Long-Term Care

Governors’ State of the State addresses reveal policy and programmatic trends. This document tracks those comments made in such addresses that indicate wider policy initiatives that impact older adults and people with disabilities. A state-by-state analysis of 43 State addresses and budgets helps to illuminate overall trends in aging and disability policies, such as Medicaid changes and the restructuring of state departments and programs affecting long-term services and supports (LTSS).

Published monthly, this report and website tool focuses on state actions in managed care for people who receive Medicaid-funded LTSS and on state initiatives relating to services and costs. The Tracker includes updates on State Demonstrations to Integrate Care for Dual Eligible Individuals, the Balancing Incentives Payment Program (BIPP), states developing or implementing Medicaid State Plan amendments under §1915(i), and states pursuing the Communities First Choice Option under §1915(k).

The National Association of State Units on Aging (NASUA) is pleased to share a comprehensive set of recommendations for reform of the Older Americans Act (OAA) when it is reauthorized by the 109th Congress in 2005. NASUA believes that the forthcoming reauthorization of the Act provides an opportunity to modernize its structures, programs, and services to prepare to serve the next generation of older persons and their families.

State aging and disability agencies have operated within a tumultuous environment for the past several years. It has become increasingly more difficult to reconcile the needs of older adults and people with disabilities with the resources available to address those needs. Five themes are identified from the 2012 state of aging and disabilities surveys, which include the acceleration of Medicaid managed long term services and supports and continuing loss of historical knowledge around the nation.

This letter provides State Directors of State Units on Aging (SUAs) with information regarding the CMS decision to reduce Medicare skilled nursing facility (SNF) payments by 11.1% for FY 2012 (a reduction of $3.87 billion). The decision is supposed to create more efficiency in the Prospective Payment System (PPS). The memo describes the implications of such a decision coupled with frozen or reduced Medicaid payments to SNFs and Long Term Care Hospitals (LTCHs).

This report is the product of a dialogue concerning the role of the Ombudsman program as representation for residents of long-term care facilities in a system that is moving towards home and community-based long-term care. The report follows three key areas in which Ombudsmen can play a role—HCBS, diversion from nursing homes, and transition from institutional care—and considered the program’s resources, federal limitations, and conflicts of interest.

Collaboration between Long-Term Care Ombudsmen and Aging and Disability Resource Centers (ADRCs) is beneficial in making informed long-term care choices. ADRCs are a vital bank of information for people considering home and community-based services in lieu of institutional settings. This report presents findings from a survey of states’ Ombudsman programs on what types of collaboration exist; some work with ADRCs by making referrals, conducting training, and/or exchanging information.

The aging services network is critical for those navigating the “information maze” in order to make informed decisions about long-term services and supports (LTSS). But most of these services do not target the majority of Americans who are private paying consumers. Aging and Disability Resource Centers (ADRCs) are one service that aims to increase the level of services offered to private payers. This report includes the results of a survey measuring ADRCs’ engagement with private payers.

This report is meant to serve as an overview of the State Long-Term Care Ombudsman Program (SLTCOP), which was established to advocate for people living in long-term care facilities. The report is useful to State Unit on Aging (SUA) Directors by providing program history, practices, and unique role in the aging network. The report also discusses the implications for the LTC Ombudsman role as residents move away from facilities to home and community-based services.

The goal of this coordinated national campaign from n4a & NASUA is to provide the resources to implement consumer-centered and cost effective long-term care strategies authorized in the 2006 reauthorization of the Older Americans Act. Empower the Aging Services Network to implement these strategies through a three-pronged program encompassing person centered access to information, evidence-based disease management and health promotion activities, and enhanced home and community-based services.