Eligibility

The Patient Protection and Affordable Care Act (PPACA) established the Community Living Assistance Services and Supports (CLASS) program, a new federally administered voluntary insurance program to help adults age 18 and over with disabilities pay for long-term services and supports (LTSS). This publication describes the major provisions of the legislation, including requirements for enrollment and eligibility, benefits and services, premium amounts, the CLASS Act trust fund, and timelines.

Integral to the coverage framework laid out in the reform law is a dramatic expansion of the Medicaid program. This primer provides key information about the program today, including a definition of what it is, who and what services are covered, Medicaid expenditures and how they are financed, and information of how health reform reshapes the program for the future.

Review a draft of VHA’s VD-HCBS Procedures including participation requirements, target population details, services and goods offered, allowable expenditures, referral and follow up processes, rate determination and construction, VAMC payments, payment rates for non-professional workers and workload reporting. VA contacts are listed. This is a working document, revised on 3/22/10.

What provisions in health care reform will have the most direct impact on family caregivers? This overview discusses long-term care incentives, including the CLASS Act, Community First Choice Option, the extension of Money Follows the Person demonstration programs and ADRC initiatives. The brief also addresses care quality and coordination, and changes involving health care coverage and health care workforce development.

How are states getting the word out about benefits counseling? The state of Maine created a 'Work Incentives Planning and Assistance' website that has information about free services and eligibility, referral forms that can be printed and mailed to get an appointment, an online request-for-services form, materials for referring agencies, and resources for people with disabilities returning to work. A link to this page is available and could be a useful model for other MIG states.

Looking for sample e-newsletters funded by the MIG grant and geared towards employing people with disabilities? The state of Maine created 'Working Together e-News' as a way of providing timely, relevant, business-oriented information and updates for employers that are interested in diversifying Maine's workforce. An archive of these newsletters are provided on their website and could serve as an example to other states considering a newsletter sponsorship model.

Looking for a sample strategic MIG plan? Through the NYS Strategic Plan, the MISCC Employment committee and New York Makes Work Pay team have developed and implemented a set of cross-systems strategic recommendations to close the employment gap through executive, legislative and budgetary action. Find the Strategic Plan, as well as a link to the New York Makes Work Pay website.

Find national and state by state estimates of the increases in coverage and the associated costs compared to a baseline scenario without the Medicaid expansions in health reform. Findings show there will be large increases in coverage and federal funding in exchange for a small increase in state spending. Since it is impossible to predict the behavior of each state, the analysis examines two participation rate scenarios differing in the strength of outreach and enrollment efforts.

While 1915(c) waivers are a prominent vehicle for the delivery of HCBS, they are not the only mechanism available to States. CMS developed a technical assistance paper that outlines the enrollment authorities that States may consider when designing managed HCBS programs, the review and approval process for each, and rate setting techniques that may be useful. The appendix offers a useful chart outlining the authorities, including their key flexibilities and limitations.

Explore this toolkit, which identifies some of the best reform timelines, resources to help explain temporary high-risk pools, Medicaid and Medicare changes, reform’s impact on private coverage, provisions for small businesses, and the important state role in implementing reform. Included are an extensive listing of experts, contact information, and websites. The toolkit was based on a briefing for journalists, and a link to a webcast of this briefing is included.