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Policymakers should expand participant-directed service models (also called consumer-directed and self-directed models) that permit payment to relatives in publicly
The Centers for Medicare & Medicaid Services should require a needs assessment of all family caregivers who assist Medicaid HCBS program participants.
The federal government should eliminate Medicaid's bias favoring nursing facilities.
The federal government should convert the Money Follows the Person (MFP) demonstration program into a permanent state option with increased Federal Medical Assistance Percentage.
Congress and the states should expand funding for a wide range of HCBS through Medicaid, the Older Americans Act (OAA), the Social Services Block Grant program, and other pr
All long-term services and supports (LTSS) program participants should have the option to purchase and direct their own services.
Individuals who self-direct their services should have the same protections regarding quality of care and access to appeal procedures as do other participants of Medicaid-funded LTSS.
Until a comprehensive national LTSS program is implemented, the following intermediate steps should be taken:
The federal and state government should conduct regular, thorough, and consistent oversight.
Consumers and their family caregivers, as appropriate, should be the focus of all LTSS programs and services.