Long Term Services and Supports

ACL recently published a new report sharing new information and insights on Older Americans Act (OAA) services, reveals major OAA milestones, and key information on the impact and necessity of services for older adults. This report includes highlights from OAA Title III programs in 2018.

COVID-19 is a long-lasting and complex disaster situation involving a public health emergency and an economic crisis, with particularly acute impacts for older adults, people with disabilities, and others with certain health conditions. States are responding with changes in policies and procedures to ensure individuals have access to public benefit programs (e.g. Medicare Savings Programs, LIS/Extra Help, SNAP, and LIHEAP). ADvancing States has a new brief highlighting where states are with benefit access and enrollment since the onset of the COVID-19 pandemic. Results in the brief comes from the 2021 ADvancing States Membership Survey: COVID-19 Benefits Access and Enrollment, a follow-up to the 2020 survey.

The NIDILRR-funded Community Living Policy Center published a research brief discussing the results of a recent study of the long-term services and supports needs of people with disabilities and older adults in the US. The study explores how many people need more services than they currently receive and the connection between unmet HCBS needs and community living and health outcomes. The brief describes study findings and potential next steps for researchers and service providers to address gaps in services and supports.

This report explores the role played by managed care organizations delivering Medicaid long term services and support programs during the COVID-19 pandemic. The report looks at the roles and responsibilities of governments, nursing homes, and MLTSS plans and argues their role in the pandemic response as well as the role of federal funding and data use, should all be examined further to inform future policy.

States received approval for temporary changes to their HCBS programs from CMS, within the Department of Health and Human Services to enable states to limit in-person contact to reduce the spread of COVID-19. This GAO report describes the temporary changes to Medicaid HCBS programs and examines CMS’s monitoring and evaluation of the effects of those changes.

In May 2021, CMS released a final rule regarding vaccination education, access, and reporting for residents and staff of nursing and care facilities for individuals with intellectual and developmental disabilities. Recently, CMS sent detailed implementation guidelines to the state agencies responsible for overseeing ICFs/IID. This memo details the responsibilities of ICFS/IID within the new guidelines.

CMS released a SHO letter with updated guidance to assist states in planning for resuming normal state Medicaid, CHIP, and BHP operations for the eventual end of the public health emergency. The SHO provides updated guidance regarding the extended timeframe for states to complete pending work in eligibility and enrollment to up to 12 months after the PHE ends and redetermination of eligibility requirements states must complete after the PHE for all beneficiaries before taking adverse actions.

NASHP has published an Appendix K interactive map, supported by The John A. Hartford Foundation, to track each state’s new flexibilities in modified 1915 (c) and 1115 waivers. States are using these waivers and amendments to ensure that their older adults and family caregivers are receiveing the LTSS services they need during the pandemic.

On Monday, July 12, 2021 three ACL grantees released a digital book titled, 30 Years of Community Living for Individuals with Intellectual and/or Developmental Disabilities. The book shares personal perspectives on community living and inclusion shared by people with intellectual and/or developmental disabilities (ID/DD) who served as advisors to the project. The book was written by the directors of three longitudinal studies funded by ACL’s Projects of National Significance program.

This publication from Health Management Associates analyzes the approaches that Medicaid programs in DC, Idaho, Maine, Washington and Alabama used to coordinate Medicare and Medicaid services without standalone Medicaid MLTSS programs. The paper focuses on Medicaid and Aging agencies overseeing programs that provide long-term services and supports fee for service and explores effective methods to coordinate and integrate care with Medicare Advantage Dual Eligible Special Needs Plans.