ADvancing States

This presentation at the 2012 Aging in America Conference provides an overview of the basics of Medicaid and traces the major trends in reform, including the Olmstead decision and subsequent move toward home and community-based services; the promulgation of Medicaid Managed Long-Term Services and Supports (LTSS); and a focus on “dual eligibles”.

This is a summary of the results of a mini-survey conducted in January 2012. The purpose of this survey was to gain insight on different states’ requirements for Medicaid-funded personal care attendants (PCAs). The results from 24 respondent states showed variation in requirements, from required background checks to CPR training and other educational and health requirements.

The Senior Community Service Employment Program is the only federally mandated job training program that explicitly serves low-income adults, age 55 and older, to promote economic self-sufficiency and community service. This paper provides an overview of the program’s goals, its structure in different states, its funding, and the relationship between stakeholders. The mission of the SCSEP serves to empower older individuals by making them more employable in both the public and private sectors.

There are many questions surrounding the debt ceiling. This Q & A answers many of the questions State Units on Aging Directors and their staffs have had regarding the debt ceiling, the federal government’s obligations, and implications for obligations such as Social Security, Medicare and Medicaid. It is a guide to understanding the basics of the debt ceiling and the implications for not increasing it.

Determining the federal budget for the coming fiscal year (FY) is nearly a year-long process. This flow chart explains the federal budget’s lifecycle—from federal agencies’ justification for funds to the House and Senate Appropriations Committees to the President’s authorization. It is a concise visualization of the process leading up to a federal fiscal year commencement.

The Administration on Aging makes funds available to grantees through state Discretionary and Formula grants. This table lists the grant estimates for FY11 and FY12 and compares them to the actual discretionary state formula grant allotment for FY10. The different programs included in the table are Home and Community-Based Services, Nutrition Services, Preventive Health Services, Family Caregiver Support Services, Long-Term Care Ombudsman Program, and Prevention of Elder Abuse and Neglect.

States administering the Older Americans Act (OAA) have the option of providing recipients with a choice to cost share when using services. This brief explains the stipulations and parameters surrounding cost sharing – what OAA services allow or prohibit cost sharing and under what circumstances must services be provided when clients are unable to pay the cost share.

A February 2012 online survey consisting of 30 questions was sent to all states and focused on three topics: consumer-directed personal care services; assessments and care plan changes; and case management. The survey results provide information about respondent states’ practices regarding Medicaid funded LTSS. Consumer-directed care was found to be provided majorly through waivers; most assessments contracted out; and case management paid for as a service rather than administrative cost.

Budgeting is a crucial aspect in the deliverance of Older Americans Act (OAA) services. This brief provides information geared at State directors to help them better understand various funding sources and requirements. This summary explains the Inter-State Funding Formula on which the Administration of Aging (AoA) distributes OAA funds as well as the Intra-State Funding Formula (IFF) on which states distribute OAA funds.

Money Follows the Person (MFP) is one program that appropriates federal grants to states to design programs to transition Medicaid beneficiaries from institutional care to home and community-based services. Beginning as a demonstration program, there are many impediments and uncertainties surrounding implementation. This overview provides a description of impediments as an opportunity for solutions that anticipate implementation issues and touches upon program start up, capacity, and access.