MCLE Health Law Basics Plus 2013 - Post-Acute Care

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My annual presentation at the Massachusetts Continuing Legal Education two-day extravaganza intro to health law. See resources collected at http://j.mp/MCLEHealthLaw

Health & Medicine Entertainment & Humor

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MCLE Health Law Basics Plus 2013
Post-Acute Care
November 14, 2013

David Harlow JD MPH
THE HARLOW GROUP LLC
blog healthblawg.com
twitter @healthblawg

3
THE HARLOW GROUP LLC

Post-Acute Care Acronym Bingo
SNF

DPH

COPs

DON

MA

ALF

HPC

SOM

MMQ

PACE

HHA

CHIA

CMS

RAP

SCO

IDR

EOEA

PPS

OASIS

HCBS

MAC

OBRA

RUGS

GAFC

CFCO

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THE HARLOW GROUP LLC

Future of Health Care: the Home
• Patient-centered care
• Non-institutional options
▫ Cheaper & better
• Federal dollars back up the philosophical change
▫ Equal access to institutional/noninstitutional care

5
THE HARLOW GROUP LLC

Key ACA Provisions affecting Long Term Care
•

Community First Choice Option - A new state plan option to provide home- and
community-based services that includes an increase in federal matching funds for program
costs

•

The
„ State Balancing Incentives Payment Program - A temporary program that
provides qualifying states with an increase in their federal match for Medicaid Home- and
Community-Based Services (HCBS) costs

•

Changes to Medicaid’s 1915(i) Option for Home- and Community-Based Care „
Improvements to Medicaid’s existing state plan option for providing Home- and CommunityBased Services (HCBS), 1915(i)

•

Expanded Spousal Impoverishment Protection in Medicaid - Requires states to
„
extend the same spousal impoverishment protections that apply to institutional care to homeand community-based care

•

Extending Money Follows the Person Demonstration Project - Helps Medicaid
„
eligible individuals transition from institutions back to the community

•

Additional Funding for Aging and Disability Resource Centers - Funding for aging
„
and disability resource centers

7
THE HARLOW GROUP LLC
http://healthlawonline.blogspot.com OR http://j.mp/MCLEHealthLaw

9
THE HARLOW GROUP LLC

Contact
David Harlow JD MPH
THE HARLOW GROUP LLC
for contact info, txt dharlow to 50500

about.me/davidharlow
harlowgroup.net
healthblawg.com
twitter.com/healthblawg
david@harlowgroup.net
617.965.9732

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SOCIAL WORK CASE STUDIES: FOUNDATION YEAR 66 Social Work Research: Program Evaluation Major federal legislation was enacted in 1996 related to welfare reform. Financial assistance programs at the national level for low- income families have been in place since the mid-1960s through the Aid to Families with Dependent Children (AFDC) program. The Personal Responsibility and Work Opportunity Reconciliation Act of 1996, or welfare reform, created TANF (Temporary Assis- tance for Needy Families). Major components of the new TANF program were to limit new recipients of cash aid to no more than 2 years of TANF assistance at a time and to receive no more than 5 years of combined TANF assistance with other service programs during their lifetimes. The goal was to make public assistance a temporary, rather than a long-term, program for families with children. Beyond these general rules, each of the 50 states was given substantial latitude to adopt requirements to fit their own objectives. The new law also allowed states that reduced their public assistance expenses to keep whatever support was already being provided by the federal government for use at their own discretion. This was seen as a way to encourage states to reduce welfare dependency. In response, the state of California decided to call its new program CalWORKs, the California Work Opportunity and Responsibility to Kids program. CalWORKs is California’s application of the new TANF federal law. Like most of the other states, CalWORKs provided its 58 counties with a fair amount of discretion in how to implement the new provisions. Some counties chose to develop strong upfront “employment-first” rules that mandated recipients be employed as soon as possible. Others chose a response that included testing and assessment and the provision of education and training services. One of the largest counties in the San Francisco Bay Area developed several options for CalWORKs recipients, including immediate job readiness (Job Club) help, remedial education for recipients lacking basic skills, and vocational training at local community colleges and adult education centers for those seeking higher level education and skills. Recipients could take up to Laureate_FoundationCases.indd 66 3/23/15 3:58 PM RESEARCH 67 5 years to complete these activities and even longer in certain circumstances to maximize their chances of success. Recipients were predominantly single mothers. If recipients fully complied with the rules, they received a variety of financial incentives, while those who did not comply received sanctions that often resulted in reduced benefit levels. The county provided grants to a wide array of education, training, and service programs to work as partners in serving the needs of participants. In 1996, the county’s CalWORKs program enrolled approximately 22,000 families in various forms of public assistance programs. Of these, approximatel.

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