Leveraging Federal and State Authorities to Ensure Access to LTSS: Resource Guide and Update

Prepared for The SCAN Foundation

Populations who use long-term services and supports (LTSS) are particularly vulnerable to contracting COVID-19 and experiencing severe cases due to their age or because they often live with one or more chronic conditions. Roughly 2.5 million older adults and other individuals with complex care needs receive care in nursing homes and other congregate care settings, which have been particularly susceptible to COVID-19 outbreaks. Another 10 million individuals receive assistance at home or in their communities, which in many cases has been disrupted due to caregivers being subject to stay-at-home orders, having no access to child care as schools shut down, not having adequate access to personal protective equipment needed to provide care safely and, in some cases, entering isolation after becoming sick or being exposed to COVID-19.

In a resource guide prepared for The SCAN Foundation, Manatt Health provided a tool for policymakers and other stakeholders to understand how states deployed federal emergency funding and Medicaid regulatory flexibilities to improve access to LTSS for older adults and people with disabilities of all ages. The resource guide also highlighted state policy goals in implementing regulatory flexibilities available during the COVID-19 public health emergency, as well as specific examples of how states ensured continued access to LTSS by expanding remote service delivery options, expanding and stabilizing providers and the LTSS workforce, maintaining continuity of care for LTSS recipients through modified assessment policies and processes, and extending home care to new populations.

To provide insights into the latest developments, Manatt Health has produced a brief update to the resource guide, sharing new information based on a scan of new or modified regulatory flexibilities and other state administrative actions as well as states’ overall responses to the pandemic to ensure access to LTSS for high-risk individuals. The updated guide finds that as states operationalized their existing temporary Medicaid regulatory flexibilities, they gained greater insights into long-standing vulnerabilities in their LTSS systems that were worsened during the pandemic and turned their attention to making long-term system improvements.

Click here to access the original resource guide and here to access the update.

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