Aging/Older Adults

The Community First Choice (CFC) HCBS plan of Maryland has been approved by the Centers for Medicare & Medicaid Services. CFC is authorized under 1915(k) of the social security act, and is often called a 1915(k) state plan option. This file contains the approval letter, summary form, and approved SPA pages of the Maryland State Plan.

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.

This study aimed to describe and characterize the published literature on disparities between racial and ethnic groups among individuals with Alzheimer's disease and related dementias. The literature shows consistent and adverse disparities among blacks and Hispanics compared to non-Hispanic whites in the prevalence and incidence of Alzheimer's disease, mortality, participation in clinical trials, use of medications, use of LTSS, health care expenditures, quality of care, and caregiving.

Despite states' rebalance of long-term care (LTC) systems with greater emphasis on home and community-based services (HCBS), many low-income elderly, persons with physical disabilities, and persons with intellectual/developmental disabilities continue to reside in institutions. Through an analysis of Medicaid enrollment and LTC claims data, this report provides information on the characteristics of institutionalized enrollees, their stays, and the interaction of institutional services and HCBS.

This study focuses on understanding the rates and patterns of enrollment in Medicaid among individuals already enrolled in Medicare, the factors that predict this transition to dual coverage, and those that predict nursing home entry. This volume provides estimated econometric models that predict beneficiaries' enrollment in Medicaid, and their entry into long-term nursing home stays.

This report developed new estimates of the program's effects for Program of All-Inclusive Care for the Elderly (PACE) enrollees in eight states based on more recent data. PACE plans provide coordinated acute and long-term care services to nursing home eligible seniors residing in the community.

Shifting the balance in publicly-funded long-term care provision away from institutional care toward greater reliance on home and community-based services has been a federal goal for the past three decades -- a goal often referred to as "re-balancing" state LTC systems. This report explores inter-state variations in LTC expenditure and service use patterns, in terms of institutional and non-institutional services, and also by Medicaid LTC users' age and type of disability.

This report is a comprehensive account of the number of individuals in each state who received Medicaid-funded LTSS in calendar year 2010 based on the Medicaid Analytic eXtract (MAX). The MAX data source is a set of Medicaid administrative data files designed to facilitate Medicaid research. The report identifies the number of people by population group who received institutional and non-institutional services. With some exceptions, State and national data are included.

This report brings together available evidence on the effect of PACE on several key outcomes: Medicare and Medicaid costs, hospital and nursing home utilization, quality of care, satisfaction and quality of life, and mortality. The authors summarize findings from past studies and assess their methodological approach. They improve on these earlier evaluations by conducting a more detailed review of the studies, as well as a more rigorous assessment of the quality of evidence presented in each.

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.