Posted on November 16, 2009 20:36
Categories: Medicaid | State and Local | Special Populations
Topics: Medicaid | Seniors | Spending | State Data
This report released October 6, 2009 by the National Center for Assisted Living (NCAL) found that Medicaid spending on home- and community-based services (HCBS) increased 81.5 percent from FY2001 to FY2007, while nursing home spending grew 9.8 percent over the same period. The report found that, from 2001 to 2007, Medicaid nursing home spending went from $42.7 billion to $46.9 billion while HCBS spending increased from $9.2 billion to $16.7 billion. In addition, the number of people receiving Medicaid services in licensed assisted living settings increased 44 percent from 2002 to 2009 and HCBS Medicaid waivers now cover services in residential settings in 37 states while an additional 13 states provide coverage directly though the state Medicaid plan.
From the report's major findings:
-
Coverage of services in licensed assisted living settings increased compared to previous reports. Participants served through home and community-based services (HCBS) and §1115 waivers and state plan services increased 9.2% between 2007 and 2009 and 43.7% between 2002 and 2009.
-
Including state general revenue programs, the number of participants increased 11% between 2007 and 2009 and 44% between 2002 and 2009.
-
The number of §1915 (c) and §1115 waiver participants rose 122% between 2002 and 2009.
-
Thirty-seven states use §1915 (c) HCBS waivers to cover services in residential settings; 13 states use the Medicaid state plan services (personal care or other state plan service); four include services in residential settings under §1115 demonstration program authority; and six use state general revenues. States may use more than one funding source.
-
Tiered rates are the most common method for reimbursing assisted living providers (19 states), and flat rates are used in 17 states.
-
Forty states do not include room and board paid by the resident in the assisted living rate.
-
Twenty-three states cap the amount that can be charged for room and board.
-
Twenty-four states supplement the federal Supplemental Security Income (SSI) payment. Payment standards range from $722 to $1,350 a month.
-
Twenty-five states permit family members or third parties to supplement room and board charges.
-
Twenty-three states require apartment-style units, 40 states allow units to be shared, and 24 states allow sharing by choice of the residents.
-
Screening for mental health needs is performed by case managers and assisted living facility (ALF) staff in nine states, by case managers only in 10 states, and by ALF staff in nine states.
-
Mental health services are arranged by ALFs in 16 states and by case managers in 20 states; such services may be provided directly by ALFs in three states.
Full Report: State Medicaid Reimbursement Policies and Practices in Assisted Living (PDF | 609.74 KB)
National Center for Assisted Living. (2009). State Medicaid reimbursement policies and practices in assisted living. Mollica, Robert L.
E-mail to Friend |
Print |
Permalink |
Post RSS
