ADvancing States

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.

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.

There has been effort to create standards for senior centers at a state level. Many State Units on Aging (SUAs) coordinate with Area Agencies on Aging (AAAs) to fund, develop, and foster these standards. This report summarizes findings from a survey of 38 states concerning various areas related to senior centers, including funding sources, operational guidelines, and required services. Most states reported some common practices and 16 states provide guidance for their senior centers.

There are many opportunities for states’ Medicaid information systems and administrative functions to be federally subsidized with funding. This brief describes the variety of administrative systems that qualify for federal financial participation (FFP), including the Medicaid Management Information System (MMIS) and health information technology (HIT). The systems are used to support people with disabilities and older adults.

The federal government reached a compromise to the budget crisis for fiscal year 2011 (FY11) with a bill consisting of billions in cuts to discretionary spending. This analysis of the Continuing Resolution (CR) for FY11 discusses the inconsistent allocation of funding and provides descriptions of the appropriated amounts for different departments and programs, especially those impacting the aging and disability network. The report is complemented by a budget table showing the amount of funds.

The aging services network is critical for those navigating the “information maze” in order to make informed decisions about long-term services and supports (LTSS). But most of these services do not target the majority of Americans who are private paying consumers. Aging and Disability Resource Centers (ADRCs) are one service that aims to increase the level of services offered to private payers. This report includes the results of a survey measuring ADRCs’ engagement with private payers.

A Silver Alert program establishes a notification system to alert the public of missing persons who are elderly or have cognitive impairments. This report identifies which states have Silver Alert programs, those that do not, and those with pending legislation. This report provides a brief summary of the legislations that established programs in certain states, the agencies administering the program, and the program requirements for initiating an alert.