The revised Senate health care bill brings an idea that should be a hard sell for the over 3 million older adults and people with disabilities who rely on Medicaid for in-home care. On top of a massive almost $800 billion cut to Medicaid that guarantees shrunken programs and eliminated services, the Senate bill kills CFC and replaces it with an inferior version that provides fewer services for a limited time only.
Governing.com: As Demand for At-Home Care Grows, States Debate How to Pay for It (7/2017) Justice in Aging’s Kevin Prindiville discusses the increasing funding need for at home and in-community-based programs as older Americans opt to stay home. “The trend is shifting at every level to care at home and in community-based settings. People are increasingly asking for and expecting this.”
The state of California is moving forward with implementation of the Health Homes for Patients with Complex Needs also known as the Health Homes Program (HHP). The HHP is aimed at providing extensive care coordination for the highest risk Medi-Cal beneficiaries to improve their health outcomes. Implementation is scheduled to begin in certain counties starting January 1, 2017.
New federal regulations have established first-time standards for when settings qualify as “community-based” for the purposes of Medicaid-funded Home and Community-Based Services (HCBS). Each state is charged with developing a transition plan to meet these standards. These plans will have a huge impact on older adults receiving Medicaid-funded HCBS in assisted living, adult day services, and other settings.
Consumers and their advocates must be heard in the states’ transition planning processes. Justice in Aging’s new issue brief provides policy recommendations for consideration by states and stakeholders. The transition plans must confront and answer many important questions.
- What service models are eligible for payment?
- Should services in assisted living facilities be covered?
- What about adult day care programs?
- Does the size of these programs matter?
- And should programs be allowed to be “secure”, i.e., locked, if they care for persons with dementia?
The recommendations address (among other things) how to assess settings for compliance, judging whether a setting is integrated with the community, protecting consumers from eviction, and applying the regulations when consumers have dementia.
Where do you want to live as you grow old and —very likely, at some point — lose the ability to take care of yourself? Probably, you want to remain at home, with necessary assistance along with ongoing contact with friends and family. Alternatively, you probably do not want to move into a nursing home.
The new federal home and community-based services (HCBS) regulations offer an opportunity for states and stakeholders to improve Medicaid long-term services and supports for older adults. At the state and national level, the transition process to comply with the regulations is initiating thoughtful discussions about what it means to provide quality, community-based care, in a variety of settings. Read More
In early 2014, after a lengthy public process, CMS finalized new rules that define the characteristics of a Home & Community-based Services (HCBS) setting. The new standards aim to improve HCBS quality and ensure individuals who receive Medicaid HCBS services can engage and fully participate in community life, better control and coordinate their care, and have opportunities to seek employment in competitive settings.
In response to persistent confusion and misinformation about the new HCBS settings rules, a group of national disability and aging organizations (including Justice in Aging) put together a Q&A written for advocates and the general public to explain the transition process and what the rules do and do not require.
States must submit state-wide transition plans to CMS before March 17, 2015 and must first provide the public opportunity to comment on these plans. You can find information on your state’s status at hcbsadvocacy.org. Justice In Aging has a number of resources on the new rule, available here.
In this July tool for consumers, NSCLC shares four tips regarding state transition plans for new Medicaid HCBS regulations. States now are beginning to release their transition plans to bring their Medicaid HCBS systems into compliance with the new federal regulations on community-based settings. It is essential that consumers and their representatives be prepared to evaluate those plans and advocate for improvements.
June 2014 — To assist government officials and stakeholders, Justice in Aging has written Just Like Home: An Advocate’s Guide for State Transitions Under the New Medicaid HCBS Rules. The guide provides analysis and recommendations for multiple aspects of the new regulations, including determining which settings are disqualified for HCBS, and enforcing consumer protections.