Long Term Services and Supports

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.

The Community Living Policy Center (CLPC) released a brief describing how short-term extensions of the Money Follows the Person (MFP) program have curtailed state efforts in transitioning individuals out of institutions. The CLPC based their findings on CMS data on annual transitions in each state.

This issue brief from the MLTSS Institute focuses on aspects of delivering effective care to individuals eligible for both Medicare and Medicaid. Only about 2/3 of states have undertaken any activity to better integrate care for dually eligible beneficiaries; many have encountered a number of barriers in pursuing better integration of the Medicare and Medicaid programs. This issue brief identifies key questions that states should ask themselves before they design an integrated care program.