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MLTSS Care Coordination and Ombudsman Case Studies

Community-based organizations will be notably impacted by States' implementation of MLTSS programs. Case studies on ombudsman programs and care/service coordination–culled from the MLTSS intensive at the 2013 HCBS Conference–complement the issue brief on CBO readiness. The ombudsman case studies highlight activities in Wisconsin, Hawaii, & Minnesota, while the care/service coordination case studies discuss CBO experiences in Massachusetts & Ohio. Both studies feature successful CBO practices.

Short URL: http://www.advancingstates.org/node/65962

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Measuring Up: A Novel Approach to Assessing State Oversight of Medicaid Managed Care

The lack of recognized standards for what constitutes sufficient monitoring has hindered efforts to assess the effectiveness of state oversight of managed care plans. This brief describes an approach used to evaluate state oversight of a new Medicaid managed care program for individuals with disabilities in Washington. The approach evaluates both the type and vigor of monitoring activities by the state and the degree to which the state's activities achieved their desired program outcomes.

Short URL: http://www.advancingstates.org/node/65960

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Safety Net Health Plans: Working with Providers in Underserved Areas to Integrate Behavioral Health and Primary Care

Better integration of physical and behavioral health is a critical component of improving outcomes and reducing costs for Medicaid beneficiaries, especially those with high levels of need. This report profiles four examples where the safety net community – health plans, community health centers, community mental health centers, and the centers’ primary care and behavioral health clinicians – have collaborated to develop programs to integrate care for this population.

Short URL: http://www.advancingstates.org/node/65948

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State Standards for Access to Care in Medicaid Managed Care

The OIG report examines state standards and requirements for network adequacy and access to care. The report was based on surveys and interviews of state officials, CMS employees, and External Quality Review Organizations. In the report, OIG notes that state standards on access to care vary widely, and that state oversight of health plans also varies. Based on its findings, OIG offers recommendations to CMS in the report.

Short URL: http://www.advancingstates.org/node/65893

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Evidence-based Best Practices in the Public Vocational Rehabilitation Program that Lead to Employment Outcomes

The state-federal vocational rehabilitation program serves approximately one million individuals a year and spends about $3 billion annually. This article looks at evidence-based best practices from the program.

Short URL: http://www.advancingstates.org/node/65889

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An Inventory of Publicly Funded Participant-Directed Long-Term Services and Supports Programs in the United States

After a decade of changes in federal law, regulation, and policy designed to promote the growth of publicly funded participant-directed long-term services and supports (PD-LTSS) programs, the number of these programs has grown considerably. This article details the process for developing this data resource, describes some of the major characteristics of PD-LTSS programs in the United States, and discusses possible implications and areas for future research.

Short URL: http://www.advancingstates.org/node/65887

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Transitioning Long Term Services and Supports Providers Into Managed Care Programs

This paper identifies the concerns and considerations in transitioning traditional LTSS providers from fee-to-service models to a managed care program.The findings of the study are based on qualitative interviews conducted with a variety of stakeholders, including state Medicaid program officials, representatives from managed care companies, LTSS providers, LTSS provider associations, and private consultants.

Short URL: http://www.advancingstates.org/node/65883

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Strengthening Long-Term Services and Supports: A Tool to Assess and Improve Medicaid Managed Care

This tool promotes consumer-focused MLTSS by making it easier to identify weaknesses and promote better practices. The tool combines a checklist for assessing MLTSS with examples of practices, policies or contract language that implement the criteria.

Short URL: http://www.advancingstates.org/node/65878

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Older Americans Act Reauthorization Listening Sessions

ADvancing States organized members of the Aging Network at listening forums in 3 cities for the reauthorization of the Older Americans Act. The sessions fostered public input, which ADvancing States used to form recommendations for improvement according to its policy principles. The letter outlining these is addressed to Assistant Secretary of Aging, Kathy Greenlee. Some recommendations are to advance the network with more funding and to modernize the language of the Act to reflect person-centered objectives.

Short URL: http://www.advancingstates.org/node/53189

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Charting the Ombudsman Program’s Role in a Modernized Long-Term Care System

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.

Short URL: http://www.advancingstates.org/node/53183

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