Long Term Services and Supports

After a decade of changes in federal law, regulation, and policy designed to promote the growth of publicly funded participant-directed long-term services and supports (PD-LTSS) programs, the number of these programs has grown considerably. This article details the process for developing this data resource, describes some of the major characteristics of PD-LTSS programs in the United States, and discusses possible implications and areas for future research.

This paper identifies the concerns and considerations in transitioning traditional LTSS providers from fee-to-service models to a managed care program.The findings of the study are based on qualitative interviews conducted with a variety of stakeholders, including state Medicaid program officials, representatives from managed care companies, LTSS providers, LTSS provider associations, and private consultants.

This white paper provides an inventory of all current MLTSS programs and a projection of future programs as of July 2012. The report includes state-by-state results and synthesizes findings across states, reporting national enrollment, characteristics of contractors and multiple program features.

This State Long-Term Services and Supports (LTSS) Scorecard is a multidimensional approach to measure state-level performance of LTSS systems that assist older people, adults with disabilities, and their family caregivers. This second edition of the State LTSS Scorecard measures LTSS system performance across five key dimensions: affordability and access; choice of setting and provider; quality of life and quality of care; support for family caregivers; and effective transitions.

Medicaid LTSS is not a system that was purposefully built, but rather one that evolved over time out of legacy programs that were designed to meet the needs of different populations, differing state approaches to policy, court decisions, client advocacy, and changing ideas about where and how LTSS should be provided. MACPAC’s future work on Medicaid LTSS will focus on building a better understanding and moving policy in the direction of a more efficient and effective system of LTSS.

This tool promotes consumer-focused MLTSS by making it easier to identify weaknesses and promote better practices. The tool combines a checklist for assessing MLTSS with examples of practices, policies or contract language that implement the criteria.

The Money Follows the Person (MFP) demonstration grant program helps long-term residents of institutions move back to the community. This report aims to answer several questions about the expenditures (medical care and long-term services and supports [LTSS] expenditures) of people who transition from institutional care to community-based LTSS.

In 2014, ADvancing States surveyed state aging and disability agencies regarding the significant policy, fiscal, and operational issues occurring within each state. The survey collected detailed information about the structure of agencies, the supports provided, and the populations served by aging and disability agencies. Of particular interest is the summary of services provided in Medicaid waivers across the country. All of this information is presented in the charts accompanying this document.

The report features select qualified, demonstration, and supplemental services that seem particularly innovating and promising. The MFP grant program allows states to test and implement innovative services without the restrictions of a waiver. This report provides illustrative examples of how states are taking advantage of this flexibility, particularly in the areas of pre-transition and short-term services.

Review the progress by the 42 MFP grantee states (including the District of Columbia) that are actively transitioning MFP participants. MFP grants support state efforts to help individuals living in institutions move to home and community-based settings if that is where they wish to receive LTSS. During the second half of 2013, states transitioned 5,485 new enrollees, bringing the total number of people that had ever transitioned to the community through MFP to 40,693 at the close of 2013.