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States should be required to conduct annual scheduled in-home surveys that assess clients’ experience and involvement in care plans and outcomes.

States should extend the purview of their existing ombudsman programs to include long-term services and supports delivered in homes.

States should require agencies to establish grievance and appeals procedures and provide consumers with written notice of their right to voice grievances.

States should require that home-care providers adequately train family caregivers who agree to use technology (such as home dialysis, tube feeding, and continuous intravenous infu

States must demonstrate to CMS that their methods to ensure backup workers are available to all individuals who receive Medicaid-funded home and community-based servic

Federal and state governments should ensure that people with dementia and other mental disorders receive necessary treatment and LTSS in the most a

Services should be implemented and operated by the level of government that can most appropriately and efficiently deliver them.

LTSS consumers should have access to a full range of mental health services.

States should ensure that all training programs for direct-care workers in all LTSS settings address the care of all populations with mental disorders. This includes treatment for