Long Term Services and Supports

The Financial Alignment Initiative (FAI) is intended to improve the quality of care and reduce spending for low-income people who are dually eligible. Mathematica researchers conducted a study to identify reasons for the varying participation rates across states. This brief explores the details of two major factors: passive enrollment and demonstration/MLTSS alignment.

The Home and Community Based Services (HCBS) Conference is hosted annually by ADvancing States (formerly known as NASUAD). This event highlights best practices from across the country in home and community-based services. The conference includes federal, state, and local policymakers as well as those who administer, manage, and deliver waiver and other HCBS programs. This link contains all of the slide presentations from the 2019 HCBS Conference.

This blog post discusses the concept of using value-based payment models in Managed LTSS. The post reviews the challenges of using VBP in HCBS and highlights lessons learned from CHCS' work with five MLTSS states.

This fact sheet from the AARP Public Policy Institute takes a closer look at LTSS, revealing insights and new information, such as: what LTSS encompass, who needs LTSS, who provides LTSS, and where people with LTSS reside.

On July 31, Governor Tom Wolf of Pennsylvania announced, by an executive order, an overhaul of the state services and systems to protect the most vulnerable Pennsylvanians. The executive order establishes an Office of Advocacy and Reform, Child Advocate, and Council on Reform. The executive order also lists responsibilities of the state agencies and the Governor’s Office of Performance through Excellence.

This fact sheet was developed as part of the Center’s Helping States Support Families Caring for an Aging America initiative. Six states – Alabama, Idaho, Iowa, New Hampshire, South Carolina, and Virginia- are involved with the initiative. This fact sheet provides an overview of unpaid family caregiving and lists options state leaders can consider implementing in order to support family caregivers in their state.

The Centers for Medicaid & Medicare Services released a report that profiled the 10 states with the greatest change in Long-Term Services and Support (LTSS) system balancing. The report highlights characteristics of the 10 states and compares their change in LTSS system balancing with other states and provides a national overview on LTSS system balancing. State profiles consist of characteristics and strategies states utilized in their progress towards rebalancing their LTSS systems.

CMS released a bulletin addressing frequently asked questions regarding Electronic Visit Verification (EVV) requirements to beneficiaries receiving in-home care. This bulletin responds to questions surrounding beneficiaries with live-in caregivers, services delivered partially in the beneficiary's home, the provision of medical supplies, equipment, and appliances as a component of the Medicaid home health benefit, and the use of web-based timesheets as an EVV method.

The report provides an overview of the expected increased need for direct care workers and a breakdown of the current direct care workforce. In each description of barriers facing the direct care workforce, PHI includes program and policy recommendations. Challenges and recommendations in this report include areas regarding: wages and benefits, training, advanced roles, supervision, recruitment and retention, data collection, decision-making, family caregivers, and matching service registries.

In 2021, under a recently released rule from CMS, D-SNPs will be required to notify the state or state’s designee when enrollees experience Medicare-covered hospital or skilled nursing facility admissions in order to ensure timely transitions of care. The Integrated Care Resource Center has released a brief that examines approaches from three states – Oregon, Pennsylvania, and Tennessee – to develop and implement information-sharing processes for their D-SNPs that support care transitions.