June 24, 2016
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NASUAD, in Partnership with NCIL, Releases I&R/A Survey Report
The National Information and Referral Support Center, administered by NASUAD, in partnership with the National Council on Independent Living (NCIL), shares findings from the aging and disability I&R/A field in the report The Changing Landscape of Aging and Disability Information and Referral/Assistance: 2015 Survey of Aging and Disability I&R/A Agencies. This report captures the current state of I&R/A service provision, including trends and developments, challenges and opportunities, and promising practices, through survey responses provided by representatives from state agencies on aging and disability, Area Agencies on Aging, Aging and Disability Resource Centers, Centers for Independent Living, non-profit human service organizations and national organizations. Key themes to emerge from the survey data are:
Theme 1: Funding and Sustainability are Significant Concerns among Aging and Disability I&R/A Agencies;
Theme 2: Partnerships and Networks Continue to Evolve to Serve Both Older Adults and Individuals with Disabilities;
Theme 3: A Changing Environment and Expanding Roles Provide New Opportunities and Challenges for I&R/A Agencies;
Theme 4: Quality Matters to Effective I&R/A Service Delivery; and
Theme 5: The Use of Technology has Increased, but There Remains Room for Growth.
Survey findings underscore that aging and disability I&R/A agencies are operating in a time of change. In a policy, fiscal, and service delivery environment that presents both challenges and potential opportunities, aging and disability I&R/A agencies must continue to cultivate partnerships and leverage innovations that enhance and modernize the provision of I&R/A services. 

 Click here to view the report.
NASUAD Publishes Fact Sheet on Medicaid Third-Party Liability and Older Americans Act
The National Association of States United for Aging and Disabilities (NASUAD), in consultation with the Centers for Medicare & Medicaid Services (CMS) and the Administration for Community Living (ACL) published a fact sheet regarding coordination of benefits between Older Americans Act programs and Medicaid LTSS services.  Medicaid generally serves as the "payer of last resort" and individuals must exhaust all other sources of funding prior to receiving Medicaid payment for a service.  However, there are particular exemptions to this requirement - leading to some confusion about the interactions between Older Americans Act funding and similar services that may be covered by LTSS options such as 1915(c) waivers, 1915(i) or Managed LTSS programs. NASUAD developed this fact sheet to highlight guidance on these interactions.

Click here to view the fact sheet.
Presentations from Aging and Disability Symposium, 2016 AIRS Conference Available
Presentations from the National Aging and Disability Symposium at the 2016 AIRS I&R Training and Education Conference are now available on the NASUAD website. The Symposium is convened by the National I&R Support Center with the support of the following partners: the Administration for Community Living (ACL), the National Association of Area Agencies on Aging (n4a), the National Council on Independent Living (NCIL) and AIRS. The Symposium included a pre-conference summit that highlighted activities and resources of the I&R Center and its partners, and incorporated a special focus on person-centered thinking. In addition, workshop sessions featured national, state, and local professionals presenting on key topics impacting aging and disability I&R/A programs such as quality assurance and customer satisfaction, aging caregivers, innovations in transportation services, transition for youth with disabilities, and resources for serving diverse consumers.

Click here to view the presentations. 
NASUAD I&R Center Webinar: Disability & Rehabilitation Resources 
The National I&R Support Center will host a webinar on Disability and Rehabilitation Resources that attendees can use to help consumers with disabilities of all ages. This webinar is scheduled for Wednesday, July 20, 2016, from 3:00 p.m. to 4:00 p.m. ET.

If your agency and your partners are looking for good, evidence-based programs, tools, and materials that can help clients with disabilities, then this webinar is for you! The grantees of the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) generate a wealth of ready-to-use guides, tools, webinars, and more for everything from creating welcoming congregations to testing the accessibility of the local health club. Our presenter, Jessica Chaiken, Media and Information Services Manager, HeiTech Services, Inc. for the National Rehabilitation Information Center, will sample the diverse library of NIDILRR-funded resources that your agency can use right now to help people with disabilities live independently, and show you where to find more. This webinar is an encore presentation of a session given at the 2016 AIRS I&R Conference. Pre-registration is required for this webinar. Space is limited so make sure to register as soon as possible.

Click here to view details and register.
Registration for the 2016 HCBS Conference is Open! 
Join us for the National Home and Community Based Services (HCBS) Conference held in Washington, DC, August 29 - September 1. The Conference offers a unique blend of policy, program, and practice issues for professionals interested in home and community based services for individuals of all abilities and in all settings. Quickly becoming the "go-to" conference for learning in the expanding field of HCBS and long-term services and supports, the Conference allows states to share best practices, present unique partnerships, and recognize the work of their peers. 

The National HCBS Conference will include federal, state, and local policymakers and those who administer, manage, and deliver waiver and other HCBS programs. The Conference always sees a strong presence from U.S. Health and Human Services ranging from the Administration for Community Living including (AoA, Office of Disability, and AIDD) to CMS, HRSA, SAMHSA, Office of Developmental Disabilities, and other federal agencies.

Click here to view details and register. 
NASUAD and HSRI Release NCI-AD Report and Launch New Website
On Thursday, June 9, 2016, the National Association of States United for Aging and Disabilities (NASUAD), in collaboration with the Human Services Research Institute (HSRI), released the results from a six-state deployment of the National Core Indicators - Aging and Disabilities (NCI-AD™) adult consumer survey. While 13 states are participating in the NCI-AD survey in 2016, six of the states - Colorado, Georgia, Maine, Mississippi, New Jersey, and North Carolina- opted for a rapid-cycle survey period in order to receive their results more quickly. A report with data from all 13 states - including Delaware, Indiana, Kansas, Minnesota, Ohio, Tennessee, and Texas - will be released in winter 2017.

The NCI-AD project's primary aim is to collect and maintain valid and reliable data that give states a broad view of how their publicly-funded long term services and supports (LTSS) impact the quality of life and outcomes of service participants. NCI-AD brings an important value proposition to the field of aging and disability services through development of indicators and outcomes that assess quality of life, community integration, and person-centered services.

Click here to view the full report.
Click here to view the full press release.

NASUAD and HSRI also launched a new website dedicated to the NCI-AD project. NCI-AD.org is a repository of information, reports and data about the NCI-AD project, and includes profiles of each participating state, overview materials and published reports.

Contact NASUAD NCI-AD Project Director, Kelsey Walter, for more information. 
HCBS Clearinghouse E-Clips
This section of  Friday Update highlights reports that have been added to the HCBS Clearinghouse within the past week. Visit www.nasuad.org/hcbs for more information.
Rehabilitation and Habilitation Benefits in Qualified Health Plans
The American Occupational Therapy Association (AOTA) released a new report that reviews the rehabilitation and habilitation benefits available in Qualified Health Plans (QHPs) that are on the Affordable Care Act's Health Insurance Marketplaces. "Analysis of Rehabilitation and Habilitation Benefits in Qualified Health Plans" reviews 724 QHP's offered on the marketplace across all metal levels.  It examines the degree to which the plans cover various therapies and the effect deductibles and co-payments had on the therapies. The report compares how coverage and benefits have changed in the last two years since AOTA last conducted this review in 2014.

Click here to view the publication.
NASBO Fiscal Survey of States Report
On Tuesday, June 21, 2016, the National Association of State Budget Officers (NASBO) released the Spring 2016 "Fiscal Survey of States" report. The report indicates that, for the first time, estimated state general fund spending and revenues in fiscal 2016 surpassed their fiscal 2008, pre-recession peak levels after adjusting for inflation. However, the progress has been uneven across states, and long-term spending pressures remain in areas such as health care, education, pensions, and infrastructure.

Click here to view the publication.
From the Administration
Administration for Community Living
ACL Seeks Comments on Draft SILC Indicators of Minimum Compliance
The Workforce Innovation and Opportunities Act (WIOA) of 2014 requires the Administration for Community Living (ACL) to develop and publish indicators of minimum compliance for Statewide Independent Living Councils (SILCs). ACL reviewed indicators developed and approved by the SILC Congress and the National Council on Independent Living (NCIL). The current draft includes revisions that were made to address feedback received at the SILC Congress in January 2016. ACL is providing a public comment opportunity through Monday, August 15, 2016.

Click here to view the proposed rule.
Centers for Medicare and Medicaid Services
2016 Medicare Trustees Report
On Wednesday, June 22, 2016, the Medicare Board of Trustees issued their annual report to Congress on the financial operations and actuarial status of the program.  The trustees project that the Hospital Insurance Trust Fund will remain fully funded until 2028, 11 years longer than projected before passage of the Affordable Care Act. The trustees also found that per-enrollee Medicare spending growth has been slower than GDP per capita and overall health expenditures per capita. Total Medicare spending is projected to grow at a 6.9% average annual rate over the next decade, reflecting increased enrollment due to growth in the over-65 population. Medicare Trustees also highlighted that growth in prescription drugs costs continue to exceed other Medicare costs and overall health expenditures. In addition, it's projected that Medicare's "hold harmless" protection could be triggered this year based on early data showing the potential for a small Social Security cost of living adjustment. The final adjustment will be announced in the fall based on updated data.

Click here to view the report.
Medicaid Expenditure & Enrollment Data 
The Centers for Medicare & Medicaid Services (CMS) released updated Medicaid enrollment and preliminary expenditure data, which is reported by states through the Medicaid Budget and Expenditure System (MBES). The enrollment data provides the total number of enrollees in Medicaid, and for states that have expanded Medicaid, the number of enrollees for the new adult eligibility group, referred to as the VIII Group, is also reported. The new enrollment data is from October 1, 2015 to December 31, 2015. The expenditure data provides a summary level data associated with Medicaid expenditures as well as a breakout of expenditures associated with individuals in the VIII group. The updated expenditure data is from the collection form CMS-64 for the period April 1, 2015, through June 30, 2015.

Click here to view enrollment data.
Click here to view expenditure data.
Payment Error Rate and Medicaid Eligibility Quality Control Programs
On Monday, June 20, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a notice regarding proposed changes to the Payment Error Rate Measurement (PERM) and Medicaid Eligibility Quality Control (MEQC) programs. The proposed rule addresses the new eligibility provisions of the Affordable Care Act and makes other general improvements to the PERM and MEQC programs. The proposed rule also includes policies that are intended to reduce state burden and increase the focus on the continuous reduction of improper payment rates. Comments on this proposed rule are due by Monday, August 22, 2016.

Click here to view the proposed rule.
Health and Human Services
Better Outcomes for Dually Eligible Older Adults through Integrated Care
The Department of Health and Human Services (HHS) published a report about the Minnesota Senior Health Options (MSHO) program. The Centers for Medicare and Medicaid Services (CMS) and the State of Minnesota started MSHO as a pilot in 1997 to better serve dually eligible beneficiaries age 65 and older. MSHO plans coordinate all the Medicare and Medicaid benefits that their members receive, including Medicare coverage of acute medical care and Medicaid coverage of long-term services and supports. Over the years, MSHO has been a platform for delivery system reform within Minnesota. The report evaluates MSHO's effectiveness by using the experiences of similar beneficiaries inside and outside of MSHO. The HHS Assistant Secretary for Planning and Evaluation contracted with RTI International to complete the analysis of outcomes from 2010 to 2012.

Click here to view the publication.
United States Census Bureau
Facts for Features: Americans with Disabilities Act 
The United States Census Bureau published its latest Facts for Features,"Anniversary of Americans with Disabilities Act: July 26." The publication provides a demographic snapshot of the U.S. population with a disability and examines various services available to them. The statistics come from various censuses and surveys, covering differing periods of time. On July 26, 1990, President George H.W. Bush signed into law the Americans with Disabilities Act, which prohibits discrimination against people with disabilities in employment, transportation, public accommodations, commercial facilities, telecommunications, and state and local government services. 

Click here to view the publication.
From Congress
Senate Hearing on Person-Centered Care
On Thursday, June 23, 2016, the Senate Special Committee on Aging held a hearing to explore ways to improve the quality and access to care for people with serious illness and to discuss models of care that are already being used. Committee Chairman Susan M. Collins (R-ME) as well as Senators Sheldon Whitehouse (D-RI), Bob Casey (D-PA), Joe Donnelly (D-IN), Elizabeth Warren (D-MA), and Tim Kaine (D-VA) participated in the hearing.
Witnesses included Dr. Atul Gawande, Executive Director of Ariadne Labs, Professor at Harvard School of Public Health, Professor of Surgery at Harvard Medical School, and Staff Writer for the New Yorker; Dr. Kate Lally, Chief of Palliative Care at Care New England Health System; and Amy Berman, Senior Program Officer at the John A. Hartford Foundation. Testimony focused on the importance of educating physicians on how to have discussions about person-centered care with patients and families as well as fostering a culture where families also have these discussions themselves.  
In addition, Senator Sheldon Whitehouse (D-RI) introduced the Removing Barriers to Person-Centered Care Act that is intended to improve coordination between health care providers and place greater emphasis on the preferences of Medicare beneficiaries with advanced illnesses.  

Click here to view a recording of the hearing.
Click here to view a press release about the Removing Barriers to Person-Centered Care Act.
From Other Organizations
American Society on Aging
2017 Aging in America Conference Call for Presentation Proposals
The American Society on Aging (ASA) is hosting the 2017 Aging in America Conference (AiA17) and has issued a call for presentation proposals.  The focus of AiA17 is innovation, including innovative policies, programs, practices, models, businesses, technologies, learning, and more from across the field of aging. Submit a proposal to share ideas, research, innovative programs, new models, successful outcomes, and policy agendas. AiA17 is scheduled for March 20 - 24 in Chicago, and nearly 3,000 multidisciplinary professionals who focus on improving the lives of older adults are expected to attend. The deadline to submit a proposal is Thursday, June 30, 2016.

Click here to apply. Please contact ASA at info@asaging.org if you need more time to submit your proposal.
Gerontological Society of America
World Congress of Gerontology and Geriatrics Call for Abstracts
The Gerontological Society of America is hosting the 2017 World Congress of Gerontology and Geriatrics and has issued a call for abstracts. The conference is scheduled for July 23 - 27, 2017, in San Francisco, California.  Over 6,000 thought leaders, industry pioneers, scientists, researchers, and innovators from across multiple disciplines in the field of aging are expected to attend. The event is convened every four years, and the last time it was hosted in the United States was 32 years ago.  This is a unique opportunity for presenters to share their work with a large national and international audience of experts in aging. Submissions are due by Friday, July 15, 2016.

Click here to view details and apply.
National Aging and Disability Business Center
Webinar: Times of Transformation: The Changing LTSS Environment for the Aging and Disability Networks
The National Aging and Disability Business Center is hosting an upcoming webinar, "Times of Transformation: The Changing LTSS Environment for Aging and Disability Networks." Presenters from the Administration for Community Living (ACL), the Centers for Medicare & Medicaid Services (CMS), and the National Association of Area Agencies on Aging (n4a) will speak about new efforts to integrate care for people with Medicare and Medicaid, and how aging and disability organizations can participate. This session will highlight the trends, opportunities, and challenges facing community-based organizations as they work to help older adults and people with disabilities live successfully at home and in the community.  The free webinar will take place on Wednesday, June 29, 2016, from 1:00 p.m. to 2:00 p.m. ET.

Click here to view details and register.
National Legal Resource Center
Webinar: Elder Abuse Series
The National Legal Resource Center (NLRC) has two upcoming webinars in their series of National Elder Rights Training Project sessions.  Additional sponsorship for the webinars is provided by the Administration for Community Living (ACL). "Capacity and Vulnerability to Elder Abuse" will discuss legal standards of capacity necessary for valid transactions involving wills, contracts, Powers of Attorney, and guardianship or conservatorship. The speakers will discuss cognitive capacity, consent, and undue influence. The webinar is scheduled for Wednesday, June 29, 2016, at 2:00 p.m. ET.

The "Legal Responses to Elder Abuse: The Role of APS, Legal Aid, and Protection and Advocacy" webinar will explore best practice models of collaborations between legal provider, adult protective services, and protection and advocacy networks in responding to difficult legal issues arising from elder abuse. This webinar is scheduled for Thursday, June 30, 2016, at 2:00 p.m. ET.

Click here to register for the Capacity and Vulnerability to Elder Abuse webinar. 
Click here to register for the Legal Responses to Elder Abuse webinar.
National Quality Forum
Home and Community Based Services Quality Measure Comments
The National Quality Forum (NQF) is convening a stakeholder committee to develop recommendations for the improvement of quality measurements of home and community based services (HCBS). NQF released the third interim report, "Addressing Performance Measure Gaps in Home and Community Based Services to Support Community Living: Priorities for Measure Development," to guide the changes of future quality measures. NQF encourages individuals to view the report and make comments by Friday, July 15, 2016, at 6:00 p.m. ET.

Click here to view the report and submit comments. 

National Respite Network
National Lifespan Respite Conference Sponsorship and Exhibitors
Sponsorship and exhibitor opportunities are available for the 17th National Lifespan Respite Conference. The event is hosted by the Colorado Respite Coalition, Easter Seals CO, the National Multiple Sclerosis Society - CO/WY Chapter, and the Colorado Department of Human Services, in collaboration with the ARCH National Respite Network. The conference will be held in Denver, Colorado from September 20-22, 2016. The theme is Elevate Respite, and it will challenge conference attendees to heighten awareness about the innovation and progress being made to support the nation's family caregivers. The deadline for sponsorship commitment is Tuesday, July 5, 2016, and all fees are due by Friday, July 29, 2016. 

Click here to view sponsorship information.
Click here to view exhibitor information.
University of New Hampshire, Kessler Foundation, Association of University Centers on Disabilities
Webinar: nTIDE Lunch and Learn
The Employment Policy & Measurement Rehabilitation Research and Training Center (EPM-RRTC) at the University of New Hampshire, in partnership with Kessler Foundation and the Association of University Centers on Disabilities (AUCD), have launched a monthly webinar. On the first Friday of every month, there will be a live broadcast via Zoom webinar to share the results of the latest nTIDE findings, based upon the Bureau of Labor statistics jobs report. Additionally, the monthly webinars will feature news and updates from the field of Disability Employment and a discussion from an invited panelist on current disability related findings and events. The next nTIDE webinar is scheduled for Friday, July 8, 2016, at 12:00 p.m ET.

Click here here to register.
Jobs & Internships 
TMG Seeks Full-Time IRIS Consultants
TMG is the IRIS Consultant Agency (ICA) and Self-Directed Personal Care contractor for Wisconsin's IRIS program. IRIS is a long-term support program where eligible individuals self-direct their publicly funded, community based long-term care services. TMG is seeking two full-time IRIS Consultants. An opportunity is available for consultants living in Winnebago County, and another for consultants in Chippewa County or Dunn County. TMG's IRIS Consultants (ICs) are home-based employees who partner with individuals enrolled in the IRIS program to identify their long-term care goals and find creative ways to achieve them. Qualified applicants must have a minimum of a Bachelor's degree in a social work, psychology, human services, counseling, nursing, special education or a closely related field (or four years of commensurate experience if no degree) and one year of direct experience related to the delivery of social services to the target groups; knowledge of Long Term Care programs and familiarity with principles of self-determination; ability to use a variety of technology including but not limited to; Outlook, Skype, PowerPoint, Excel, Word, online portals and databases; and must possess a valid driver's license and maintain adequate auto insurance for job-related travel to home visits and attending meetings and conferences as requested. Both applications are due by Thursday, June 30, 2016.

Click here to view the Winnebago County posting.
Click here to view the  Chippewa or Dunn County posting.
Funding Opportunities 
2016 NBCUniversal Tony Coehlo Media Scholarships Available 
The American Association of People with Disabilities (AAPD) is offering eight NBCUniversal Tony Coelho Media Scholarships thanks to a generous contribution from NBCUniversal. Eligible applicants for this scholarship are "second year associate students, undergraduate sophomores, juniors, and seniors; and graduate students with disabilities with an interest in the entertainment, media, or communications industries." This scholarship was named in honor of Tony Coelho, a former United States Representative from California and the primary author and sponsor of the Americans with Disabilities Act (ADA).  Scholarship recipients will receive $5,625 to help with the associated expenses of education at their colleges or universities. All applications must be submitted by July 1, 2016, at 5:00 p.m. ET. 

Click here to view details and apply. 
Senior SNAP Enrollment Initiative
The National Council on Aging (NCOA) is seeking proposals from community-based organizations for up to eight new Senior SNAP Enrollment Initiative sites. The recipients of these awards will be responsible for submitting at least 1,250 new SNAP applications on behalf of eligible older adults. These awards will be targeted to organizations already engaged in SNAP outreach and enrollment work and looking to expand to seniors, or organizations who have already engaged in benefits outreach and enrollment work with seniors and want to expand their program to include SNAP. Required Letters of Intent are due Wednesday, July 6, 2016 and full proposals are due Wednesday, August 3, 2016.

Click here to view details and apply.

NCOA is hosting an optional webinar to answer questions about the RFP process on Thursday, June 30, 2016, from 3:00 p.m. to 4:00 p.m. ET
Click here to register for the webinar.
Wyoming Seeks HCBS System
The Wyoming Department of Health is seeking a contractor to provide a commercial off the shelf (COTS) system, or previously developed system that is operational and configurable, to support Wyoming's Home and Community Based Services (HCBS) Waiver Programs.  The system will replace the current Electronic Medicaid Waiver System (EMWS) that is used to manage the state's five Medicaid Waiver Programs. The Agency's vision is to acquire a system that contains the functionality of the current EMWS and incorporates the functionality for medical assessments, currently housed in the Public Health Nurse Informatics System (PHNI), and functionality for provider enrollment, re-enrollment, credentialing, re-credentialing, certification, and re-certification, currently housed in the Information Management for Providers System (IMPROV). The awarded contract will include three base years beginning on January 1, 2017, or when the transition phase criteria are met. Three additional one year extensions will be available based on the vendor and system performance. Proposals will be accepted through the Public Purchase online bidding system until Monday, July 18, 2016, at 4:00 p.m. ET. 

Click here to access the Public Purchase System.
Partnerships in Employment Systems Change
The Administration for Community Living (ACL) released the Partnerships in Employment Systems Change grant. The purpose of the funding opportunity is to encourage state partnerships and systems change efforts that will contribute to the 1) the development of policies that support competitive employment in integrated settings as the first and desired outcome for youth and young adults with developmental disabilities including intellectual disabilities; 2) the removal of systemic barriers to competitive employment in integrated settings; 3) the implementation of strategies and best practices that improve employment outcomes for youth with intellectual and developmental disabilities; and 4) enhanced statewide collaborations that can facilitate the transition process from secondary to post-secondary school, or other pre-vocational settings, to complete employment in integrated settings.  Eligible applicants include state and local governments, public and private institutions of higher education, independent school districts, nonprofit organizations, and public housing authorities. All applications are due by 11:59 p.m. ET on Tuesday, July 26, 2016. 

Click here to view the full posting.
Building the Business Capacity of Community-Based Aging and Disability Networks for Integrated Services Partnerships
The Administration for Community Living (ACL) announced two new funding opportunities that seek to expand the readiness of community-based aging and disability organizations (CBO) for contracting with integrated care entities, and prepare state agencies and CBOs to be active stakeholders and partners in the development and implementation of integrated care systems.

The Learning Collaboratives for Advanced Business Acumen Skills initiative is intended to achieve the following tasks: organize and conduct three to five topically-based action learning collaboratives to address issues such as continuous quality improvement, infrastructure and technology, generating and maintaining volume, data pooling, and more; provide targeted technical assistance to networks of CBOs; and create knowledge and capture insights through these collaboratives to incorporate into future curriculum for national dissemination.

The purpose of the Business Acumen for Disability Organizations initiative is to develop baseline knowledge about the content and infrastructure needs of CBOs through surveys and feasibility studies; and utilize a learning collaborative model to provide targeted technical assistance to up to 15 state coalitions of CBOs that seek to build their business capacity to contract with health care entities (e.g. hospitals, health systems, accountable care organizations, managed/integrated care plans).

The original closing date for both applications was Monday, July 11, 2016. ACL published updated announcements last week with a new closing date of 11:59 p.m. ET on Thursday, July 28, 2016, for both applications.
Click here to view the announcements.

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