Financing HCBS

The Robert Wood Johnson Foundation and National Academy for State Health Policy created a resource that explains the funding sources available to states for meeting the health-related social needs of low-income persons. The publication specifically brings attention to funding sources that states can use to help adult high-cost/high-need residents live.

The Employment Policy and Measurement Rehabilitation Research and Training Center, with funding from the National Institute on Disability and Rehabilitation Research, published a report on financing transition services. Multiple funding streams, or braiding of resources, are used to fund the services and supports available for transition-age youth seeking employment or higher education. This report examines who the payers of last resort are based on different regulatory and legal requirements.

This Primer is a design guide for state policy makers who are considering acuity-based resource allocation. Included in the report is: background information on different HCBS case mix approaches, the steps in the development of a case-mix resource allocation system, essential decision points to consider during the state policy development process, and best practice recommendations. This Primer is recommended as a tool for policy makers, state staff, and stakeholders.

The Medicare Board of Trustees released their annual report to Congress on the financial operations and actuarial status of Medicare on July 22, 2015. The report included a projection indicating that the trust fund will remain solvent until 2030, which is 13 years longer than the 2009 prediction. Medicare covered 53.8 million people last year and the report provides a break down of the expenditures of each individual part of Medicare and its overall cost.

Convergence Center for Policy Resolution and the Long Term Care Financing Collaborative released two papers regarding the affordability and vision for delivery of long term care in the United States. The papers reflect the idea that the role of families and communities must be recognized when delivering long term services and supports. Additionally, giving elders the ability to finance their own care increases independence and autonomy and allows for support of family members and communities.

This report addresses: 1) federal programs that fund HCBS and supports for older adults, in particular in-home and nutrition services, affordable housing, and transportation; 2) how HCBS and supports are planned and delivered in selected localities; and 3) agencies’ efforts to promote a coordinated federal system of HCBS for older adults.

This report offers recommendations for federal and state entities from a thorough review of the legal and regulatory home and community-based services (HCBS) framework outlined by the Americans with Disabilities Act and new HCBS regulations. The bearing of setting size and configuration on the quality of supports and services received by people with intellectual and developmental disabilities and individuals with mental health disabilities in home and community-based arrangements is the focus.

This letter from several Congress members from the state of Ohio to the U.S. Department of Health & Human Services expresses concern for the January 10, 2014, rule from CMS that amends regulation of the type of settings in which states can use federal Medicaid funds to pay for home and community based services. The members detail concern that the rule could inhibit the availability of specific residential settings.

The Community First Choice (CFC) HCBS plan of California has been approved by the Centers for Medicare & Medicaid Services. CFC is authorized under 1915(k) of the social security act, and is often called a 1915(k) state plan option. This file contains the approved SPA pages of the California State Plan.

The Community First Choice (CFC) HCBS plan of Montana has been approved by the Centers for Medicare & Medicaid Services. CFC is authorized under 1915(k) of the social security act, and is often called a 1915(k) state plan option. This file contains the approval letter, summary form, and approved SPA pages of the Montana State Plan.