Public-Sector Approaches to Financing Long-Term Services and Supports

Background

The major source of public financing for long-term services and supportsLTSS encompasses a broad range of assistance with activities of daily living and health-related tasks for people with functional limitations caused by physical or mental impairments. LTSS may be delivered in institutions or in a person’s home or a residential care setting. ( LTSSLTSS encompasses a broad range of assistance with activities of daily living and health-related tasks for people with functional limitations caused by physical or mental impairments. LTSS may be delivered in institutions or in a person’s home or a residential care setting. ) is the joint federal and state MedicaidA joint federal/state program that provides health care and LTSS. However, to qualify for Medicaid LTSS, people must have extremely low assets and income, or they have to “spend down” most of their assets. program. MedicaidA joint federal/state program that provides health care and LTSS. However, to qualify for Medicaid LTSS, people must have extremely low assets and income, or they have to “spend down” most of their assets. pays for nursing facility care and increasing (but still limited) amounts of home and community-based services. However, to qualify for MedicaidA joint federal/state program that provides health care and LTSS. However, to qualify for Medicaid LTSS, people must have extremely low assets and income, or they have to “spend down” most of their assets. , people must have extremely low assets and income or spend almost all their assets and income to pay for their health care and LTSSLTSS encompasses a broad range of assistance with activities of daily living and health-related tasks for people with functional limitations caused by physical or mental impairments. LTSS may be delivered in institutions or in a person’s home or a residential care setting. .

MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). generally does not pay for LTSSLTSS encompasses a broad range of assistance with activities of daily living and health-related tasks for people with functional limitations caused by physical or mental impairments. LTSS may be delivered in institutions or in a person’s home or a residential care setting. . It funds medically necessary home health careA Medicare benefit provided in an individual’s home. Eligibility requires that an individual be under the care of a physician who authorizes all services and certifies that the person is homebound  and in need of intermittent skilled services. , but consumers must be homebound“Homebound” is a Medicare designation for individuals who (1) need the help of another person or medical equipment such as a walker or a wheelchair to leave their home, or (2) whose doctor believes leaving home could endanger their health. and need skilled nursing or therapy to receive the benefit. MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). also pays for postacute care in a skilled-nursing facility if an individual has had a prior hospital stay of at least three days (see also Health Care Coverage: Medicare).

Smaller public programs provide LTSSLTSS encompasses a broad range of assistance with activities of daily living and health-related tasks for people with functional limitations caused by physical or mental impairments. LTSS may be delivered in institutions or in a person’s home or a residential care setting. , including the Department of Veterans Affairs program, the Social Services Block GrantA fixed federal appropriation that states may use at their discretion within broad federal guidelines. program, and Title III of the Older Americans Act. Each program has its own eligibility criteria and covers only limited amounts of LTSSLTSS encompasses a broad range of assistance with activities of daily living and health-related tasks for people with functional limitations caused by physical or mental impairments. LTSS may be delivered in institutions or in a person’s home or a residential care setting. (see also The Older Americans Act). In addition, most states have LTSSLTSS encompasses a broad range of assistance with activities of daily living and health-related tasks for people with functional limitations caused by physical or mental impairments. LTSS may be delivered in institutions or in a person’s home or a residential care setting. programs paid for out of general revenueRevenue that can be used for any purpose. . Still, they serve only a limited number of people.

Several recent legislative efforts in Congress have included proposals that would cap the federal contribution (overall in a  block grantA fixed federal appropriation that states may use at their discretion within broad federal guidelines.  or per person in a per capita cap) to MedicaidA joint federal/state program that provides health care and LTSS. However, to qualify for Medicaid LTSS, people must have extremely low assets and income, or they have to “spend down” most of their assets. . Both a  block grantA fixed federal appropriation that states may use at their discretion within broad federal guidelines.  and a per capita cap would shift costs to the states and reduce the availability and quality of  long-term services and supportsLTSS encompasses a broad range of assistance with activities of daily living and health-related tasks for people with functional limitations caused by physical or mental impairments. LTSS may be delivered in institutions or in a person’s home or a residential care setting.  in both nursing facilities and home- and community-based settings.

Found in Public-Sector Approaches to Financing Long-Term Services and Supports