CLASS Act

President Obama’s proposed budget outlines the Administration’s fiscal and program priorities for FY13. ADvancing States’s preliminary analysis is framed by an interest in aging and disability program funding. The analysis reveals the proposal’s requests for food and nutrition services, independent living, caregiver support, protection of vulnerable adults, and Medicare and Medicaid. The accompanying chart shows the President’s FY12 and FY13 requests for relevant aging and disability programs.

Bowles and Simpson, the co-chairs of the National Commission on Fiscal Responsibility and Reform drafted their recommendations to achieve fiscal sustainability. This analysis provides an overview of the commission’s formation, its structure and recommendations, and its potential impact on the aging and disability networks. The report’s legislative recommendations have implications for Medicaid, Medicare, Social Security, Community Living Assistance Services and Supports (CLASS), and more.

This report examines the importance of Medicaid as a safety net for financing long-term services and supports (LTSS). Most older adults will require some form of LTSS, but paid LTSS can be very expensive. Unpaid, family caregiving has enormous economic value and currently accounts for the greatest portion of LTSS provision. However, if an individual needs paid LTSS, and can't afford LTSS insurance, Medicaid is often needed after an individual spends down their assets.

This critical essay examines how effectively the Patient Protection and Affordable Care Act (ACA) addresses prevailing deficiencies in the nation's long-term care system and whether the ACA will result in meaningful reform. This article also reviews the basic problems plaguing the long-term care sector and the provisions within the ACA meant to address them, including incentives/options for expanding home- and community-based care and a number of research and demonstration projects.

Discussions were conducted to uncover lessons from abroad for Community Living Assistance Services & Supports (CLASS), a federally run voluntary public long-term care insurance program created under the Accountable Care Act of 2010. Discussions were conducted during an international conference of LTC experts, followed by personal meetings & individual correspondence. Findings indicate that programs in the five countries studied have lessons, both positive & negative, relevant to CLASS design.

The Affordable Care Act of 2010 offers options & financial incentives for states seeking to expand systems of long-term services and supports. Many of these opportunities work together & build on existing initiatives, resulting in a strengthened infrastructure for service provision & an LTSS system that meets the needs of Medicaid beneficiaries. Key provisions of the ACA are summarized in this issue brief, followed by considerations for states seeking to take advantage of new opportunities.

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.

Review slides from the CMS Leadership Summit on building capacity and coordinating support for family caregivers and the LTSS direct service workforce, held on September 16-17, 2010. Topics include ACA Opportunities for Family Caregivers and the Direct Care Workforce; Assistance and Support Services for Caregivers; DSW Policy Issues and Challenges; Building Capacity and Coordinating Support for Family Caregivers and the LTSS Direct Care Workforce.