December 5, 2014
In This Issue
* NASUAD Publishes Updated State Medicaid Integration Tracker
* MIPPA Outreach Materials for Low-Income Medicare Beneficiaries with Disabilities
*ACL:Older Americans Month Empowers Older Adults and Communities to "Get into the Act"
*ACL:Open Enrollment for Health Coverage
*CMS: Barbara Edwards Resigns from CMCS
*CMS: Proposed Changes to the Medicare Shared Savings Program Regulations
*CMS Releases New SSI/Spousal Impoverishment Standards
*FCC Seeks Nominations for New Diversity Advisory Committee
*ASPE Releases SASH Evaluation
*ODEP Launches Expanded Employment First State Leadership Mentoring Program
*Congress Working to Pass Appropriations
*House Overwhelmingly Passes ABLE Act
*Wyoming Releases Medicaid Expansion Proposal
*AIRS Releases 2015 Conference Call for Proposals
*Insititute on Disability: Annual Disability Statistics Compendium Released
*CMS: National Health Expenditures Continued Slow Growth in 2013
*KFF: New Medicaid Managed Care Market Tracker and Web Briefing
*Mathematica:Webinar: Disability Research Seminar Series
*NAHSP: Webinar: A Walk in Someone Else's Shoes
*NCOA: New Medicare Data Visualization Tool
*NCOA: Webinar: Three Online Tools to Help Older Adults Save Money
*NCOA Grants for New Benefits Enrollment Centers
*PhRMA: Conversations on Medicare
*Job Postings
*Friday Updates Archive
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NASUAD Publishes Updated State Medicaid Integration Tracker

NASUAD has published the December 2014 Edition of the State Medicaid Integration Tracker. The State Medicaid Integration Tracker is a monthly report summarizing state actions in Managed Long Term Services and Supports (MLTSS), as well as State Demonstrations to Integrate Care for Dual Eligible Individuals and other Medicare-Medicaid Coordination Initiatives.


The Tracker also includes updates on state participation in other LTSS activities, including: the Balancing Incentive Program; Medicaid State Plan Amendments under §1915(i); Community First Choice Option under §1915(k); and Medicaid Health Homes.


Please note that the Tracker has been reformatted beginning with the November 2014 Edition, in order to improve readability. The monthly PDF now only includes new updates for each state. 


Click here to view this month's Tracker.
Click here for comprehensive information on each state, as well as archived versions of the Tracker.
Click here to sign up for alerts on Tracker updates.

MIPPA Outreach Materials for Low-Income Medicare Beneficiaries with Disabilities

In collaboration with consumers and professionals in the aging and disabilities network, NASUAD has developed outreach materials to promote Medicare low-income subsidies to beneficiaries with disabilities. NASUAD created three posters to educate Medicare beneficiaries with disabilities about subsidies that may help them save on Medicare costs.  NASUAD also developed a Tip Sheet for MIPPA outreach professionals to use as a quick reference tool about Medicare low-income subsidies and referral resources. The posters include an editable space wherein outreach professionals may add contact information for their preferred referral source.


Click here to view or download the Posters and Tip Sheet.

From the Administration
Administration for Community Living

Older Americans Month 2015 Theme Announced

Each May, the Administration for Community Living (ACL) celebrates Older Americans Month to recognize older Americans for their contributions to the nation. In honor of the upcoming 50th anniversary of the Older Americans Act (OAA), ACL is focused on how older adults are taking charge of their health, getting engaged in their communities, and making a positive impact in the lives of others. The theme for Older Americans Month 2015 is "Get into the Act."


The 2015 Older Americans Month can serve as a vehicle for individual and community empowerment. By promoting and engaging in activity, wellness, and inclusivity, more Americans than ever before can "Get into the Act." As Older Americans Month approaches, ACL will provide additional information on events and activities.

Census Bureau

Census Bureau Issues Report on Older Americans with a Disability  

On December 2nd, the Census Bureau released Older Americans with a Disability: 2008-2012. The report examines the demographic and socioeconomic characteristics, as well as the geographic distribution of the older population with a disability, with a focus on those in poverty or living alone. Data for this report come from the American Community Survey (ACS) 5-year estimates with interviews conducted in 2008 to 2012 pooled together.  


The report finds that nearly 40 percent of people age 65 and older had at least one disability. Key finding include the following:  


  • More than one-third of those 85 and older with a disability lived alone, compared with one-fourth of those age 65 to 74.
  • About 13 percent of the older household population with a disability lived in poverty; in contrast, 7 percent of those without a disability were in poverty.
  • The older population with a disability was disproportionately concentrated among those 85 and older. This group represented 13.6 percent of the total older population but accounted for 25.4 percent of the older population with a disability.
  • Women 65 and older were more likely than men 65 and older to have five of the six types of disability included in the American Community Survey, especially ambulatory difficulty.


Click here to access the report. 

Centers for Medicare & Medicaid Services

Barbara Edwards Resigns from CMCS

After five years with the Center for Medicaid and CHIP Services, Barbara Edwards has announced her resignation as Director of the Disabled and Elderly Health Programs Group, effective at the end of the year. During her time as Director, Edwards served as a leader in the re-balance of Medicaid's long term services and supports expenditures, assisted with Medicaid expansion in 28 states, and oversaw the development of a new national pharmacy pricing benchmark. Deputy Director Alissa DeBoy will serve as Acting Group Director while CMCS seeks to hire a permanent director. 

Proposed Changes to the Medicare Shared Savings Program Regulations

On December 1, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update and improve policies governing the Medicare Shared Savings Program.  The proposed rule addresses suggested changes to several program areas including beneficiary assignment, data sharing, available risk models, eligibility requirements, participation agreement renewals, and compliance and monitoring.  Additionally, the proposed rule seeks comment on issues related to financial benchmarking and waivers for program and other payment rules.  There will be a 60-day public comment period on the proposal.


To access a fact sheet on the proposed changes, click here.

To view the proposed rule, click here.

CMS Releases New SSI/Spousal Impoverishment Standards

On November 25, CMS announced the new spousal impoverishment standards and income eligibility criteria for several Medicaid LTSS options. The income and resource standards are adjusted based upon the annual inflationary update to the Supplemental Security Income (SSI) federal benefit rate and the Consumer Price Index (CPI). Specifically, the updates would impact eligibility for programs such as the optional "special income level" institutional eligibility category which allows LTSS participants to qualify for Medicaid if their income is below 300% of the SSI federal benefit rate. Although this is an optional category, most states have chosen to adopt it. The bulletin also announced updated spousal impoverishment standards, which allow the husband or wife of an individual receiving Medicaid LTSS to retain a share of the couple's income and assets without affecting their spouse's eligibility. Spousal impoverishment standards are mandatory for institutional placement and were also mandated for HCBS participants in the ACA during the period lasting from 2014-2019. Standards should be updated in accordance with this information for the provisions that become effective on January 1, 2015.


Click here to view the 2015 SSI and Spousal Impoverishment Standards chart that displays the new standards. 
Federal Communications Commission

FCC Seeks Nominations for New Diversity Advisory Committee

This week the Federal Communications Commission announced the formation of a Disability Advisory Committee and seeks nominations for membership. The Committee will provide an opportunity for consumers and other stakeholders to provide feedback and recommendations to the FCC on a wide array of disability issues.


Click here for more information on the Committee and the nomination process. The deadline to nominate Committee members is January 12, 2015.

Health and Human Services
ASPE Releases SASH Evaluation

The Office of Disability, Aging and Long-Term Care Policy recently published the First Annual Report for the Support And Services at Home (SASH) Evaluation. SASH is a model of care coordination centered on affordable housing sites for older adults. The program is intended to improve health and decrease health care expenditures among elderly residents of affordable housing developments by connecting residents with community-based services and promoting coordination of health care. The report describes implementation challenges and early impacts of the SASH program, which was launched in July 2011. 


Click here for the full report. 

Office of Disability Employment Policy

ODEP Launches Expanded Employment First State Leadership Mentoring Program  

The Office of Disability Employment Policy (ODEP) has expanded direct and virtual technical assistance, training, ongoing mentoring, and policy development support to 15 core states as part of the Employment First State Leadership Mentoring Program (EFSLMP). The FY2015 EFSLMP core states include Alabama, Arkansas, Delaware, District of Columbia, Hawaii, Illinois, Iowa, Maryland, Maine, Michigan, North Carolina, Ohio, Pennsylvania, Tennessee, and Utah. Since its inception in FY2012, the EFSLMP has provided intensive onsite and virtual technical assistance to state governments in the areas of capacity building in the dissemination of customized employment and other effective practices that lead to integrated employment as the priority outcome of services to individuals with significant disabilities; provider transformation strategies; approaches to successful employer engagement; and school-to-work transition models.

From Congress
Congress Working to Pass Appropriations 

Over the past several weeks, Congress has been working to pass a package of appropriations bills that would continue funding for government operations. The current appropriations authority expires on December 11, so a funding measure must be passed before this date in order to keep the government open. Negotiators indicate that proposed legislation will include funding for most of the Federal government through the end of FY2015 (i.e. until September 30, 2015). The proposed funding levels for various programs have not yet been announced as negotiators continue to work through the final details; however, appropriators expect to introduce legislative language early next week. Due to the tight deadlines associated with the current funding authorization and some continuing disagreement over policy items that may be included in the legislation, it is possible that Congress will need to pass another short-term continuing resolution that funds government at current levels for 60 or 90 days. The most likely course of action will become more clear early next week.  

House Overwhelmingly Passes ABLE Act

On Wednesday, December 3, the House voted 404-17 to pass the Achieving a Better Life Experience Act, or ABLE Act. Trumpeted as the broadest legislation to help people with disabilities since 1990, the bipartisan bill allows Americans with disabilities to open tax-sheltered bank accounts to pay for certain long-term expenses. Modeled after tax-free college savings accounts, the bill would affect as many as 54 million Americans born with disabilities, amending the federal tax code to allow states to establish the program. ABLE accounts could accrue up to $100,000 without the person losing eligibility for government aid, and Medicaid coverage would continue no matter how much money is deposited in the accounts.


Click here to view the bill. 

From the States
Wyoming Releases Medicaid Expansion Proposal

Last week the Wyoming Department of Health (WDH) released a plan for Medicaid expansion. The department calls its recommended plan, "Wyoming's Strategy for Health, Access, Responsibility and Employment," or the "SHARE Plan." The proposal includes such components as cost sharing, a work benefit and appropriate case management. If approved by the Wyoming Legislature and signed into law, the SHARE Plan would include two new programs based on participant income. Wyoming Governor Matt Mead (R) supports the Medicaid expansion plan.


The expansion would cover more than 17,000 Wyoming residents and inject $100-120 million in new federal funds into Wyoming's economy. Additional analysis suggests this funding would create approximately 800 new jobs.


Click here to view the full release. 

From Other Organizations
Alliance of Information and Referral Systems
AIRS Releases 2015 Conference Call for Proposals

The Alliance of Information and Referral Systems (AIRS) has released the call for proposals for the 2015 Annual Information and Referral (I&R) Training and Education Conference. Next year's conference is being held in Dallas, Texas with pre-conference intensives on May 27 and the regular conference May 28-30


AIRS is seeking workshops addressing the breadth of I&R service delivery. The Aging and Disability track provides a valuable opportunity to share developments and effective practices in serving older adults and persons with disabilities with I&R colleagues across the country. This track is coordinated by NASUAD's I&R Support Center, which strongly encourages aging and disability I&R agencies to review the call for proposals and consider a submission. Past topics are listed on the AIRS site here, and the current call for proposals is available here. For ideas on workshop topics, please see these suggestions from conference attendees. Additionally, topics such as elder justice, mental health, aging with a disability, developments in home and community-based services, cross-sector partnerships and collaboration, no wrong door system building, ADRC funding and sustainability, business acumen, and data collection and quality assurance are topics of interest in aging and disability I&R. 

The deadline for proposal submissions is February 10, 2015. Send submissions for the Aging and Disability track to Nanette Relave at

Institute on Disability

Annual Disability Statistics Compendium Released

The Institute on Disability at the University of New Hampshire has released the Annual Disability Statistics Compendium, a publication of statistics on people with disabilities and government programs that serve the population with disabilities. The Compendium is a web-based tool that pools disability statistics and is designed to serve as a reference guide to government publications. The publication includes sections on key statistics such as: population and disability prevalence; employment and earnings; veterans; health insurance coverage; Medicare and Medicaid; Special Education programs; vocational rehabilitation; federal government spending and employment; and international disability statistics.


Click here to access the Compendium.

Health Affairs

National Health Expenditures Continued Slow Growth in 2013

According to a report by Health Affairs, health spending continued to grow at a slow rate last year, extending a historic slowdown in medical spending. The report states that in 2013 US health care spending increased 3.6 percent to $2.9 trillion, or $9,255 per person. Health care spending decelerated 0.5 percentage point in 2013, compared to 2012, as a result of slower growth in private health insurance and Medicare spending. Slower growth in spending for hospital care, investments in medical structures and equipment, and spending for physician and clinical care also contributed to the low overall increase; however, faster growth in Medicaid spending, due to Medicaid expansion, helped to partially offset the slowdown.


Click here to view the report. 

Kaiser Family Foundation

New Medicaid Managed Care Market Tracker and Web Briefing

More than half of the nation's 67.9 million Medicaid beneficiaries now receive their health care in comprehensive managed care organizations (MCOs) -- and the number and share are growing. As states expand their use of Medicaid managed care, the Kaiser Family Foundation has launched a new interactive tool to enhance understanding and analysis of this important sector of the Medicaid program. The Medicaid Managed Care Market Tracker provides the latest data on risk-based Medicaid managed care for the 39 states that contract with MCOs and are home to more than 90 percent of all Medicaid beneficiaries nationwide. Constructed with data from multiple sources, the Tracker gathers and organizes a wide range of information in an interactive format that can be used flexibly for national, state-level, MCO-level, firm-level, and insurance market-level analysis.


On Thursday, December 11 at 12:30 p.m. ET, the Kaiser Family Foundation will host an interactive web briefing with Medicaid managed care expert who will demonstrate how the new Medicaid Managed Care Market Tracker tool can be used to retrieve and analyze Medicaid managed care data, and will answer questions from the audience about the tool.  


Register for the webinar here.

Mathematica Policy Reseach
Webinar: Disability Research Seminar Series

Policymakers are searching for ways to improve the supports workers receive after the onset or worsening of a major medical condition, with the objective of reducing exit from the labor force and entry into Social Security Disability Insurance. Mathematica Policy Research will host a webinar on Mondaym titled: The Disability Consequences of Poor Quality of Care Under Workers' Compensation and Findings from a Quality Improvement Initiative in Washington State, on December 8 from 12:00-1:30 p.m. ET, to explore new research findings from Washington State's workers' compensation system.


Dr. Gary Franklin, medical director for Washington's workers' compensation program and professor at the University of Washington, and Professor Thomas Wickizer of Ohio State University will present findings from recently published research in which they: identify deficiencies in the care delivered to workers' compensation claimants; describe the approach used to improve the quality of care by a Washington State care coordination and improvement initiative implemented by the Center for Occupational Health and Education (COHE); and evaluate the COHE initiative's impacts on lost work time, net benefit costs, and other outcomes.


Click here to view the event page. 

National Academy for State Health Policy
Webinar: A Walk in Someone Else's Shoes: Payment Reform Perspectives from Providers and Private Payers

On Monday, December 15 from 12:30-2:00 p.m. ET, NASHP will host a webinar on multi-payer reforms and the roles of providers and insurers. As states design and implement multi-payer payment reforms, extensive collaboration with and buy-in from payers and providers is necessary. This panel-style webinar will feature a discussion with representatives from a commercial insurer, a self-insured employer, a large hospital system, and a primary care practice. Panelists will discuss their interaction with state delivery and payment transformation as well as their goals and motivations for participating in such efforts. The webinar audience will learn about the unique challenges that each of these stakeholders face in implementing state health system reforms and the ways in which states can better collaborate with payers, purchasers, and providers.


Register for the webinar here.

National Council on Aging
New Medicare Data Visualization Tool
NCOA's has developed a new data tool which offers three different modes of visualization of low-income Medicare beneficiaries who face disability and/or difficulty with ADLs and who may be eligible for but not receiving benefits. The first visualization displays an aggregated view of the number and percentage of low-income Medicare beneficiaries with any self-reported disability or difficulty within a state. The second visualization displays a view of the percentages and numbers of low-income Medicare beneficiaries with specific self-reported disabilities or difficulties within a state. The third visualization displays a breakdown of the proportion and number of low-income Medicare beneficiaries within a given state or county by types of self-reported difficulties or disabilities. Using this data, agencies and community-based organizations helping people access benefits can get a clearer picture of the sorts of difficulties people in their service areas face.

Click here to access the new visualization tool.

Webinar: Three Online Tools to Help Older Adults Save Money
On Wednesday, December 10 from 2:00-3:00 p.m. ET, NCOA will present a  webinar on money-saving resources for those who may not qualify for benefits programs. The webinar will highlight three free, online tools that older adults and the professionals who serve them can use to find budgeting tools, jobs, benefits, and more.
  • Launched earlier this year, EconomicCheckUp® includes spending and debt calculators; job skills training and employment resources; and a personalized financial security assessment.
  • My Medicare Matters®, an educational site, and Medicare QuickCheck tool can help people with Medicare and those aging into Medicare determine how to select the most appropriate coverage that suits their personal situation and when to enroll.
  • BenefitsCheckUp® is a comprehensive online tool that screens for thousands of public and private programs, including Medicaid expansion and property tax relief.
 Click here to register.
NCOA Grants for New Benefits Enrollment Centers
NCOA's Center for Benefits Access is seeking nonprofit or public agencies to be part of our next cohort of Benefits Enrollment Centers (BEC). BECs use person-centered strategies in a coordinated, community-wide approach to find and enroll Medicare beneficiaries-both seniors aged 65+ years and adults living with disabilities, aged 21-64, who have limited income and resources-into available benefits. The primary focus is on Medicare Part D Extra Help (or Low-Income Subsidy, LIS), Medicare Savings Programs (MSP), Medicaid, Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamps), and Low-Income Home Energy Assistance Program (LIHEAP).
Organizations eligible to apply for BEC grants include state or community-based nonprofit organizations, government agencies, faith-based organizations, and coalitions addressing the needs of older adults and younger adults with disabilities. Organizations that have been funded in the past as BECs are not eligible for this award. Successful applicants will receive up to $100,000 over 15 months to enroll Medicare beneficiaries in core benefits. The deadline for full proposals is December 12th, 5:00 p.m. ET.
Click here to access the RFP.
Pharmaceutical Research and Manufacturers of America 
Conversations on Medicare
Each week, PhRMA publishes Conversations, a weekly forum of question and response from a mix of field experts

to facilitate constructive debate on health and medical topics. This week, PhRMA asked, "What should Medicare enrolled seniors and individuals living with disabilities be doing to take advantage of the Medicare Part D open enrollment period?" 


Six experts in the field, including NASUAD's Executive Director, Martha Roherty, shared input, advice and helpful tips to making the most of the Medicare Open Enrollment season which ends Sunday, December 7th.

To view the expert responses or join the conversation, click here.

2015 National Health Policy Conference

The NHPC brings together experts in health policy who will provide analysis and feedback on the health policy environment and will discuss how changes in government will impact ACA implementation. With input from leading health policy experts, the conference aims enhance your understanding of the current and future health policy landscape. Designed as an in-depth, two day interactive conference, the NHPC will take place February 9-10, 2015 at the Renaissance Washington, DC Downtown Hotel. Sessions will address innovations in care delivery and financing, updates on state experiences with Medicaid and the exchanges, and opportunities and challenges for the evolving health care workforce.


Click here to view the full conference agenda and register.

Early registration by December 19 receives a discounted rate.

Alzheimer's Disease Research Summit 2015

The Alzheimer's Disease Research Summit 2015: Path to Treatment and Prevention will be held February 9-10, 2015 at the National Institutes of Health. The central goal of the Summit is to continue the development of an integrated multidisciplinary research agenda necessary to address critical knowledge gaps and accelerate the discovery and delivery of effective treatments for Alzheimer's patients at all stages of disease. Key to achieving this goal is the identification of resources/infrastructure and multi-stakeholder partnerships necessary to successfully implement this research agenda and strategies to empower patients and engage citizens.


Click here to register.

2015 Aging in America Conference

The American Society on Aging is hosting its 2015 Aging in America Conference from March 23-27 at the Hyatt Regency in Chicago. The five-day conference includes workshops on senior poverty, the 2015 White House Conference on Aging, and the National Forum on Social and Health Disparities in Aging. The full conference schedule is available here.


Register here by December 5 to save $100. 
Job Postings
Public Policy Intern at NASUAD

The National Association of States United for Aging and Disabilities (NASUAD), the membership organization of the agencies in state government that manage programs for older people and adults with physical disabilities, seeks a public policy intern.


Responsibilities include analyzing aging and disability data, developing and/or maintaining databases, assisting with project management, and conducting legislative and policy research. 


Applicants must have strong data analytic, data management, research and written communication skills. Candidacy for a Master's Degree in Public Policy, Public Administration or Public Health is required. Hours are flexible to accommodate classes.


To apply, please send a resume and cover letter to: NASUAD is committed to providing equal opportunities for all applicants for employment.

CMS Medicaid Innovation Accelerator Program Hiring Opportunities

The Centers for Medicare & Medicaid Services (CMS) is seeking highly qualified candidates to stand up and staff the new Medicaid Innovation Accelerator Program (IAP). The IAP is a new technical assistance program launched by Center for Medicaid & Children's Health Insurance Program (CHIP) Services (CMCS) within CMS. The goal of IAP is to improve health and health care for Medicaid recipients by providing direct technical support to states in their efforts to accelerate new payment and service delivery reforms. The IAP will be a vehicle to work closely with states as well as with health plans, providers and beneficiaries on these critical issues.  


To support this important new initiative, CMCS has openings at a variety of levels (GS 12-14). CMCS is seeking health care professionals to work primarily in suburban Baltimore, MD; however, some positions may be filled in one or more of the following CMS locations: Washington, DC, Boston, MA, New York, NY, Philadelphia, PA, Atlanta, GA, Kansas City, MO, Chicago, IL, Dallas, TX, Denver, CO, or San Francisco, CA. We are seeking candidates with some or all of the following skill sets to drive service delivery and payment innovation in the Medicaid program:  

  • Developing Health Services Delivery and Payment Models

  • Data Analytics

  • Quality Metrics

  • Risk Adjustment

  • Financial Modeling

Knowledge of Medicare and/or Medicaid law, regulations, and policies or other national health care systems is preferred. Also required are excellent skills in communication, teamwork, and policy analysis.  


Positions close on Friday, December 12, 2014.

Click here for additional details and links to positions. 

Friday Update Archive


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