Eligibility

Money Follows the Person (MFP) is one program that appropriates federal grants to states to design programs to transition Medicaid beneficiaries from institutional care to home and community-based services. Beginning as a demonstration program, there are many impediments and uncertainties surrounding implementation. This overview provides a description of impediments as an opportunity for solutions that anticipate implementation issues and touches upon program start up, capacity, and access.

The goal of this paper is to identify programs around the country associated with serving and coordinating the care of individuals with disabilities. CHPR conducted a literature search, a series of interviews with national experts, & a review of 6 promising practices. Included in the review: planning; implementation; eligibility; funding and authority; contracting; delivery system and services offered; care management and care coordination processes; evaluation and outcomes; and replication.

What has the ACA achieved over the past two years? According to the report, the ACA provides important insurance consumer protections, such as prohibitions on pre-existing condition exclusions, lifetime limits, and annual limits on certain benefits. Review a highlight of other key achievements.

Interested in how to use media to market your program? Minnesota has developed short video clips to make it easier for consumers to learn about “You Decide. Your Help.” The following video segments show viewers how to use the consumer directed service option to provide the help you need to continue to live at home. These clips give viewers the basic information on what the option is, who is eligible and who to contact for more information.

How has Utah used it's MIG grant to better serve its disabled population? The Mission of the Division of Services for People with Disabilities (DSPD) is to provide long-term supports and services. This handout summaries the agencies' goals, application requirements, services, eligibility and includes a separate section geared specifically to the blind and visually impaired. Written for potential clients, it can also provide a detailed outline of how any state could structure their own program.

This public policy issue brief from the Alzheimer’s Association describes functional eligibility issues for people with dementia and discusses how six states determine eligibility for Medicaid-funded long-term care services. Based on an analysis of these states provisions, the paper makes recommendations for appropriately assessing the long-term care needs of people with dementia, and for setting level-of-care criteria that treat people with physical and cognitive impairments equitably.

This innovative disability and health data tool uses data from the Behavioral Risk Factor Surveillance System (BRFSS) to identify disparities in health between adults with and without disabilities. Find data on a range of health indicators for your state and compare the health of adults with and without disabilities and certain health conditions. Maps, data tables and state profiles are available.

This bulletin reviews policy when Medicaid funding is available for certain administrative costs related to activities conducted by state Long Term Care Ombudsman (LTCO) programs that benefit the state's Medicaid program. It also summarizes the basic requirements for Medicaid administrative claiming of LTCO program activities and provides a link where states and LTCO programs can find more information regarding specific program activities that may be eligible for Medicaid administrative funding.

This summary draws attention to some of the most important aspects of CMS’s recently released guidance for states and stakeholders on the use of managed care for long-term services and supports (MLTSS) as well as transitioning LTSS providers into managed care systems and developing MLTSS programs. CMS identified 10 important elements that should be incorporated into managed LTSS and this document can assist consumers and their representatives in understanding these elements.

Few employer-sponsored and private insurance plans offer the range of services that workers with disabilities may need. Medicaid Buy-In programs are a viable option that allows these workers to receive needed services without spending down for Medicaid. This report describes findings from a study of characteristics and service utilization of higher-income enrollees compared to regular Medicaid enrollees. Providing these programs may keep higher-income workers with disabilities employed.