Physical Disabilities

At the beginning of 2013, 16 states had Medicaid managed long-term services and supports (MLTSS) plans, with mandatory or voluntary enrollment. Target populations varied by state. In 13 states, MLTSS plan members were afforded the choice to participant-direct (PD) at least some HCBS services. Based on 5 in-depth state case studies expectations regarding availability and take-up of PD services in MLTSS varied as did methods of communicating expectations. PD varied from 1.2% in AZ to 24% in NM.

This checklist is designed to help consumers and other stakeholders assess state Medicaid Managed LTSS. It is based on federal guidance released in May, Community Catalyst’s paper “Putting Consumers First: Promising Practices for Medicaid Managed Long-Term Services and Supports,” and stakeholder recommendations on meeting consumers’ needs.

This guidance document is intended to provide guidance to states on how to apply the revised protocols for External Quality Review (EQR) of Medicaid managed care organizations, released in 2012, to managed long term services and supports (MLTSS) programs. Although the protocols already apply to MLTSS generally, this document offers specific suggestions to make their application to long term services and supports (LTSS) clearer and provides suggestions, examples and illustrations.

The annual Medicaid Long Term Services and Supports expenditure report includes Medicaid expenditures for all LTSS, including institutional and non-institutional settings, by service category and state. The data come primarily from CMS-64 reports.

In January of 2013, ADvancing States sent a survey to its members and a list of long-term care contacts in the states asking how/where they are serving individuals with these complications and what services have been most effective. The survey is at the request of a ADvancing States member that works closely with their mental health program staff to serve individuals who are eligible for both mental health and aging/disability programming.

State aging and disability agencies have operated within a tumultuous environment for the past several years. It has become increasingly more difficult to reconcile the needs of older adults and people with disabilities with the resources available to address those needs. Five themes are identified from the 2012 state of aging and disabilities surveys, which include the acceleration of Medicaid managed long term services and supports and continuing loss of historical knowledge around the nation.

There are many opportunities for states’ Medicaid information systems and administrative functions to be federally subsidized with funding. This brief describes the variety of administrative systems that qualify for federal financial participation (FFP), including the Medicaid Management Information System (MMIS) and health information technology (HIT). The systems are used to support people with disabilities and older adults.