Long-Term Care

Special Needs Plans (SNPs), authorized by the Medicare Modernization Act, offer state Medicaid programs a new potential vehicle for coordinating Medicare and Medicaid benefits for dual eligibles. This report investigates the degree to which states (and plans) are using this option to develop more fully integrated Medicare-Medicaid models for dual eligibles needing long-term care services.

Recognizing the importance of measuring progress toward rebalancing, CMS contracted with Thomson Medstat to develop a model profile of one state and a companion technical assistance guide that other states can readily use to replicate and adapt the profile. Review Pennsylvania’s profile based upon their long-term support system across all disability and age groups. The technical assistance guide illustrates what a profile can provide and discusses the methods for development.

This letter announces the availability of a new technical assistance tool for use by States who wish to assess the current state of their long-term care systems, including their progress towards rebalancing. \"A Model State Profile for Assessing a State Long-Term Care System\", along with a \"Technical Assistance Guide to Assessing a State Long-Term Care System\" are now available on the CMS website.

Putting innovative research to work in the policymaking process takes tenacity and understanding on the part of researchers and lawmakers. This report offers a four-stage framework to support effective use of research in health policymaking and improve communications between researchers, state policymakers and program administrators. Review a case study from Massachusetts plus communication strategies and key practical lessons on understanding, developing, implementing, and evaluating policy.

The Georgetown University Long-Term Care Financing Project has two newly-revised fact sheets National Spending on Long-Term Care, looks at total spending for nursing home and home care services nationwide, in total and by major payers. Medicaid and Long-Term Care, describes Medicaid's role in financing long-term care, with a particular focus on home and community-based services and how states' provision of these services may be affected by the policy changes in the Deficit Reduction Act of 2005.

Is there a growing recognition that loneliness, helplessness, and boredom plague long-term care? This report examines six issues facing policymakers: financing and insurance, supporting and educating caregivers, the challenges of changing the physical and organizational environments in which services are delivered, recruiting and retaining a qualified workforce, designing a more effective regulatory control system, and adapting and integrating health information technology to long-term care.

Medicaid clients and advocates have stressed the importance of case management services to ensure that clients have access to supports, choice among providers and services to meet their needs. Quality became a primary topic of discussion for the Quality for Equality (Q4E) Committee. The Q4E identified concerns regarding the process by which the Department and case management agencies incorporate client input into quality improvement initiatives. Review the Q4E’s final report and recommendations.

This report describes examples of more narrowly focused state legislation that is setting the policy and infrastructure for consumer direction, expanding the direct care workforce, and supporting persons who return to the community after living in institutions. The Appendix includes the specific legislative language of selected bills covered in the report.

An advisory committee of consumers, providers, practitioners, advocates and experts worked collaboratively to identify the major challenges preventing people with mental illness from discharging out of nursing facilities and into less restrictive communities. This report is a result of their work and aims to make available a framework for successful transition programs. The best practices described are offered as a guide for service providers, advocates, and mental health clients themselves.

HCBS.org News CLIPS highlights the important work of Real Choice Systems Change Grantees. In each issue, we examine a topic related to home and community-based care by providing an overview of recent papers and publications. The Fall issues provides an overview of the reports available on Money Follows the Person, a program that allows states to rebalance their long-term care support systems to support people in community-based alternatives rather than institutional settings.