1. Federal Updates Presented by Becky A. Kurtz Director, Office of LTC Ombudsman Programs NALLTCO Member Meeting – November 16, 2014

2. Status of Final Rule for LTC Ombudsman Program June 2013 – notice of proposed rulemaking (NPRM) published in Federal Register: – http://www.regulations.gov/#!documentDetail;D=AOA_FRDOC_0001-0002 http://www.regulations.gov/#!documentDetail;D=AOA_FRDOC_0001-0002 August 2013 – public comments due (received 85 unduplicated comments) ACL worked on drafting responses to comments and finalizing rule October 2014 -- Health and Human Services review and clearance complete Currently – Office of Management and Budget (OMB) reviewing (have 90 days to review) Next step -- Final Rule published in the Federal Register

3. Status of National Ombudsman Reporting System (NORS) Next September 2014 – ACL contract with ICF in place Currently -- Working to design the data elements (i.e. the data you and/or your State Office collect and your State Office sends to ACL/AoA) – Our office has been involving NASOP and NALLTCO representatives throughout the process. – Plan will be published in the Federal Register so there will be opportunity for public comment. Next step -- develop the technology that will be used to transmit the data to ACL/AoA

4. Status of National Ombudsman Resource Center (NORC) June 2014 – New 3-year cooperative agreement awarded to the Consumer Voice for the Resource Center September 2014 – supplemental grant awarded to focus on: – Emergency Preparedness/Disaster Response and the Role of the Elder Rights Team Anticipation of ACL issuance of model policies and procedures for LTC ombudsman programs – Promoting Collaboration Between Long-Term Care Ombudsman Programs and Protection & Advocacy Programs – Next Steps – Improving the Coordination and Effectiveness of Long-Term Care Ombudsmen and Legal Service Developers

5. Big Changes in States’ Delivery of Long-Term Services and Supports 1.Home and Community Based Services (HCBS) Rule January 2014 – Final HCBS regulations set forth new Medicaid requirements under which states may provide HCBS long-term services and supports. http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Long-Term-Services-and- Supports/Home-and-Community-Based-Services/Home-and-Community-Based-Services.html http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Long-Term-Services-and- Supports/Home-and-Community-Based-Services/Home-and-Community-Based-Services.html Purpose: enhance the quality of HCBS and provide additional protections to individuals that receive Medicaid HCBS services. Includes assisted living, board and care in many states Currently – States are amending waivers, developing transition plans, opportunities for advocates: to give information to States as they evaluate providers’ ability to meet the rule; to comment on your States’ transition plans (hcbsadvocacy.org)hcbsadvocacy.org

6. Big Changes in LTSS -- #2 2. Managed Long-Term Services and Supports (MLTSS) – Delivery of LTSS through capitated Medicaid managed care programs Currently: Increasing numbers of States are using MLTSS as a strategy for: expanding HCBS, promoting community inclusion, ensuring quality and increasing efficiency. – Includes nursing homes in many (but not all) States – Includes most demonstration programs for dually eligible populations (i.e. Medicare and Medicaid) Lots of changes going on... How are the changes impacting the people you serve?

7. Contact Information For more information about ACL: U.S. Department of Health and Human Services, Administration for Community Living, Washington DC 20201 www.acl.gov For more information about the National Ombudsman Resource Center: www.ltcombudsman.org