New Mexico

At the beginning of 2013, 16 states had Medicaid managed long-term services and supports (MLTSS) plans, with mandatory or voluntary enrollment. Target populations varied by state. In 13 states, MLTSS plan members were afforded the choice to participant-direct (PD) at least some HCBS services. Based on 5 in-depth state case studies expectations regarding availability and take-up of PD services in MLTSS varied as did methods of communicating expectations. PD varied from 1.2% in AZ to 24% in NM.

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.

In January of 2013, ADvancing States sent a survey to its members and a list of long-term care contacts in the states seeking information about guardianship laws and practices and about how states assure appropriate use of durable powers of attorney. Review the results from the 20 states who responded.

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 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”.

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.

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).