Housing

This letter provides guidance to states on how the long-term services and supports-related rules, including the estate recovery rules, in section 1917 of the Social Security Act (the Act), and federal regulations at 42 C.F.R. 435.700, et seq., apply to individuals who are eligible for Medicaid under Modified Adjusted Gross Income (MAGI) eligibility rules (“MAGI individuals”) and receive coverage for long-term services and supports (LTSS).

Money Follows the Person (MFP) is one program that appropriates federal grants to states to design programs to transition Medicaid beneficiaries from institutional care to home and community-based services. Beginning as a demonstration program, there are many impediments and uncertainties surrounding implementation. This overview provides a description of impediments as an opportunity for solutions that anticipate implementation issues and touches upon program start up, capacity, and access.

State aging and disability agencies have operated within a tumultuous environment for the past several years. It has become increasingly more difficult to reconcile the needs of older adults and people with disabilities with the resources available to address those needs. Five themes are identified from the 2012 state of aging and disabilities surveys, which include the acceleration of Medicaid managed long term services and supports and continuing loss of historical knowledge around the nation.

Held in May 2005 this national conference was designed to meet the unique training needs of waiver program operators. This year’s conference, titled "The Sun Shines Brighter at Home," offered substantive opportunities to learn about the national initiatives, policy directions and grant programs that shape the current environment. The attached agenda has links to all of the presentation overheads.

Home modifications can make performing tasks easier, reduce accidents and support independent living. Examples include lever door handles that operate easily with a push, handrails on both sides of staircase and outside steps, and ramps for accessible entry and exit. Check out this directory of state resources on home modification to find resources in your state. Also note the link to Disability.gov, where you can find more information on accessible housing options.

The April 2005 Advanced Strategies Subgroup call hosted Leonard Sandler, law professor from the University of Iowa. Mr. Sandler presented information to the conference call participants on the development of the Easy Access Home Bill that was introduced in the Iowa Legislature in 2005. These summary notes provide an overview of the presentation and the subgroup discussion.

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.

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.

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.

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.