December 19, 2014
In This Issue
*NASUAD Publishes Report on CBO Readiness for MLTSS.
*NASUAD Commends Elder Justice Funding
*Webinar: Find New Volunteers in the New Year: Ideas on How to Reach More People
*CMS Issues Guidance on Non-Residential HCBS Settings
*CMS Announces Round Two State Innovation Models Initiative Model Test & Model Design Awards
*CMS Releases Monthly Medicaid Eligibility and Enrollment Report
*State Medicaid Director Letter on "Free Care" Policy
*DOJ and OCR Issue Joint Letter on FSLA Rule and Olmstead
*FCC Seeks Nominations for New Diversity Advisory Committee
*HHS: 2015 Healthy Aging Summit Call for Abstracts
*Congress Passes ABLE Act
*Report Offers Ways to Increase Affordable Drugs Within Medicare Rx Program
*Surgeon General Confirmed
*Tennessee Looks to Expand Medicaid
*AIRS Releases 2015 Conference Call for Proposals
*ACAP Releases Two Papers on Safety Net Health Plans and Integrated Care
*Mathematica: New Issue Brief on Medicaid Managed Care Oversight
*NAHSP: New Learning Collaborative: Request for Applications
*NCOA: Healthy LGBT Aging Photo Contest
*NDNRC: New Population-Specific Fact Sheets
*Think College: Survey on Accreditation Standards
*Job Postings
*Friday Updates Archive
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NASUAD Publishes Report on CBO Readiness for MLTSS
The National Association of States United for Aging and Disabilities (NASUAD) has published a new report "Community-Based Organizations and MLTSS: An Issue Brief to Assess CBO Readiness." As almost half of the States have implemented Managed Long Term Services and Supports (MLTSS) programs, community-based organizations (CBOs), such as Area Agencies on Aging and Centers for Independent Living, will be significantly impacted. At the 2013 HCBS conference, NASUAD, with support from the SCAN Foundation, held a day-long intensive to discuss these impacts. The resulting report outlines five discrete roles that CBOs are well-suited to play in MLTSS programs, using as a reference point CMS' 2013 guidance on MLTSS program design and implementation. CBOs are advised to consider a few key questions when assessing the feasibility of taking on new or expanded  roles in MLTSS programs.  

Case studies on ombudsman programs and care/service coordination - also culled from the 2013 MLTSS intensive - are provided in separate documents. The ombudsman case studies highlight activities in Wisconsin, Hawaii, and Minnesota, while the care/service coordination case studies discuss CBO experiences in Massachusetts and Ohio.
Click here to view the CBO report, and click here to access the case studies.
NASUAD Commends Elder Justice Funding
As a founding member of the Elder Justice Coalition (EJC), NASUAD is pleased to celebrate the official funding for the Elder Justice Act alongside the EJC. President Obama signed the omnibus spending bill, securing the first direct Congressional appropriation for the Elder Justice Act, into law on December 16th, 2014.

The bill includes $4 million for a new Elder Justice Initiative to "provide competitive grants to States to test and evaluate innovative approaches to preventing and responding to elder abuse." Additionally, the spending bill substantially increases funding for the Crime Victims Fund from $730 million to $2.361 billion, which should lead to additional funding for victim assistance grants.

NASUAD also applauds the constructive steps taken by the Administration this past year including the publication of the Elder Justice Roadmap Initiative and the establishment of a new Office of Elder Justice and Adult Protective Services within the Administration for Community Living.
Webinar: Find New Volunteers in the New Year: Ideas on How to Reach More People
Join us Thursday, January 8th, 1:00 p.m. to 2:00 p.m. ET to learn about resources for growing your volunteer base. The "Got an Hour?" Campaign is designed to help local agencies attract volunteers to programs that work with seniors. The webinar will review the "Got an Hour?" Campaign's downloadable materials , webinars, and a search tool (powered by to help connect prospective volunteers with opportunities and programs in their own neighborhood.

The "Got an Hour?" Campaign was developed through the Aging Network Volunteer Collaborative to help local agencies throughout the country attract volunteers to programs that work with seniors.

Click here to join the visual component of the webinar.
To listen you must call 888-346-3659, Passcode: 33688
From the Administration
Centers for Medicare & Medicaid

CMS Issues Guidance on Non-Residential HCBS Settings

On December 15, the Centers for Medicare and Medicaid Services (CMS) added a set of exploratory questions and frequently asked questions to the Home and Community-Based Services (HCBS) regulation toolkit on According to CMS, these complete the sub-regulatory guidance that CMS plans to issue at this time about compliance with the HCBS regulations; consequently, states should move forward with developing and/or modifying their waiver-specific and statewide transition plans to address non-residential HCBS services. The exploratory questions, as promised, mirror closely the residential settings exploratory questions that were released earlier this year. These questions are not a checklist that have to be answered for all services but serve as considerations for system evaluation. This document also provides considerations for assessing services that are highly clinical/medical in nature, such as medical adult day programs. The non-residential setting FAQs begin on page nine of the comprehensive set of FAQs and include answers to questions of particular interest to agencies serving older adults, including disability-specific settings such as dementia-specific adult day centers, secured access settings and non-residential services such as adult day services provided in an institutional setting among others.

The "Exploratory Questions to Assist States in Assessment of Non-Residential Home and Community-Based Service (HCBS)/Settings" and the "HCBS Final Regulations 42 CRF Part 441: Questions and Answers Regarding Home and Community-Based Settings" documents are both available here.

CMS Announces Round Two State Innovation Models Initiative Model Test & Model Design Awards

On December 16th, the Centers for Medicare & Medicaid Services (CMS) announced the recipients of 11 Model Test and 21 Model Design awards under the second round of the State Innovation Models (SIM) initiative. In round two, the SIM initiative is providing over $665 million to support state-led, multi-payer health care payment and service delivery models that will improve health system performance, increase quality of care, and decrease costs for Medicare, Medicaid, and Children's Health Insurance Program (CHIP) beneficiaries and for all residents of participating states.

Over $622 million in Model Test awards will support 11 states that are ready to implement their State Health Care Innovation Plans, proposals describing a state's strategy to utilize available regulatory and policy levers to accelerate transformation. CMS will work with Model Test states for four years. The Model Test awardees are: New York, Iowa, Colorado, Connecticut, Delaware, Idaho, Michigan, Ohio, Tennessee, Washington, and Rhode Island.

Over $42 million in Model Design awards will support 21 entities in engaging a diverse group of stakeholders to further refine a State Health Care Innovation Plan. States receiving Model Design awards will have twelve months to submit their State Health Care Innovation Plans to CMS. The Model Design awardees are: Arizona, Utah, Pennsylvania, Maryland, California, Illinois, New Jersey, Puerto Rico, Commonwealth of the Northern Mariana Islands, American Samoa, District of Columbia, Hawaii, Kentucky, Montana, Nevada, New Hampshire, New Mexico, Oklahoma, Virginia, West Virginia, and Wisconsin.

Click here for more information on the State Innovation Models Initiative.

CMS Releases Monthly Medicaid Eligibility and Enrollment Report 

On Thursday, December 18, CMS released the latest Medicaid Eligibility and Enrollment report.  The report, covering October 2014, demonstrates that Medicaid enrollment continued to climb throughout 2014 after ACA open enrollment ended.  According to CMS, an additional 428,311 individuals were enrolled in October 2014 compared to September 2014. The Medicaid program grew by approximately 9.7 million individuals between September 2013 and October 2014.  Although states that adopted the Medicaid expansion saw the largest enrollment increases, the monthly report indicates that many states who did not expand their programs also saw substantial enrollment increases. This is largely due to the impact of simplified eligibility processes, mandatory eligibility changes in ACA, and the increased knowledge of the program due to ACA outreach. The next report will include some additional information about potential impacts of the next ACA open enrollment period.

To access the full report, click here.

State Medicaid Director Letter on "Free Care" Policy

CMS released an State Medicaid Director Letter (SMDL) on Monday, December 15 addressing the obligations of Medicaid programs to provide reimbursement for services rendered to Medicaid beneficiaries which are otherwise provided at no charge to the general public. This policy has long impeded States' ability to claim Federal funds for payments made to other public agencies on behalf of Medicaid beneficiaries. CMS has now clearly stated that Medicaid reimbursement is available for covered services under the approved state plan that are provided to Medicaid beneficiaries, regardless of whether there is any charge for the service to the beneficiary or the community at large. As a result, Federal Financial Participation (FFP) is available for Medicaid payments for care provided through providers that do not charge individuals for the service, as long as all other Medicaid requirements are met.  The impact this policy change may have on OAA-funded services is still being analyzed but it can be expected that it will be helpful to states providing OAA services to Medicaid beneficiaries.

Click here to view the letter.
Department of Justice

DOJ and OCR Issue Joint Letter on FSLA Rule and Olmstead

On December 15, the Department of Justice's Civil Rights Division and the Department of Health and Human Services' Office for Civil Rights issued joint guidance regarding Olmstead and the implementation of the Department of Labor's Fair Labor Standards Act (FLSA) regulatory revisions finalized October 1, 2013 (effective on January 1, 2015). This 'Dear Colleague' letter stresses that notwithstanding the year of non-enforcement that DOJ had previously announced, states are to consider their obligations and individual's rights under the integration mandate of Title II of the Americans with Disabilities Act and the 1999 landmark Supreme Court decision, Olmstead v. L.C. More specifically, states are obligated to ensure that people with disabilities are not placed at serious risk of institutionalization because of changes that may be made to the home health service delivery system, such as across-the-board caps on service hours. The letter strongly suggests that states, in implementing the revised FLSA rules, should consider offering reasonable exceptions to those caps to account for individuals' needs.

Click here to read the complete letter.
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
2015 Healthy Aging Summit Call for Abstracts  

The HHS Office of Disease Prevention and Health Promotion requests abstracts addressing the science of healthy aging for presentation at the 2015 Healthy Aging Summit, to be hosted July 27-28 in Washington, DC. The goals of the summit are to: 1) explore the science on healthy aging; 2) identify knowledge gaps that need to be filled; 3) promote prevention in improving quality of life in later years; and 4) mobilize action to improve the delivery of care for those aging in place or in transition between care settings. Submissions should address these goals. Presentations that focus on collaboration with diverse partners and have international applications are encouraged.  


Click here for more information on the Summit. Submission deadline is Monday, February 2 at 11:59 p.m. ET

From Congress
Congress Passes ABLE Act 
Congress has passed the Achieving a Better Life Experience (ABLE) Act of 2014 to encourage and assist individuals and families in saving funds for the purpose of supporting individuals with disabilities to maintain health, independence, and quality of life. The bill (H.R. 647) passed the House of Representatives on December 3, 404 to 17. On Tuesday, December 16, the bill passed the Senate as part of a larger tax package by a margin of 76 to 16. The legislation amends the Internal Revenue Code to create tax-advantaged savings accounts to allow savings for qualified disability expenses such as expenses for education, housing, transportation, employment training and support, assistive technology and personal support services, health, prevention and wellness. Additionally, savings in ABLE accounts are intended to supplement, but not replace, benefits provided through private insurance, the Supplemental Security Income program, Medicaid, the beneficiary's employment, and other sources. As such, funds in ABLE accounts are to be disregarded in determining eligibility for means-tested federal programs except as described in the legislation. To reduce the overall cost of the program, the legislation includes restrictions such as that qualified individuals are limited to individuals whose disability or blindness occurred before the age of 26.

More information on the bill can be found here.
Report Offers Ways to Increase Affordable Drugs Within Medicare Rx Program

On Monday, December 15th, the U.S. Senate Special Committee on Aging released a new bipartisan report that focuses on ways to increase the use of generic drugs within the Medicare Part D program. In addition to the report, the committee is calling the Government Accountability Office (GAO) to examine the cause behind recent price increases for certain generic drugs, like heart medication digoxin which has been on the market for years. On average, the retail price of a generic drug is 75 percent lower than the retail price of a brand-name drug.  A 2010 Congressional Budget Office (CBO) report estimated the use of generic drugs in the Part D program saved beneficiaries and taxpayers approximately $33 billion in one year alone.

 The issue of generic drug price spikes has recently attracted attention from the Justice Department and the Senate Committee on Health, Education, Labor & Pensions Subcommittee on Primary Health and Aging.

Specifically, the Committee's report outlines a series of policy recommendations that include:  

  • Providing incentives to prescription drug plan sponsors who increase generics use;
  • Finding innovative ways to expand generic drug usage among low-income subsidy beneficiaries;
  • Increasing education of beneficiaries and health professionals on the safety, effectiveness and cost benefits of generic medications;
  • Improving investigations of questionable pharmacy billing practices that thwart efforts to incentivize generics.

The committee's findings were part of comprehensive two-year review that analyzed drug plan formularies, pharmacy billing, physician prescribing practices, and plan sponsor programs to incentivize generics use. Click here to view the full report.

Surgeon General Confirmed 

The Senate voted 51 to 43 to confirm new Surgeon General Vivek Murthy this past Monday. Dr. Murthy, a Harvard and Yale-educated doctor at Brigham and Women's Hospital in Boston, was nominated to the post by President Obama in November 2013.

From the States 
Tennessee Looks to Expand Medicaid

Tennessee Governor Bill Haslam (R) has proposed the Insure Tennessee Plan, an alternative plan for expanding Medicaid. Tennessee Hospital Association has committed to pay expansion costs beyond what the federal government covers.

Five key areas of the governor's plan include: 

  • A fiscally sound and sustainable program;
  • Providing two new private market choices for Tennesseans;
  • Shifting the delivery model and payment of health care in Tennessee from fee-for-service to outcomes based;
  • Incentivizing Tennesseans to be more engaged and to take more personal responsibility in their health;
  • And preparing participants for eventual transition to commercial health coverage.

 If the expansion plan is approved by the state Legislature during a special session in January, Tennessee will join 27 states that have expanded Medicaid under the Affordable Care Act.

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
Association for Community Affiliated Plans
ACAP Releases Two Papers on Safety Net Health Plans and Integrated Care

The Association for Community Affiliated Plans (ACAP) recently released two new fact sheets regarding Safety Net Health Plans. The first, Working with Providers in Underserved Areas to Integrate Behavioral Health and Primary Care, examines four Safety Net Health Plan endeavors to bridge the longstanding divide between physical and behavioral health services. The disconnect in services contributes to considerably worse health outcomes for individuals who live with mental illness. The report profiles four examples where the safety net community - health plans, community health centers, community mental health centers, and the centers' primary care and behavioral health clinicians - have collaborated to develop programs to integrate care for this population.


The second publication, Safety Net Health Plans Deliver Better Care and Increase Access via Telemedicine, describes the efforts of five Safety Net Health Plans to implement telemedicine and offers policy suggestions aimed at lowering barriers to its adoption.Telemedicine is one strategy health plans use to maximize their network capacity in order to meet the primary and specialty care needs of individuals and families--including those who recently gained coverage through the expansion of the Medicaid program. Telemedicine can be of particular help to patients who live in areas with few or no specialists, as it can spare them a long wait for an appointment or a long drive.

Mathematica Policy Research 
New Issue Brief on Medicaid Managed Care Oversight
The majority of Medicaid beneficiaries are covered under state contracts with managed care organizations, and yet there are no recognizable standards to guide effective state monitoring of managed care plans. In addressing this gap, Mathematica has released a new assessment on state oversight of Medicaid managed care. The issue brief describes a new approach used to evaluate state oversight of the Apple Health program, a Medicaid managed care program for individuals with disabilities, in Washington State. The approach evaluates both the type and vigor of monitoring activities by the state and the degree to which the state's activities achieved their desired program outcomes.

Click here to access the issue brief.
National Academy for State Health Policy
New Learning Collaborative: Request for Applications

The NASHP has announced a new learning collaborative for states developing and implementing programs to integrate primary care, behavioral health, and social services for individuals with chronic medical conditions and comorbidities-- particularly vulnerable, low-income populations. Up to six selected states will receive 18 months of targeted technical assistance tailored to supporting the development and implementation of integration programs. Applications must be submitted by Friday, January 9 at 5:00 p.m. ET.


Click here to view the full request and application. 

National Council on Aging 
Healthy LGBT Aging Photo Contest
The National Resource Center on LGBT Aging and the National Institute of Senior Centers are seeking photos highlighting the beauty of LGBT aging. Submissions should be fun, diverse, and positive photos that exemplify what it is to be an aging lesbian, gay, bisexual, and/or transgender person. Winners will receive an Amazon gift card and have their story featured online. The submissions period will be open from January 13 to March 13.

Find contest details here
National Disability Navigator Resource Collaborative 
New Population-Specific Fact Sheets
The NDNRC has released additional issues in a series of new population-specific fact sheets designed to help Navigators identify what issues are unique to consumers with specific conditions so that they can assist them as they make decisions related to their healthcare coverage. "What to Know When Assisting a Consumer with Multiple Sclerosis" and "What to Know When Assisting a Consumer with Intellectual Disability" were published last Friday. Along with the population-specific fact sheets, the NDNRC will add four new topical fact sheets focused on: renewals and redeterminations; moving from coverage-to-care for people with disabilities; meeting the communication needs of specific disability populations; and disability etiquette.
Click here to view a complete list of published and soon-to-be released fact sheets.
Think College 

Survey on Accreditation Standards for Students with Intellectual Disabilities 

The Think College National Coordinating Center's Accreditation Workgroup has developed draft accreditation standards for higher education programs for students with intellectual disabilities. Comments on its Draft Model Accreditation Standards for Programs that Serve Students with Intellectual Disabilities are being collected now via an online survey. The Workgroup is seeking input from educators, parents, and other interested parties.

The deadline to complete the survey is Saturday, December 20. To view the survey, 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

Next March 23-27, Aging in America, the annual conference of the American Society on Aging, will take place in Chicago and will offer five days of intensive learning, networking, and community-building. Aging in America is the nation's largest multidisciplinary conference for professionals who work with older adults, including aging service providers, policymakers, social workers, senior center professionals, healthcare providers, caregivers, and anyone with a passion for improving the lives of older adults.  

Conference attendees, exhibitors, and presenters will:

  • Learn about new and innovative ideas that will help you in your work with older adults;
  • Discover practical solutions to the challenges you face on a day-to-day basis;
  • Connect with peers and leaders who will transform the way you think about aging;
  • Reach a community of professionals who collectively influence the lives of hundreds of thousands of older people through their everyday work.


NASUAD members can save 10% on registration fees by using the discount code NASUAD10. Register by January 31, and save an additional $50. Click here to register. 
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.  


The application window has been extended, and positions now close on Friday, December 19, 2014. Click here for additional details and links to positions. 

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