Federal UpdatesPresented by Becky A. Kurtz

Director, Office of LTC Ombudsman ProgramsNALLTCO Member Meeting – November 16, 2014

Status of Final Rule for LTC Ombudsman Program

• June 2013 – notice of proposed rulemaking (NPRM) published in Federal Register:– http://www.regulations.gov/#!documentDetail;D=AOA_FRDOC_0001-0002

• August 2013 – public comments due (received 85 unduplicated comments)

• ACL worked on drafting responses to comments and finalizing rule• October 2014 -- Health and Human Services review and clearance

complete• Currently – Office of Management and Budget (OMB) reviewing

(have 90 days to review)• Next step -- Final Rule published in the Federal Register

Status of National Ombudsman Reporting System (NORS) Next

• September 2014 – ACL contract with ICF in place• Currently -- Working to design the data elements (i.e. the

data you and/or your State Office collect and your State Office sends to ACL/AoA)– Our office has been involving NASOP and NALLTCO

representatives throughout the process.– Plan will be published in the Federal Register so there will be

opportunity for public comment.• Next step -- develop the technology that will be used to

transmit the data to ACL/AoA

Status of National Ombudsman Resource Center (NORC)

• June 2014 – New 3-year cooperative agreement awarded to the Consumer Voice for the Resource Center

• September 2014 – supplemental grant awarded to focus on:– Emergency Preparedness/Disaster Response and the Role of the Elder

Rights Team• Anticipation of ACL issuance of model policies and procedures for LTC ombudsman

programs

– Promoting Collaboration Between Long-Term Care Ombudsman Programs and Protection & Advocacy Programs – Next Steps

– Improving the Coordination and Effectiveness of Long-Term Care Ombudsmen and Legal Service Developers

Big Changes in States’ Delivery of Long-Term Services and Supports

1. Home and Community Based Services (HCBS) Rule• January 2014 – Final HCBS regulations set forth new Medicaid

requirements under which states may provide HCBS long-term services and supports. • http://

www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Long-Term-Services-and-Supports/Home-and-Community-Based-Services/Home-and-Community-Based-Services.html

• Purpose: enhance the quality of HCBS and provide additional protections to individuals that receive Medicaid HCBS services.• Includes assisted living, board and care in many states

• Currently – States are amending waivers, developing transition plans, opportunities for advocates:• to give information to States as they evaluate providers’ ability to meet the rule;• to comment on your States’ transition plans (hcbsadvocacy.org)

Big Changes in LTSS -- #2

2. Managed Long-Term Services and Supports (MLTSS)– Delivery of LTSS through capitated Medicaid managed care programs

Currently: Increasing numbers of States are using MLTSS as a strategy for:• expanding HCBS, • promoting community inclusion, • ensuring quality and increasing efficiency.

– Includes nursing homes in many (but not all) States– Includes most demonstration programs for dually eligible populations (i.e.

Medicare and Medicaid)

Lots of changes going on . . . How are the changes impacting the people you serve?

Contact InformationFor more information about ACL:U.S. Department of Health and Human Services, Administration for Community Living, Washington DC 20201www.acl.gov

For more information about the National Ombudsman Resource Center:www.ltcombudsman.org