ADvancing States

The debate surrounding the deficit reduction and the debt ceiling for FY 2012 has many implications for aging and disability policies, especially Older Americans Act (OAA) services. This brief outlines the current negotiations and proposals put forth to reach a long-term, bipartisan budget reduction agreement, including the McConnell Plan; the McConnell-Reid Plan; the Gang of Six; the Coburn Plan; and the Senate Budget Resolution. The Congressional Appropriations process is also discussed.

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 analysis of the President’s $3.73 trillion proposed budget for FY12 includes an outline of each funding recommendation for discretionary, appropriated programs. Included in the analysis is a comparison of HR1, the GOP-backed budget resolution that reduces spending via broad cuts, with the President’s proposed budget; a good indicator of what sorts of budgetary windows may be necessary for bipartisan support and how the budget may affect the fiscal health of aging and disabilities programs.

Governors’ State of the State addresses reveal policy and programmatic trends. This document tracks those comments made in such addresses that indicate wider policy initiatives that impact older adults and people with disabilities. A state-by-state analysis of 43 State addresses and budgets helps to illuminate overall trends in aging and disability policies, such as Medicaid changes and the restructuring of state departments and programs affecting long-term services and supports (LTSS).

Published monthly, this report and website tool focuses on state actions in managed care for people who receive Medicaid-funded LTSS and on state initiatives relating to services and costs. The Tracker includes updates on State Demonstrations to Integrate Care for Dual Eligible Individuals, the Balancing Incentives Payment Program (BIPP), states developing or implementing Medicaid State Plan amendments under §1915(i), and states pursuing the Communities First Choice Option under §1915(k).

The National Association of State Units on Aging (NASUA) is pleased to share a comprehensive set of recommendations for reform of the Older Americans Act (OAA) when it is reauthorized by the 109th Congress in 2005. NASUA believes that the forthcoming reauthorization of the Act provides an opportunity to modernize its structures, programs, and services to prepare to serve the next generation of older persons and their families.

Review a new survey of organizations that provide services within the I&R/A Network. The following themes emerged from the survey: aging and disability networks continue to integrate; the use of technology in I&R/A service delivery is slow to develop; the role of I&R/A organizations is expanding; and there are opportunities for improved coordination and quality service delivery. Review the recommendations that address these themes.

State aging and disability agencies have operated within a tumultuous environment for the past several years. It has become increasingly more difficult to reconcile the needs of older adults and people with disabilities with the resources available to address those needs. Five themes are identified from the 2012 state of aging and disabilities surveys, which include the acceleration of Medicaid managed long term services and supports and continuing loss of historical knowledge around the nation.

This letter provides State Directors of State Units on Aging (SUAs) with information regarding the CMS decision to reduce Medicare skilled nursing facility (SNF) payments by 11.1% for FY 2012 (a reduction of $3.87 billion). The decision is supposed to create more efficiency in the Prospective Payment System (PPS). The memo describes the implications of such a decision coupled with frozen or reduced Medicaid payments to SNFs and Long Term Care Hospitals (LTCHs).

This report is the product of a dialogue concerning the role of the Ombudsman program as representation for residents of long-term care facilities in a system that is moving towards home and community-based long-term care. The report follows three key areas in which Ombudsmen can play a role—HCBS, diversion from nursing homes, and transition from institutional care—and considered the program’s resources, federal limitations, and conflicts of interest.