Ombudsman

This document is designed to enable new State Unit on Aging (SUA) Directors to quickly understand the unique role of the State Long-Term Care Ombudsman Program (SLTCOP). The Older Americans Act (OAA) establishes this program with responsibilities that make it different from other aging programs. Within the network of services provided under the OAA, the LTCOP has some mandates that set it apart from other services.

This chart shows the projected fiscal impact for FY2013 on Older Americans Act programs (such as HCBS Supportive Services, Home-Delivered Nutrition, Long-Term Care Ombudsman Program, and Preventive Health Services) after the passage of the Budget Control Act (BCA) of 2011. The chart displays calculated estimates of fiscal impact from both the Congressional Budget Office (CBO) and the Center on Budget and Policy Priorities (CBPP). Both the CBO and the CBPP estimates show cuts to all programs.

Collaboration between Long-Term Care Ombudsmen and Aging and Disability Resource Centers (ADRCs) is beneficial in making informed long-term care choices. ADRCs are a vital bank of information for people considering home and community-based services in lieu of institutional settings. This report presents findings from a survey of states’ Ombudsman programs on what types of collaboration exist; some work with ADRCs by making referrals, conducting training, and/or exchanging information.

This report provides background on MLTSS to brief the intellectual and developmental disability community, as well as the President and the Secretary of the Department of Health and Human Services, on managed care and changes in LTSS administration so that they may take action and influence outcomes. The report also contains a number of recommendations related to disability stakeholder engagement, choice and self-determination, consumer protections and rights and quality measurement.

This policy brief provides a comparison of CMS’ finalized memoranda of understanding with California, Illinois, Massachusetts, Ohio, and Virginia to test a capitated model and with Washington to test a managed fee-for-service (FFS) model to integrate care and align financing for dual-eligibles. These 2013 demonstrations will introduce changes in the care delivery systems and will test a new system of payments and financing arrangements among CMS, the states and providers.

CMS created a financial alignment demonstration to better promote coordinated care for dual-eligibles. The fee-for-service managed care model has received less attention than capitated managed care. However, this model could be useful in states or regions where traditional managed care organizations are not well established or do not function well. This brief makes some assessments of the advantages and difficulties of the model and identifies elements necessary for successful implementation.

A survey of state aging, disability and Medicaid agencies was conducted in 2012, in order to better understand challenges and concerns for funding and providing quality LTSS. Five common themes were identified in this report, including staff turnover and reductions during a sluggish recovery of state budgets. Other findings include an overall expansion of home and community-based services, LTSS transformation and reduced funding and high demand for non-Medicaid aging and disability services.

States play among the most critical roles in responding to and ameliorating disability unemployment. Find examples of state policy related to disabilities, a selection of state programs and initiatives, descriptions of select federal policy, and primary source documents. Topics covered include housing, employment, community integration, long-term care, health, disability awareness and benefits counseling.