Wendy Fox-Grage is a senior strategic policy advisor for the AARP Public Policy Institute. She works on state long-term care issues, including Medicaid and home and community-based services.

Paying for Home- and Community-Based Services: Lessons From Oregon

Many older adults need services to stay in their homes or in community-based settings. Getting help with shopping, meal preparation, transportation, medication management, bathing, dressing or mobility can extend community living. But Medicare and private health insurance do not pay for these types of services, and Medicaid (which does) is limited to people with low incomes and almost no savings. As a result, most people pay for these services out of their own pockets. The Symposium Even people who can …

Aging and Disability Resource Centers: Scorecard Highlights the Need for Information and Access to Services

Most Americans will eventually need services to help them live independently, either as consumers or as caregivers providing support to family and friends. However, many of them do not know where to turn for help or how to pay for these services. That’s a major reason Aging and Disability Resource Centers – referred to as ADRCs – are critically important to help them find the services they need. ADRCs offer a “single point of entry” for clients and families to …

The New Federal Rule on Home- and Community-Based Services: All Eyes on the States

The U.S. Centers for Medicare & Medicaid Services (CMS) recently took an important step toward helping low-income people with disabilities. In January, CMS issued a final rule [CMS-2249-F/CMS-2296-F] giving states new flexibility and responsibilities for using Medicaid dollars to pay for home- and community-based services (HCBS). The rule – which should help Medicaid recipients overcome fragmented systems of care and limited options for living in the community – is likely to affect states in three significant ways. New Definition of …

The Growing Problem of Elder Abuse: A Discussion with Assistant Secretary Kathy Greenlee

Recent research by the Public Policy Institute uncovered a disturbing trend: Caseloads for adult protective services (APS) have increased since the start of the last recession, but the funding for these services either remained flat or decreased in many states. That’s particularly troubling because APS programs provide safeguards for adults who cannot protect themselves, and APS caseworkers are the first responders to victims of elder abuse.   To better understand what’s at stake, I spoke to Kathy Greenlee, head of …

Transition to Medicaid Managed Long-Term Services and Supports: How Is It Going?

States are rapidly moving from fee-for-service to managed care for Medicaid long-term services and supports (LTSS). An inventory conducted for the federal government found that the number of states using Medicaid Managed LTSS grew from 8 in 2004 to 16 in 2012, and an AARP Public Policy Institute study  shows 11 states planning to develop new Medicaid Managed LTSS programs in 2013. Pros and Cons There are advantages as well as concerns about moving to capitated, risk-based managed care for Medicaid enrollees with LTSS needs. …

Health Homes: Who Knew?

A new model of care called “health homes” is quietly spreading through many states, as Medicaid programs work to improve care for people with chronic conditions. The problem: Few people know what health homes are – or worse, they confuse them with home health services. What are health homes? Health homes are not a place (even though “home” is in the term). They represent an approach in which providers or health teams coordinate care across settings for people with chronic …