Long-Term Care

Medicaid finances nearly half of all LTSS spending. Review an update to existing data on Medicaid financial eligibility standards for nursing home and HCBS waiver services for older persons and adults with disability. 2009 data were obtained on state selection of optional pathways for eligibility, income and asset standards, cost-sharing and other post-eligibility financial requirements. A copy of the survey instrument and accompanying letter to state Medicaid Directors are included.

Disability rates among older Americans have declined, and the ways in which community-dwelling older people with disabilities managed their conditions have substantially changed over the 20 years covered by this survey. Among those receiving human assistance, the vast majority were helped by family caregivers, who are increasingly taking full responsibility for providing care. Find detailed analyses of the data in two research reports that provide insight into the factors driving these changes.

State-authorized health plans whose members are qualified to receive both Medicare and Medicaid benefits face administrative challenges. This study examines care management practices in four health plans that serve persons who are dually eligible. The authors describe how health plans operationalize their integrated care management approaches and identify a common framework for integrating care.

States are curtailing optional services, extending waiting lists, cutting provider reimbursement, and taking other measures to cope with the worst economic downturn in 70 years according to a comprehensive 50 state survey. Even as state revenues shrink, the demand for services is increasing. On a brighter note, many states may participate in expanded HCBS services through ACA opportunities. Review preliminary findings presented at the National HCBS Conference in September, 2010.

This report offers a cross-site analysis of the goals, objectives, outputs, outcomes, challenges and barriers of nine FY05 FTF grants. It discusses implementation of the grants, summarizes outputs reported by grantees, and concludes with a discussion of barriers and grantee recommendations for supporting FTF efforts at the state and federal level. Basic information about each grant is included, i.e. title, grantee agency, subcontractors, activities, impacts, outcomes, and accomplishments.

Findings in this report focus on what has been learned about the status of grant implementation and factors that facilitate progress early and throughout the implementation period, and progress on grantees’ goals and achievement of Systems Transformation (ST). It presents results for both FY05 and FY06 ST Grantees, builds on findings from the first annual report and focuses on two different stages of implementation for the FY05 grantees (Year 3) and the FY06 grantees(initial 15-months).

Statistics show a significant percentage increase in older persons able to receive LTSS outside of nursing homes, however unnecessary institutionalization is still a routine problem. This report clearly delineates the limitations on progress, including differences in Medicaid structure around nursing home vs. HCBS waiver coverage. The authors recommend specific steps that federal and state governments should take to reduce unnecessary institutionalization.

Review slides from the CMS Leadership Summit on building capacity and coordinating support for family caregivers and the LTSS direct service workforce, held on September 16-17, 2010. Topics include ACA Opportunities for Family Caregivers and the Direct Care Workforce; Assistance and Support Services for Caregivers; DSW Policy Issues and Challenges; Building Capacity and Coordinating Support for Family Caregivers and the LTSS Direct Care Workforce.

Access the latest information on health care reform and learn how it impacts seniors and those with disabilities in your community. Resources include new grant releases, updates, fact sheets, blog links, state-by-state reports, CMS guidance and White House.gov links.

Grant awards totaling approximately $2.25 million to 12 states to implement the Lifespan Respite Care Program were recently awarded, adding to the twelve states that received awards in 2009. Lifespan Respite Care programs are coordinated systems of accessible, community-based respite care services for family caregivers of children or adults of all ages with special needs. Find information about the implementation of the program, and learn more about the key activities of each of the grantees.