Feds direct states to strengthen home and community-based care

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The Center for Medicaid and Medicare Services issued a bulletin August 3, urging states to continue reducing their reliance on institutions in their Medicaid long-term services and supports, LTSS.

The bulletin provides a series of recommendations to state Medicaid programs. Of particular importance, the CMS urged states to provide sustainable wages for home-care workers and create a registries of home-based workers, while reminding them that federal funds are available for the creation of such registries.

Further guidance is also provided on home-care worker qualifications and training, as a list of other relevant resources.

These steps, the CMS argues, will allow people with disabilities to continue living in integrated settings in their communities, rather than be forced to live in segregated, institutional settings.

“A stable workforce, engaged in the delivery of services and supports that address the needs and preferences of beneficiaries, is a critical element to achieving continued progress,” the bulletin states.

Last month, the CMS released its annual report on LTSS. For fiscal year 2014, a record 53 percent of LTSS were directed toward home and community-based, as opposed to institutional, services. Overall, the federal and state governments spent approximately $80.6 billion on home and community-based services, and $71.2 billion on institutional services.

Wide disparities exist between various states, however. In Oregon, 79.2 percent of LTSS were home and community-based, opposed to a mere 27.2 percent in Mississippi.