The decentralized nature of Home and Community-Based Services, and the fact that many HCBS providers travel to an individual’s home rather than service recipients traveling to provider facilities, have presented real difficulties for policymakers and advocates seeking to determine the most appropriate means of measuring network adequacy for LTSS providers. This report outlines multiple options that are available to state policymakers seeking to evaluate network adequacy for HCBS providers under MLTSS programs.
Reports & Publications
In the absence of widespread training standards, many personal care aides (PCAs) enter the field without adequate preparation, which can lead to anxieties and injuries on the job, among other concerns. Despite their career aspirations, some of these workers end up leaving their jobs because they lack the skills and confidence to provide high-quality care. Recognizing a need to raise the bar on PCA training, six states -- Arizona, Maine, Massachusetts, New York, Virginia, and Washington -- have developed model curricula for statewide implementation.
In 2014 California implemented a demonstration project called Cal MediConnect, which used managed care organizations to integrate Medicare and Medicaid, including long-term services and supports for beneficiaries dually eligible for Medicare and Medicaid. Post-enrollment telephone surveys assessed how enrollees adjusted to Cal MediConnect over time. Results showed increased satisfaction with benefits, improved ratings of quality of care, fewer acute care visits, and increased personal care assistance hours over time.
The UCSF Community Living Policy Center and the Institute for Health and Aging partnered to conduct an evaluation of Cal MediConnect (CMC). One goal of this evaluation was to assess beneficiaries' experiences with care, include access, quality, and coordination over time. To that end, researchers conducted a longitudinal telephone survey with three groups of dually eligible beneficiaries: those enrolled in CMC, those who opted out, and those in non-demonstration (non-CCI) counties. Key findings from the first telephone survey (T1) were reported in 2016.
This document provides guidance on how States can, in the process of implementing the new federal regulations outlining new procedural requirements for managed care plans' grievance and appeal systems, ensure that people with disabilities have equal access to the grievance and appeal and State fair hearing systems, as mandated by Section 504 of the Rehabilitation Act ("Rehab Act"), the Americans with Disabilities Act ("ADA"), and Section 1557 of the Affordable Care Act ("ACA").