California

The report presents findings from a 50-state survey examining how well the needs of family caregivers are assessed when states evaluate the needs of older people & adults with disabilities who qualify for HCBS programs under Medicaid. It is the first detailed analysis of family caregiver assessment tools and processes in use by the states in Medicaid waiver programs. The report also highlights “promising practices” in family caregiver assessment in 3 states, and offers policy recommendations.

The annual Medicaid Long Term Services and Supports expenditure report includes Medicaid expenditures for all LTSS, including institutional and non-institutional settings, by service category and state. The data come primarily from CMS-64 reports.

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.

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.

States endow Commissions on Aging Services with different responsibilities. States that have Commissions with more of an oversight nature advise states about aging issues and are responsible for working with legislators, advocating for seniors, and evaluating needs and services. More advisory Commissions offer guidance in identifying and researching aging issues. Results of a ADvancing States survey found that 20 states have Commissions in place, 5 with oversight capacity, and 15 that are more advisory.

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.

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”.