Long-Term Care

As almost half of the States have implemented MLTSS programs, community-based organizations, will be significantly impacted. At the 2013 HCBS conference, ADvancing States, with support from the SCAN Foundation, held a day-long intensive to discuss these impacts. This report outlines 5 discrete roles that CBOs are well-suited to play in MLTSS programs using as a reference point CMS’ 2013 guidance on MLTSS program design and implementation. To request a hard copy version, email Ali Diaz at adiaz@advancingstates.org.

The Community First Choice (CFC) HCBS plan of California has been approved by the Centers for Medicare & Medicaid Services. CFC is authorized under 1915(k) of the social security act, and is often called a 1915(k) state plan option. This file contains the approved SPA pages of the California State Plan.

The Community First Choice (CFC) HCBS plan of Montana has been approved by the Centers for Medicare & Medicaid Services. CFC is authorized under 1915(k) of the social security act, and is often called a 1915(k) state plan option. This file contains the approval letter, summary form, and approved SPA pages of the Montana State Plan.

The Community First Choice (CFC) HCBS plan of Oregon has been approved by the Centers for Medicare & Medicaid Services. CFC is authorized under 1915(k) of the social security act, and is often called a 1915(k) state plan option. This file contains the approved SPA pages of the Oregon State Plan.

The Community First Choice (CFC) HCBS plan of Maryland has been approved by the Centers for Medicare & Medicaid Services. CFC is authorized under 1915(k) of the social security act, and is often called a 1915(k) state plan option. This file contains the approval letter, summary form, and approved SPA pages of the Maryland State Plan.

Community-based organizations will be notably impacted by States' implementation of MLTSS programs. Case studies on ombudsman programs and care/service coordination–culled from the MLTSS intensive at the 2013 HCBS Conference–complement the issue brief on CBO readiness. The ombudsman case studies highlight activities in Wisconsin, Hawaii, & Minnesota, while the care/service coordination case studies discuss CBO experiences in Massachusetts & Ohio. Both studies feature successful CBO practices.

This study focuses on understanding the rates and patterns of enrollment in Medicaid among individuals already enrolled in Medicare, the factors that predict this transition to dual coverage, and those that predict nursing home entry. This volume of this report is a descriptive examination of the number and characteristics of Medicare beneficiaries who transition to dual coverage in the coming year.

This report describes the different strategies that four states are utilizing to improve the integration and coordination of care for individuals with mental health and substance use disorders. These strategies include introducing new managed care arrangements and care coordination mechanisms, enhanced payment to providers to deliver comprehensive services, and the full integration of physical and behavioral health services in managed care contracts.

The Non-Elderly Disabled Category 2 (NED2) Housing Choice Voucher Program aimed to increase access to affordable housing for non-elderly people (age 62 and under) with disabilities currently residing in institutions, such as a nursing home. This evaluation examined the program's implementation in a subset of communities that received NED2 vouchers and estimated the impact of the program on the change in the rate of community transitions among the eligible population.

Despite states' rebalance of long-term care (LTC) systems with greater emphasis on home and community-based services (HCBS), many low-income elderly, persons with physical disabilities, and persons with intellectual/developmental disabilities continue to reside in institutions. Through an analysis of Medicaid enrollment and LTC claims data, this report provides information on the characteristics of institutionalized enrollees, their stays, and the interaction of institutional services and HCBS.