All States/Territories

This letter provides guidance to states on how the long-term services and supports-related rules, including the estate recovery rules, in section 1917 of the Social Security Act (the Act), and federal regulations at 42 C.F.R. 435.700, et seq., apply to individuals who are eligible for Medicaid under Modified Adjusted Gross Income (MAGI) eligibility rules (“MAGI individuals”) and receive coverage for long-term services and supports (LTSS).

This checklist is designed to help consumers and other stakeholders assess state Medicaid Managed LTSS. It is based on federal guidance released in May, Community Catalyst’s paper “Putting Consumers First: Promising Practices for Medicaid Managed Long-Term Services and Supports,” and stakeholder recommendations on meeting consumers’ needs.

This guidance document is intended to provide guidance to states on how to apply the revised protocols for External Quality Review (EQR) of Medicaid managed care organizations, released in 2012, to managed long term services and supports (MLTSS) programs. Although the protocols already apply to MLTSS generally, this document offers specific suggestions to make their application to long term services and supports (LTSS) clearer and provides suggestions, examples and illustrations.

New research from AARP and ADvancing States finds that two-thirds of states either have or will launch new initiatives to better coordinate care for people who are dually eligible for Medicare and Medicaid services over the next two years. To contain the growth of costs and improve care, many are moving to risk-based managed long-term services and supports models. This research finds that a number of states are exploring approaches to dual services integration outside of the CMS models.

This report provides a snapshot of the APS program during a period of transition and change. Key elements driving the change include the economic environment, the continuation of states reorganization, and the federal budget impasse and decision of whether or not to fund the Elder Justice Act. ADvancing States and NAPSA will continue to collect data from the states and localities to provide updates on this evolution.

ADvancing States organized members of the Aging Network at listening forums in 3 cities for the reauthorization of the Older Americans Act. The sessions fostered public input, which ADvancing States used to form recommendations for improvement according to its policy principles. The letter outlining these is addressed to Assistant Secretary of Aging, Kathy Greenlee. Some recommendations are to advance the network with more funding and to modernize the language of the Act to reflect person-centered objectives.

The ADvancing States assessment of the AoA funded project to develop a national volunteer resource center to enhance engagement of volunteers in the Aging Network, especially Baby Boomers, consisted of an online scan and three follow-up conference calls with program directors. The results are synthesized in an overall brief and separated by program: Senior Medicare Patrol (SMP), State Health Insurance Programs (SHIP), and Long-Term Care (LTC) Ombudsman programs.

President Obama’s proposed budget outlines the Administration’s fiscal and program priorities for FY13. ADvancing States’s preliminary analysis is framed by an interest in aging and disability program funding. The analysis reveals the proposal’s requests for food and nutrition services, independent living, caregiver support, protection of vulnerable adults, and Medicare and Medicaid. The accompanying chart shows the President’s FY12 and FY13 requests for relevant aging and disability programs.

ADvancing States conducted a survey of state agencies on aging and disability to determine if they conducted participant experience surveys to ensure quality. This asked four basic questions: if the state conducts participants experience survey; the frequency of conducting the survey; how the survey was completed; and who conducts the survey. The appendices include sample participant experience surveys from various states.

Social networking is an increasingly widespread strategy for sharing information. This brief is a summary of a survey ADvancing States undertook of aging network state information and referral (I&R) liaisons to gauge level of knowledge, interest in, and possible future use of social networking. It provides a brief history of social networking as well as potential areas in which the aging network can benefit from it, both for internal use and to communicate with the public.