Long Term Services and Supports

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.

CMS has released a notice with information about the process for states to apply for a “good faith effort” (GFE) exemption, which provides up to one year of extra time to come into compliance with Electronic Visit Verification.

The National Academy of Social Insurance released a report on potential designs for universal family care. The report highlights state program design proposals for early child care and education, paid family and medical leave, and long-term services and supports. The LTSS section of the report proposes four design issues states may face in developing a social insurance program for LTSS.