Long-Term Care

This brief includes the latest (FY 2018) Medicaid HCBS enrollment and spending data from KFF’s 18th annual 50-state survey. It contains data about per-enrollee spending on HCBS by target population and HCBS waiver waiting lists. This issue brief also includes tables with detailed state-level data. One key finding analyzed here is that most HCBS enrollees receive services provided at the state option.

This report is the fourth in a series of publications from the MLTSS Institute, which was established in 2016 to drive improvements in key MLTSS policy areas, facilitate sharing and learning among states, and provide direct and intensive technical assistance to states and health plans. This issue brief focuses on delivering effective care to individuals eligible for both Medicare and Medicaid and aims to lay out the case for state Medicaid agencies to invest in integrated care programs.

The Home and Community Based Services (HCBS) Conference is hosted annually by ADvancing States (formerly known as NASUAD). This event highlights best practices from across the country in home and community-based services. The conference includes federal, state, and local policymakers as well as those who administer, manage, and deliver waiver and other HCBS programs. This link contains all of the slide presentations from the 2019 HCBS Conference.

This fact sheet from the AARP Public Policy Institute takes a closer look at LTSS, revealing insights and new information, such as: what LTSS encompass, who needs LTSS, who provides LTSS, and where people with LTSS reside.

This fact sheet was developed as part of the Center’s Helping States Support Families Caring for an Aging America initiative. Six states – Alabama, Idaho, Iowa, New Hampshire, South Carolina, and Virginia- are involved with the initiative. This fact sheet provides an overview of unpaid family caregiving and lists options state leaders can consider implementing in order to support family caregivers in their state.

The report provides an overview of the expected increased need for direct care workers and a breakdown of the current direct care workforce. In each description of barriers facing the direct care workforce, PHI includes program and policy recommendations. Challenges and recommendations in this report include areas regarding: wages and benefits, training, advanced roles, supervision, recruitment and retention, data collection, decision-making, family caregivers, and matching service registries.

In 2021, under a recently released rule from CMS, D-SNPs will be required to notify the state or state’s designee when enrollees experience Medicare-covered hospital or skilled nursing facility admissions in order to ensure timely transitions of care. The Integrated Care Resource Center has released a brief that examines approaches from three states – Oregon, Pennsylvania, and Tennessee – to develop and implement information-sharing processes for their D-SNPs that support care transitions.

CMS released an informational bulletin that provides guidance regarding new constructions and the HCBS heightened scrutiny process. The 2014 Medicaid HCBS regulation’s settings regulation requires an in-depth assessment, called heightened scrutiny, for certain providers that are presumed to be institutional. This guidance provides clarification and flexibility to states, including an overview of three potential scenarios for how newly constructed settings could receive Federal funding

The National Academy of Social Insurance released a report on potential designs for universal family care. The report highlights state program design proposals for early child care and education, paid family and medical leave, and long-term services and supports. The LTSS section of the report proposes four design issues states may face in developing a social insurance program for LTSS.

This report is the third in a series of publications from the MLTSS Institute. The report identifies the challenges and promising practices in addressing the mismatch between supply and demand for direct care workers in long term services and supports programs, all viewed through the lens of MLTSS programs. This report is co-authored by ADvancing States and Sage Squirrel Consulting, LLC.