1915c

Texas is using its MFP Demonstration to address some of the obstacles to relocation and successful access to community living through interagency collaboration, development of the necessary infrastructure to support relocation, and utilization of evidence-based practices. Attached find two presentations delivered at the 2010 HCBS conference, as well as links to the program’s on-line proposal and operational protocol.

Market approaches must become flexible with broader access to alternate providers and services such as HCBS. In the past, HCBS networks have been expensive to build and at times unwieldy to manage without sufficient dedicated resources. This presentation, which was delivered as the keynote for the September 2010 Medicaid Management Care Congress in Washington, DC., reviews the critical challenges to overcome for success in using HCBS as a strategy to extend care access.

How does ACA provide new financial incentives for states, and create opportunities within existing programs to promote Medicaid HCBS for older persons and adults with disabilities? The number and variety of new options, combined with the prospect of additional federal funds, may give some states added flexibility in balancing their LTC system. Read this fact sheet which enumerates the new programs and modifications to existing ones.

This report is the latest in a series of annual reports that present expenditures data for Medicaid Home and Community-Based Services (HCBS) waivers authorized under Section 1915(c) of the Social Security Act. Table 1 presents reported Federal Fiscal Year (FY) 2009 expenditures for each HCBS waiver in effect during that year. Table 2 presents HCBS waiver expenditures data from FY 2004 through FY 2009 by state. The remaining tables present data according to the populations served in waivers.

Find a listing of caregiver services drawn from numerous sources by DHHS’ New Freedom Initiative Subcommittee on Caregiving members, speakers and other stakeholders. The list is not intended to be exhaustive or all-inclusive. It includes several programs developed to support the caregiver such as Caring From A Distance and the National Caregiver Alliance.

While 1915(c) waivers are a prominent vehicle for the delivery of HCBS, they are not the only mechanism available to States. CMS developed a technical assistance paper that outlines the enrollment authorities that States may consider when designing managed HCBS programs, the review and approval process for each, and rate setting techniques that may be useful. The appendix offers a useful chart outlining the authorities, including their key flexibilities and limitations.

Many obstacles impede states from rebalancing their long-term supports and services (LTSS) programs toward greater emphasis on HCBS alternatives. This brief outlines policy recommendations for reforming the Medicaid-funded LTSS system to support more cost-effective and consumer-oriented long-term care options. The authors discuss the current LTC environment, barriers and promising solutions to rebalancing LTSS, and policy recommendations for improving the Medicaid LTSS system.

An expert explores patterns in services and spending under long-term care programs and examines the rise in HCBS, the existence of waivers from federal and state coverage requirements, and the changing populations who use long-term care services. He concludes with a discussion on the need to reduce the fragmentation and lack of coordination in LTC services by removing the divide between Medicare and Medicaid programs. Listen to the recorded webinar and find Mr. Ng’s published paper.

What are the policy changes related to the continuum of care for older people—specifically long term services and supports (LTSS) and chronic care coordination? This analysis examines major provisions in these areas which are organized into five categories: 1) national insurance for long term services and supports; 2) Medicaid options and incentives to expand LTSS; 3) other LTSS provisions; 4) chronic care coordination; and 5) nursing home reforms.

This presentation was part of the 2007 Government and Vendor Fiscal/Employer Agent Workshop. This presentation provided an update on policies regarding self-direction, with an emphasis on those related to fiscal management activities. The session also answered some of the more frequently asked questions and explored some of the differences between section 1915(c) waiver programs and the new State Plan options for self-directed services.