ADvancing States

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.

This presentation took place on March 20, 2012 at the Aging in America Conference to demonstrate how the aging network can benefit from working with other agencies to provide more integrated services. Namely, the State Units on Aging working with mental health and substance abuse agencies and programs to provide for more comprehensive care that takes into consideration issues unique to the aging population, such as suicide and alcohol and prescription drug abuse.

Preventive services is one way of cutting down health care costs, as well as detecting health issues early. Medicare beneficiaries have access to many preventive services, including cancer screenings, glaucoma screenings, certain immunizations, etc. This fact sheet provides an overview and chart of the different preventive services available to Medicare enrollees, outlining the different services covered under the different Medicare plans or “parts”, especially Medicare Part B.

This survey was sent to all states and consisted of three questions regarding the enrollment of Medicaid providers of home and community-based services. Of the 23 states that responded, the results highlight different enrollment procedures and opportunities for HCBS providers and varying agency oversight. The results show that Medicaid HCBS provider enrollment oversight varies by state, the majority reporting that the Medicaid agency, as opposed to the state aging agency, manages the process.

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.