Long Term Services and Supports

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.

The report provides an overview of the expected increased need for direct care workers and a breakdown of the current direct care workforce. In each description of barriers facing the direct care workforce, PHI includes program and policy recommendations. Challenges and recommendations in this report include areas regarding: wages and benefits, training, advanced roles, supervision, recruitment and retention, data collection, decision-making, family caregivers, and matching service registries.

The National Academy of Social Insurance released a report on potential designs for universal family care. The report highlights state program design proposals for early child care and education, paid family and medical leave, and long-term services and supports. The LTSS section of the report proposes four design issues states may face in developing a social insurance program for LTSS.

Many individuals with long-term services and supports (LTSS) needs either reside in institutions or are at risk for institutionalization. Rebalancing care to provide LTSS in the community is one goal of the federal Financial Alignment Initiative for Medicare-Medicaid enrollees. This profile details the experiences of the Health Plan of San Mateo (HPSM) as it implements a pilot program to help dually eligible individuals in nursing facilities transition back to community living.

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.