HCBS

The Council on Quality Leadership published a Q&A with ACL Acting Administrator and Assistant Secretary for Aging Alison Barkoff about the Home and Community Based Services (HCBS) settings rule in their latest newsletter. The Q&A session explores the settings rule, and how states can implement best practices throughout the transition period for implementation.

The Commonwealth Fund has published a compilation of state successes in transforming long-term care as a resource to support policymakers. This policy guide is the result of a nine-month partnership between CSG and the Commonwealth Fund. Subject matter experts and stakeholders from Arizona, Georgia, Hawaii, Indiana, Minnesota, New York, Pennsylvania and Virginia examine the following focus areas in long-term care: Addressing State Regulation of Long-Term Services and Supports Facilities; Optimizing American Rescue Plan Act Spending on Home- and Community-Based Services Under Medicaid; and Revitalizing the Direct Care Workforce and Supporting Family Caregivers.

This blog post from Mathematica discusses the importance of partnerships between states and the federal government through highlighting topics covered at NAMD's 2022 conference. Sessions touched on innovations developed as part of recently approved 1115 demonstrations in Arizona, Massachusetts, Oregon, and Arkansas which focused on the ways states are providing whole-person care by addressing the health-related social needs of members. The post also explores Mathematica's work with CMS and states to build stronger measurement and evaluation infrastructure for a broad range of demonstrations, including those addressing substance use disorder, mental illness, and health-related social needs.

This report examines weaknesses in the home and community-based services ecosystem and outlines a roadmap to expand community living options that meet the needs of people with disabilities. The report builds upon findings in NCD’s 2021 Progress Report: The Impacts of COVID-19 on People with Disabilities (2021) and Deinstitutionalization: Unfinished Business (2012) and illustrates how each piece of the HCBS ecosystem must operate at full capacity to ensure that appropriate community living options and support systems remain available to the disabilities community.

This Kaiser Family Foundation analysis found that 656,000 people nationwide were on state waiting lists for home and community-based services financed through Medicaid waivers in 2021. This new data is among the latest set of findings from the 20th KFF survey of state officials administering Medicaid HCBS programs in all 50 states and Washington, DC.

New data from USAging shows that existing shortages in the caregiving workforce have grown during the COVID-19 pandemic and make it difficult for older adults to age well in their homes. This new report from USAging reveals that many AAAs and their direct care provider partners across the country are facing workforce shortages hindering their ability to provide home and community-based services to older adults.

Late yesterday CMS released a State Medicaid Director Letter (SMDL 22-003) providing guidance for the first-ever HCBS Quality Measure Set, the first of two planned guidance documents from CMS. The HCBS Quality Measure Set is included in the SMD, starting on page 14. The list of measures includes the NQF number (if applicable), measure steward, and data collection method, as well as information on whether each measure addresses section 1915(c) waiver assurances and/or can be used to assess access, LTSS rebalancing, and/or community integration and HCBS settings requirements.

The Housing and Services Resource Center was created for people who work in the space of housing resources and homelessness services, behavioral and mental health services, independent living services and other supportive services. The Center is part of a partnership between the U.S. Department of Health and Human Services and the U.S. Department of Health and Human Services and the U.S. Department of Housing and Urban Development to expand affordable housing, improve home and community-based services, and address bias in America's long-term care system.

The study examined self-reported data from over 10,200 Medicaid HCBS beneficiaries across 13 states using the NCI-AD survey. Unmet needs for Medicaid HCBS were consistently and significantly associated with poor health outcomes (emergency department visits, hospital stays, and preventative care) and community living outcomes (community participation, relationships with family and friends, satisfaction with how time is spent during the day, and sense of control in life.

On Thursday, October 21, 2021 CMS launched a new “one-stop shop” for state Medicaid agencies and stakeholders on Medicaid.gov to advance transparency and innovation for home and community-based services. Through this new webpage, state Medicaid agencies and stakeholders can access information about states’ plans to enhance, expand, and strengthen home and community-based services across the country using new Medicaid funding made available by the American Rescue Plan Act of 2021 (ARP).