Long Term Services and Supports

AARP has released its fourth iteration of the Long-term Services and Supports Scorecard. This scorecard ranks states and DC in order from 1 to 51 on a wide range of issues pertaining to older adults and people with disabilities. The LTSS scorecard has five domains that states are ranked within, and each of those domains has multiple indicators that are used to derive the overall score.

This brief draws from interviews with states operating new and long-standing MLTSS programs to identify six major trends in the refinement of MLTSS and underlying LTSS delivery systems nationally. The states examined in this brief are strengthening their Medicaid MLTSS programs to serve more LTSS beneficiaries and facilitate the development of integrated care programs that reduce service fragmentation for Medicare-Medicaid enrollees, particularly through Medicare Advantage D-SNPs

During the Friday September 25, 2020 MACPAC meeting, MACPAC presented on the Management of HCBS Waiver Waiting Lists. The talk included background information on Medicaid and HCBS Waivers, data on HCBS Waiver waiting lists, and strategies for reducing or eliminating waiting lists. The slides from this presentation are included here.

US Senator Bob Casey (ranking member, Special Committee on Aging) has released a new report on how COVID-19 has exacerbated the challenges facing older Americans. The report outlines a blueprint for addressing the problems older adults face and highlights the services necessary to ensure Americans can age with dignity. This report contains policy recommendations that address three main areas: health care, economic security, and social supports.

CMS has released a new report on community transitions that occurred under the Money Follows the Person (MFP) program from 2008 to the end of 2019. The report states that during this time, states transitioned 101,540 people to community living through MFP. In the most recent year (2019), MFP grantee states transitioned a total of 4,173 individuals. The report includes additional information on transitions broken down by population and state.

This compendium includes select information on waiver capacity and waiting list management. The compendium highlights over 200 approved Section 1915(c) and Section 1115 waivers across all 50 states and DC. As an accompaniment to this compendium, MACPAC has also released an issue brief. This issue brief includes a description of the waiver analysis conducted in the compendium. It also features information from stakeholder interviews.

The National Quality Forum (NQF) has published the final report from the Person-Centered Planning and Practice Project. This report outlines recommendations from a committee of stakeholders with lived and professional experience in LTSS. The report includes the committee's final recommendations across a number of areas regarding person-centered thinking, planning, and practice.

This week, the Senate Finance Committee released the language and summaries of legislation to help nursing home efforts to stop the spread of COVID-19. The Act would call on nursing homes to ensure that a portion Federal relief funds, made available on or after July 1, for responding to COVID-19 would be used for personal protective equipment (PPE) and COVID-19 testing in long-term care facilities. The Act also has language for expanding resources for elder justice activities.

The MACPAC June 2020 Report to Congress on Medicaid and CHIP was created prior to the COVID-19 pandemic and highlights long-term challenges facing Medicaid. Across six chapters, it discusses key issues including integrated care for dually eligible Medicaid and Medicare beneficiaries, Medicare Savings Programs, and Medicaid's statutory role as the payer of last resort.

This webinar discussed two issue briefs from the MLTSS Institute on aligning Medicare and Medicaid for dually eligible individuals. The briefs covered were, "Starting from Square One: Considerations for States Exploring Medicare-Medicaid" and, “The Value of Integration to State Medicaid Agencies”. The webinar also highlighted the perspective of the District of Columbia, which is planning to launch new program elements to better integrate care.