicaid quality measures of the HCBS population. These resources include: Risk Adjustment of HCBS Composite Measures- Volumes 1 and 2; Development of an HCBS Pressure Ulcer Measure- Volumes 1 and 2; and Development of HCBS Quality Measures webinar and slides.

The Bipartisan Policy Center (BPC), with funding from the SCAN Foundation, published a report offering recommendations to improve the financing of long-term care. The BPC published another report in April 2014 that examined the challenges in financing and delivery. This report is a follow up of those findings that offers recommendations to improve these issues.

This Primer is a design guide for state policy makers who are considering acuity-based resource allocation. Included in the report is: background information on different HCBS case mix approaches, the steps in the development of a case-mix resource allocation system, essential decision points to consider during the state policy development process, and best practice recommendations. This Primer is recommended as a tool for policy makers, state staff, and stakeholders.