Long-Term Care: Federal Oversight of Growing Medicaid and Community-Based Waivers Should Be Streng the Ned
Home & community-based settings have become a growing part of states' Medicaid long-term care programs, serving as an alternative to care in institutional settings, such as nursing homes. To cover such services, however, states often obtain waivers from certain federal statutory requirements. This report reviews: (1) trends in states' use of Medicaid home & community-based service (HCBS) waivers, particularly for the elderly; (2) state quality assurance approaches, including available data on the quality of care provided to elderly individuals through waivers; & (3) the adequacy of federal oversight of state waivers. Charts & tables.
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15 waivers agency annual reports annual state reports annual state waiver annual waiver reports Appendix assessments beneficiaries served beneficiary expenditures beneficiary interviews beneficiary records reviewed beneficiary satisfaction surveys CMS regional offices community-based services complaint systems developmental disabilities disabilities draft report ensure quality federal oversight final report GAO analysis guidance HCBS programs HCBS quality HCBS waiver beneficiaries HCBS waiver programs HCBS waiver quality HCBS waivers serving HCFA Form 372 health and welfare home and community-based individuals Medicaid Medicare mental retardation monitoring number of beneficiaries number of HCBS number of waivers nursing home office waiver review on-site oversight weaknesses percent protect the health quality assurance approaches quality assurance mechanisms quality assurance system quality-of-care problems recent annual regional office review regional office staff regional office waiver renewal requirements responsible scope and methodology serving the elderly South Carolina staff assigned waiver applications waiver oversight waiver providers waiver review reports Washington welfare of waiver
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Page 47 - Services are general household activities (meal preparation, child care, and routine household care) provided by a trained homemaker when the individual regularly in charge of such activities is temporarily absent or unable to adequately manage the home and care for the personal needs of others in the home.
Page 60 - Comments from the Centers for Medicare & Medicaid Services DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services Administrator Washington, DC 20201 DATE: TO: FROM: SUBJECT: JUN 16 2004 Leslie G.
Page 8 - A waiver under this subsection shall be for an initial term of three years and, upon the request of a State, shall be extended for additional three-year periods unless the Secretary determines that for the previous three-year period the assurances provided under paragraph (2) have not been met.
Page 47 - Services which will assist individuals who receive waiver services in gaining access to needed waiver and other State plan services, as well as needed medical, social, educational and other services, regardless of the funding source for the services to which access is gained.