Long Term Services and Supports

This report highlights innovative approaches in supporting family caregivers. The report features programs in Hawaii, Maine, Minnesota, Tennessee, and Washington.

This report discusses how HHS can help rural service providers cope with the challenges of meeting the demand for home and community-based services in rural areas. Specifically, GAO recommends the consolidation of information regarding promising practices to allow local officials and rural service providers to more readily access this information.

This paper describes the roles of mobility managers and explores the benefits of focusing on the individual and their unique transportation challenges. The report highlights emerging innovations from five case studies and presents the results of a national survey and inventory of mobility managers. It also discusses the future role of mobility managers in long-term services and supports.

This research brief from the Office of the Assistant Secretary for Planning and Evaluation summarizes recent research on older adults' LTSS risks and financial resources. The brief primarily uses data from the Health and Retirement Study.

This report is the third in a series of publications from the MLTSS Institute. The report identifies the challenges and promising practices in addressing the mismatch between supply and demand for direct care workers in long term services and supports programs, all viewed through the lens of MLTSS programs. This report is co-authored by ADvancing States and Sage Squirrel Consulting, LLC.

This toolkit summarizes LTSS reform strategies adopted by state innovators. It identifies concrete policy strategies, operational steps, and federal and state authorities that states have used to advance LTSS reforms. It also includes specific case studies and advice for other states looking to implement similar reforms. In addition, CHCS has published a brief for state legislators looking for a summary of options for developing LTSS policies.

This paper focuses on how state-funded home and community-based services programs can support low-income older adults. It highlights promising practices that support maximum independence for low-income older adults and/or people with physical disabilities and their family caregivers. The paper explores programs across nine states, including Washington state’s emerging innovation: the Medicaid Transformation demonstration.

This brief highlights the critical services provided by the Older Americans Act (OAA). It also reviews the current funding challenges the program faces in light of rising inflation and increased demand for services from a growing population of older adults. The OAA was last renewed in 2016 for three years and is up for renewal again in 2019.

This study analyzes the financial burden experienced by people who require long-term services and supports. The study analyzes medical and LTSS spending among older Medicare beneficiaries, particularly the costs of assistive devices and personal care. The results show that for medical services covered by Medicare, beneficiaries with a high need for long-term services spend more than $2,700 a year out of pocket on average, twice as high as those without such need.

While healthcare payment systems are moving toward paying for value, the unique needs of individuals with I/DD and their families means that the transition toward alternative payment models (APMs) for Medicaid-funded services must be undertaken carefully. This white paper includes 14 payment reform principles to guide the development and assessment of new and emerging APMs for Medicaid I/DD services. The paper also includes 13 recommendations for current and future APMs for I/DD services.