Washington

This brief reviews Medicaid’s importance and limitations when it comes to long-term care and makes the case for strengthening Medicaid’s safety net in one of two ways—assumption of full federal responsibility for Medicare beneficiaries who also rely on Medicaid (so-called “dual eligibles”) or an enhanced federal match for Medicaid long-term care services.

NCI is a voluntary effort by public developmental disabilities agencies to measure and track their own performance. The core indicators are standard measures used across states to assess the outcomes of services provided to individuals and families. Indicators address key areas of concern including employment, rights, service planning, community inclusion, choice, and health and safety.

Many states are undergoing long-term services & supports (LTSS) transformations. The lagging economy & increased demand for publicly funded LTSS are placing pressure on state policymakers to find solutions. As a result, many states either have or plan to implement Medicaid Managed LTSS, with 12 states having existing programs & another 11 with plans for implementation. Many states used the economic downturn as an opportunity to balance services from institutional to non-institutional settings.

Despite continued fiscal pressures on states, eligibility policies remained stable in nearly all state Medicaid and Children's Health Insurance Programs during 2011. Moreover, many states used technology to increase program efficiency and streamline enrollment. The "maintenance of eligibility" requirement in the Affordable Care Act (ACA) played a key role in preserving coverage levels. Without it, more states likely would have limited eligibility or tightened enrollment procedures.

Enrollment in MFP continued to grow steadily with 15,818 cumulative transitions to the community as of June 30, 2011, a 33 percent increase from the end of 2010. The states reported 3,722 new transitions during the six-month period from January to June 2011, 9 percent more than in the previous six-month period. The report provides an overview of state MFP grantee progress on key performance indicators and challenges states reported when implementing their transition programs.

State aging & disability agencies are operating in an era of state agency reorganization, re-conceptualization of state government, & restructuring of long-term services & supports delivery systems & financing. Key elements driving continued change include the economic environment, ACA implementation, uncertainty in the federal budget particularly with the failure of the Congressional Super Committee, changes in state level leadership, & the 2012 elections.

The latest HCBS data from The Kaiser Commission on Medicaid and the Uninsured and the University of California at San Francisco analysis of The Centers for Medicare & Medicaid Services (CMS) Form 372 have been added and are available for all states and the nation for 2008. This website allows you to do an interactive search. Review the updated topics including total HCBS waivers, participants by waiver type, home health expenditures, and personal care participants.

Using six states as examples, this report illustrates how the DD Network partners, working with each other and in collaboration with state developmental disability agencies and others, have positively affected the lives of hundreds of thousands of individuals with intellectual and developmental disabilities - assuring their rightful place as full community members through advocacy, research, training, and programs that directly support individuals and families.

This report is the latest in a series on expenditures for Medicaid waivers authorized under Section 1915(c) of the Social Security Act, also known as home and community-based services waivers. For the first time, the tables include state-reported data for 1915(c) waiver services provided through managed care programs that are not identifiable in the state CMS 64 reports. Thomson Reuters collected these data for FY 2008 and FY 2009.

This document is the latest in a series of reports on Medicaid long-term services and supports (LTSS) spending. This year’s report contains newly available data and changes in the services that are included within LTSS. The report explains the changes, summarizes the data, and describes national trends.