Long-Term Care

This report provides a summary of how long-term services and supports (LTSS) are financed and describes factors that contribute to uncertainty of the future costs for LTSS, including changes in how LTSS will be delivered. Three projections of future LTSS spending for senior populations under different scenarios are offered. These scenarios differ based on projecting the number of people with varying functional limitations and the resulting need for varying degrees of LTSS.

Charts and data illustrate health-related differences between disabled and non-disabled noninstitutionalized adults in this report. Data are from the National Health Interview Survey. One section illustrates differences in access to care and health insurance coverage. Numbers on the prevalence of disabilities, demographics, and health behaviors and risks are also given.

Presentations from NASHP’s 21st annual state health policy conference are now available. The conference is planned by state health policymakers for state agencies' staff, legislators, and legislative staff. Review the presentations to learn how others are improving and innovating healthcare through state-level policy.

This is the eighth consecutive year that state Medicaid officials were surveyed to track program trends. In addition to data on expenditures and enrollment, the report outlines policy enhancements and restrictions in all states and the District of Columbia. The resource ends with a discussion of current key Medicaid issues and perspectives of State Medicaid Directors.

Determining how to optimally balance our demand for the best health care with limited funding represents one of the most challenging policy dilemmas facing the U.S. To help understand how to best accomplish this task, the document authors forecast Medicaid expenditures and enrollment for the next ten years. The data are organized by enrollment groups and service settings/categories.

This letter is another in a series of CMS communications that support state efforts to improve the quality of services and supports provided through the Medicaid Home and Community-based Services waiver program. This communication announces three new items designed to assist states in enhancing oversight and operations: GAO Mortality Study in Developmental Disabilities, HCBS Quality Requirements Grid: A Technical Assistance Tool and the National HCBS Quality Enterprise award to Thomson Reuters.

A symposium was held in January, 2008 to help the nursing and social work professions collaborate to support family caregivers. This report springs from that event. Participants explored caregiver demographics and challenges. It also identifies competency areas, best practices and support strategies for professional partners, as well as priorities for future research in the area.

The Department of Health and Human Services announces $36 million in new grant programs to 28 states to help older Americans, veterans, and people with Alzheimer’s disease to remain in their homes and communities. About $19 million of this involves a collaboration between the Administration on Aging and the Department of Veterans Affairs. The grants are designed to reach people who are not eligible for Medicaid but are at high risk for nursing home placement and to spend-down to Medicaid.

In Los Angeles County, personal care workers (PCW) that meet eligibility requirements can receive healthcare benefits. Since 2003, the Personal Assistance Services Council (PASC) of L.A. County has commissioned annual studies to examine how these benefits have effected retention and quality. Those studies are posted here along with an introductory letter. Visit the PASC website for updates.

A final rule that would allow more Medicaid beneficiaries to be in charge of their own personal assistance services, including personal care services, instead of having those services directed by an agency, was published in the Oct 3, 2008 Federal Register. The rule, effective Nov. 3, 2008, guides states that wish to allow beneficiaries who need help with activities of daily living to hire, direct, train or fire their own personal care, workers including qualified family members.