Consolidated or coordination of LTSS agencies

States should consolidate or coordinate agencies responsible for LTSS, including Medicaid, state-funded programs, Older Americans Act programs, and the state agency on aging. These consolidated or coordinated agencies should have responsibility for policy, funding, administration, and oversight of LTSS programs that serve both older and younger people with disabilities. These responsibilities should include the determination of eligibility for public programs. 

This includes Medicaid-funded institutional care and community-based programs such as personal care, home- and community-based services waiver programs, managed LTSS programs (including Programs of All-Inclusive Care for the Elderly), and state-funded LTSS programs. The consolidated agency also should have responsibility for determining financial eligibility for Medicaid and LTSS quality management. It should cover all populations of older adults and people with disabilities: older people, other adults with physical disabilities, and people with developmental disabilities.