System Transformation

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Summary of CMS Guidance on Managed Long-Term Services and Supports

This summary draws attention to some of the most important aspects of CMS’s recently released guidance for states and stakeholders on the use of managed care for long-term services and supports (MLTSS) as well as transitioning LTSS providers into managed care systems and developing MLTSS programs. CMS identified 10 important elements that should be incorporated into managed LTSS and this document can assist consumers and their representatives in understanding these elements.

Short URL: http://www.advancingstates.org/node/53409

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Care Management for Medicaid Enrollees Through Community Health Teams

The effective management of patients' complex illnesses across providers, settings, and systems places extraordinary demands on primary care providers, especially those that work in resource-limited small or rural practices. This issue brief identifies eight states that have adopted strategies to build practice capacity to care for high-need Medicaid beneficiaries through the development of community health teams and reports early data to inform other states thinking about this model of care.

Short URL: http://www.advancingstates.org/node/53406

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Managed Long-Term Services and Supports: 2012 Report to the President

This report provides background on MLTSS to brief the intellectual and developmental disability community, as well as the President and the Secretary of the Department of Health and Human Services, on managed care and changes in LTSS administration so that they may take action and influence outcomes. The report also contains a number of recommendations related to disability stakeholder engagement, choice and self-determination, consumer protections and rights and quality measurement.

Short URL: http://www.advancingstates.org/node/53399

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A State-by-State Snapshot of Poverty Among Seniors: Findings from Analysis of the Supplemental Poverty Measure

The Census Bureau created the supplemental poverty measure, in an effort to differently reflect cost of living and financial status from the "official" measure. Poverty rates among older adults are higher under the supplemental poverty measure (15%) than under the official poverty measure (9%). This analysis does a state-by-state comparison using both poverty measures to describe seniors living in poverty. An understanding of elder financial hardship is important for fiscal policy debate.

Short URL: http://www.advancingstates.org/node/53396

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Guidance to States using 1115 Demonstrations or 1915(b) Waivers for Managed Long Term Services and Supports Programs

CMS has released two important documents that outline essential elements of MLTSS programs that are in line with current best practices. The first document summarizes these essential elements and the second provides guidance for incorporating these essential elements into MLTSS programs operating under section 1115 or 1915(b) authorities. These standards will be used when CMS reviews states’ design, implementation and operation of MLTSS programs for approval and ongoing quality assurance.

Short URL: http://www.advancingstates.org/node/53394

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Money Follows the Person (MFP) Rebalancing Demonstration: A Work in Progress

Money Follows the Person (MFP) federal grants are provided to states in order to assist older adults and people with disabilities in transitioning from nursing facilities to home and community based settings. A history and current state of MFP are offered. This report provides an overview of how MFP has helped states to rebalance their LTSS programs and provides next steps and an outlook for the future of MFP or similar programs once the demonstration project’s funding has run out.

Short URL: http://www.advancingstates.org/node/53392

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At the Crossroads: Providing Long-Term Services and Supports at a Time of High Demand and Fiscal Constraint

A survey of state aging, disability and Medicaid agencies was conducted in 2012, in order to better understand challenges and concerns for funding and providing quality LTSS. Five common themes were identified in this report, including staff turnover and reductions during a sluggish recovery of state budgets. Other findings include an overall expansion of home and community-based services, LTSS transformation and reduced funding and high demand for non-Medicaid aging and disability services.

Short URL: http://www.advancingstates.org/node/53391

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Health Equity and LGBT Elders of Color

Ethnic minorities and LGBT older adults will continue to become more represented among the older adult population. A lifetime of discrimination has often adversely affected LGBT elders of color in a myriad of ways, including greater likelihood of financial instability and heightened health disparities. This report offers policy solutions to support the wellbeing of this growing population. Policy solutions include strengthened outreach and community supports to LBGT elders of color.

Short URL: http://www.advancingstates.org/node/53386

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Health Home Information Resource Center

The Affordable Care Act authorized the Medicaid Health Home State Plan Option, which allows states to design health homes to provide comprehensive care coordination for Medicaid beneficiaries with chronic conditions. States will receive enhanced federal funding to support the rollout of this new integrated model of care. This link directs to the Health Home Resource Center that provides technical assistance services for states as they submit their proposals for these health homes to CMS.

Short URL: http://www.advancingstates.org/node/53385

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Realizing the Intent of the DD Act: How the DD Network Advances the Independence, Productivity, and Integration of People with Intellectual and Developmental Disabilities Prepared

Using six states as examples, this report illustrates how the DD Network partners, working with each other and in collaboration with state developmental disability agencies and others, have positively affected the lives of hundreds of thousands of individuals with intellectual and developmental disabilities - assuring their rightful place as full community members through advocacy, research, training, and programs that directly support individuals and families.

Short URL: http://www.advancingstates.org/node/53011

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