Affordable Care ActAffordable Care ActAging Network OpportunitiesAging Network Opportunities

Judy BakerJudy BakerRegional DirectorRegional Director

Health and Human ServicesHealth and Human ServicesOctober 18, 2010October 18, 2010

Policy Trends

Federal Policy shifts toward addressing Consumer Preference

Choice-focused systems encouraged• Olmstead• Money Follows the Person • HCBS and Medicaid Innovations

Trends in Aging and Disability Services

• Aging within the community is preferred to institutionalization

Components to aging in place:– Health Care– Socialization– Mobility– Nutrition

Planning for where and when people receive LTSS is important

Key Reforms that Address Consumer Preference

CLASS Act – AAA’s will have opportunities for public outreach and education

Incentives to States to create alternatives to nursing homes

Opportunities for Demonstrations for new service delivery models

Benefits that support care coordination (prevention coverage, health risk assessments, care transitions)

LONG-TERM CARE: An Overview

Source: NASUAD

Care Transitions

Source: NASUAD

Aging Network Opportunities

Source: NASUAD

Payment Reform

Source: NASUAD

Fighting Fraud

Source: NASUAD

Aging Network OpportunitiesAging Network Opportunities

Grants for developing new evidence-based Grants for developing new evidence-based approaches to care transitionapproaches to care transition

Improving care by integrating Aging and Disability Improving care by integrating Aging and Disability Resource Centers into the hospital discharge process.Resource Centers into the hospital discharge process.

Developing new partnerships among health systems, Developing new partnerships among health systems, Medicaid, primary care physicians and managed care Medicaid, primary care physicians and managed care organizations. organizations.

Outreach and assistance to Medicare beneficiariesOutreach and assistance to Medicare beneficiaries Integrating wellness and prevention programs into Integrating wellness and prevention programs into

routine medical careroutine medical care

Options Counseling – a critical role for Aging and Options Counseling – a critical role for Aging and Disability Resource CentersDisability Resource Centers

Medicaid ExpansionMedicaid Expansion

States will be eligible for a larger States will be eligible for a larger federal match for Medicaid patients federal match for Medicaid patients requiring long-term care and in-requiring long-term care and in-home services. home services.

The Community First Choice The Community First Choice Program could expand Medicaid Program could expand Medicaid eligibility up to 150 percent of the eligibility up to 150 percent of the poverty level.poverty level.

Money Follows the PersonMoney Follows the Person

The Money Follows the Person The Money Follows the Person program, which helps people move program, which helps people move from a facility to the community, is from a facility to the community, is extended until 2016.extended until 2016.

Aging and Disability Resource Aging and Disability Resource Centers have the opportunity to Centers have the opportunity to expand.expand.

Aging Network OpportunitiesAging Network Opportunities PreventionPrevention

$100 million in grants to states to provide $100 million in grants to states to provide incentives for prevention of chronic disease. incentives for prevention of chronic disease. Coordination opportunity with health Coordination opportunity with health departments.departments.

Independent evaluation of Administration on Independent evaluation of Administration on Aging evidence-based disease prevention Aging evidence-based disease prevention program.program.

Improved collaboration between public health Improved collaboration between public health and health providers.and health providers.

Aging Network Opportunities Single entry point access to comprehensive set of

programs to support community living Collaborative, cross agency approach and

public/private partnerships Single, coordinated systems of information,

referral, and access to aging and disability long-term support services

Benefits– Increased efficiency and information sharing among agencies– Comprehensive provider database, comprehensive client assessment and case management tool– Consistent Information and consumer friendly

Aging Network OpportunitiesAging Network Opportunities

Other opportunities: Other opportunities:

● ● Creation of new forensic centersCreation of new forensic centers

● ● Culture change demonstrationsCulture change demonstrations

● ● Training for direct care workersTraining for direct care workers

Funding Changes – ADRC’s Increased funding for ADRCs - $10

million a year for 5 years ($50 million total)

Funding comes from mandatory side of the budget not discretionary side- “pre-paid for 5 years

First round of funding was incorporated in AoA mega-grant for ADRCs to develop options counseling standards

Funding Changes - Medicare Part D Coverage and Enrollment

Assistance Filling “donut hole” over next 10

years. Expanded Enrollment Period Expanded assistance for AAAs, SHIPs

and ADRCs to provide counseling and enrollment assistance.($45 million- extends previous funding through MIPPA)

Funding Changes – Health and Wellness - Project 2020 Healthy Aging, Living Well ($50 million for CMS

evaluation of AoA Evidence-based programs) Funding for Aging Network for CDSMP. Larger pot of health and wellness funds in CDC

– to access AAAs need to partner with local health departments

Medicare Benefit Educational Opportunities to inform beneficiaries about free annual physicals, colorectal screenings and mammograms.

Care Transitions Future CMS funding on evidence-based

care transitions. Hospitals to be penalized for preventable hospital readmissions that occur within 30 days of discharge.

AoA positioning the Aging Network to play role in care transitions via $2.5 million mega-grant.

Growing interest in medical community of AAAs potential role in care transition work.

Elder JusticeElder Justice

The elder justice portion of the ACA The elder justice portion of the ACA will:will:• expand adult protective servicesexpand adult protective services

• provide new funding to pay for provide new funding to pay for nationwide criminal background checksnationwide criminal background checks

• provide funding for long-term care provide funding for long-term care ombudsman programs.ombudsman programs.

Elder Justice Act Nursing home transparency to

identify owners/operators & hold them accountable

Consumer information on nursing home staffing, sanctions & inspection reports to help compare facilities

Improved training of long-term care ombudsmen & workers caring for patients with Alzheimer’s disease

The Affordable Care Act: What’s in it for the Aging

Network ADRCs Medicare Part D “donut hole”/Enrollment

Assistance Health and Wellness Care Transitions Health Home HCBS Expansion in Medicaid Protections for Vulnerable Elderly CLASS

ACA Will Require the Aging Network to ….

Forge New Partnerships Develop Unit Costing of Services Price Services at Cost ++ Expand into Private Pay Contract with Service Providers in

New Ways Expand Consumer-Directed Services Market themselves More Broadly