Promising Practices

To live successfully in the community and mitigate the risk of needing to move to an institutional setting, low-income older adults and younger people with disabilities who require long-term services and supports (LTSS) need both affordable, stable housing and appropriate services. This report is a collaboration between LeadingAge LTSS Center @UMass Boston and the AARP Public Policy Institute examining the role of affordable housing in a well-balanced LTSS system. It offers solutions that consider the bigger picture, specifically the widespread shortage of HCBS workers in tandem with unaffordable housing. 

Assistive Technology (AT) refers to any item, device, piece of equipment, or system that can increase, maintain, or improve functional capabilities for older adults and individuals of all ages with disabilities. It includes a wide range of technologies, from smart home and vehicle automation, to devices that enable communication with health care providers, or with people and programs to reduce social isolation. AT programs which run in partnership with state, local, and community organizations enable people with disabilities and older adults, caregivers and others working with them, to learn about, access and acquire AT. These programs, however, which can be real game changers and even life savers for so many families and individuals, are underutilized.

This report describes promising and emerging innovations on the use of alternative funding strategies, such as local property tax levies, to address the growing need for programs to better serve older adults. It examines how communities in three different states are utilizing local funding streams to support services for older adults. These states have instituted levy-supported initiatives to supplement services, including home-delivered and congregate meals, personal care and homemaker services, home repair support, medical and nonmedical transportation, and emergency response systems, for older adults. These promising and emerging innovations can help people with long-term services and supports needs continue to live in their own homes and communities. 

The report highlights state progress toward establishing a high-performing ADRC/NWD System by comparing results from the previous Scorecard and highlighting key themes.  The report also provides promising practices state examples and lessons learned across five states (AL, GA, MA, OH, and SD) and highlights action taken by Nevada and Virginia to address the COVID crisis.

This paper describes the key findings and emerging trends in self-direction based upon data and information collected in the 2019 National Inventory of Publicly Funded Self-Directed Long-Term Services and Supports (LTSS) Programs in the United States.  The National Inventory was conducted to support the development of the Self-Direction indicator in the 2020 LTSS State Scorecard which reports national and state-level data on the number of people receiving self-directed services per 1,000 people with any disability in the state. 

This paper describes promising practices on the use of presumptive eligibility to improve access to long-term services and supports (LTSS) in five states. These states can presume financial eligibility for Medicaid LTSS, and some of these states also can fast-track the determination process to arrange for timely home- and community-based services. These promising practices can help people with LTSS needs live in their own homes and communities.

Mobility managers are transportation coordinators for older adults, people with disabilities, veterans, and other members of the riding public. This paper highlights who mobility managers are and what they do—and why they are important now and in the future. It highlights emerging innovations from five case studies.

This paper highlights how state-funded home- and community-based services programs in 9 states are supporting low-income older adults and/or people with physical disabilities and their family caregivers to live with maximum independence at home. The paper also features a state’s emerging innovation to provide tailored services and supports for “near poor” older adults and their family caregivers.

This paper describes how four states used innovative strategies to develop and expand self-directed services programs, coordinate and personalize service options, promote stakeholder engagement and outreach, and implement training programs to expand opportunities for individuals to self-direct their LTSS.

This emerging innovations paper highlights examples of how progressive managed care plans are supporting family caregivers who are caring for plan members with long-term services and supports needs. This paper is the first ever to provide insights directly from managed care leaders about family caregiver supports.

The paper describes promising practices on how aging and disability agencies, Veterans Affairs Medical Centers, and Veteran Benefits Offices have forged partnerships to better support Veterans in community living.

Since some older adults who enter a nursing home following a hospitalization are at risk of a long-term nursing home stay, this paper describes strategies used in four highly ranked or significantly improved states that may reduce the risk of long-term nursing home care.

The paper provides concrete examples of how seven No Wrong Door Systems—sometimes called Aging and Disability Resource Centers—are promoting person- and family-centered practice.

Drawing on legal analysis, in-depth interviews with advocates and unemployment insurance officials, and analysis of available data, this paper presents detailed information on the policies and practices in place in state unemployment insurance programs that provide potential temporary financial assistance to family caregivers.