A Closer Look: Highlights From State Surveys
NASUAD Members are responsible for a wide range of complex programs that provide services to older people, people with disabilities, and family caregivers. As state aging and disability agencies plan for and implement these programs, they often encounter challenges. One of the benefits of NASUAD membership is the opportunity for state agencies to learn from one another.
As NASUAD Members tackle complicated issues, they often ask how things are done in other states. If NASUAD is not able to answer, a mini-survey is born using the online survey tool, Survey Gizmo, to facilitate the collection and analysis of data. NASUAD members have been generous in sharing their time and knowledge in response to these inquiries. Highlights from these surveys can be found below.
Medical Marijuana and Opioid Survey
In September 2018, NASUAD received a member request for information on how state agencies on aging are interacting with medical marijuana as it becomes legalized across the country. Additionally, a number of states have expressed interest in better understanding the actions that agencies on aging have taken to address the opioid epidemic across the country. In response to these requests, NASUAD drafted the 2018 Medical Marijuana and the 2018 Opioid Survey. This survey included questions regarding issues such as disseminating information to the public, drafting related policies, and/or training and educating staff. It also collected some basic information on state agencies on aging and the opioid crisis. Click here to read the results of the survey.
Area Agency on Aging (AAA) Performance Measures
In November 2014, NASUAD sent a survey to its members to learn which states have AAA performance measures in place and which states would be willing to share their AAA performance measures with others states. Click here to read the results of the survey.
Waiver Services for Individuals with Physical Disabilities
In November 2014, NASUAD sent a survey to its members to learn which states offer waiver services for individuals with physical disabilities under age 65; and what percentage of qualifying individuals utilize these waiver services in each state. Click here to read the results of the survey.
SHIP Staffing and Volunteer Levels
The State Health Insurance Assistance Program (SHIP) is a nationwide program that provides information, one-on-one counseling, and assistance to Medicare beneficiaries and their families. Counselors offer unbiased answers to questions related to Medicare, Medigap, Medicare Advantage plans, the Medicare Savings Program, Medicare Prescription Drug Coverage, Medicaid, and other health insurance programs. The Centers for Medicare & Medicaid Services (CMS) grants states money to hire staff and recruit volunteers, at the state and/or local level, who provide counseling to beneficiaries either in person or over the phone. This survey documents the location of the state-level SHIP program, and state/local SHIP staffing levels. Click here to read the results of the survey.
Mental Health Programming for Seniors and People with Disabilities
One of NASUAD's members is working closely with their mental health program staff to serve individuals who are eligible for both mental health and aging/disability programming. It has been challenging for this state agency to serve individuals with self-injurious and/or violent actions towards others in the home and community based services (HCBS) system. In January of 2013, NASUAD sent a survey to its members and a list of long-term care contacts in the states asking how/where they are serving individuals with these complications and what services have been most effective. Click here to read the results of the survey.
Guardianship Laws and Durable Powers of Attorney
In January of 2013, NASUAD sent a survey to its members and a list of long-term care contacts in the states seeking information about guardianship laws and practices and about how states assure appropriate use of durable powers of attorney. Click here to read the results of the survey.
ADRCs--State Funding Formulas
The Administration on Aging (AoA) within the Administration on Community Living (ACL) and the Centers for Medicare & Medicaid Services (CMS) have collaboratively worked to support the development of Aging and Disability Resource Centers (ADRC) in almost every state and territory in the U.S. ADRCs work to integrate and coordinate existing aging and disability service systems to create a "single point of entry" or "no wrong door" into the long-term services and supports system for seniors and people with disabilities in each state. The core functions of an ADRC are 1) information, referral and awareness, 2) options counseling, advice and assistance, 3) streamlined eligibility determination for public programs, 4) person-centered transitions, and 5) quality assurance and continuous improvement. In November of2012, NASUAD surveyed its members to learn more about their ADRC funding sources and distribution formulas. Click here to read the results of the survey.
Assistive Technology used to Support People in their Homes
Assistive technology is "any item, piece of equipment, product, or system, whether acquired commercially, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities." In recent years, there has been increasing focus on the use of assistive technology (AT) to increase the cost effectiveness of home and community based services for seniors and people with disabilities. States use various funding mechanisms to the cover the costs of AT, as most private insurance plans and Medicare limit the types and costs they will cover. In November of 2012, NASUAD surveyed its members to learn more about the types of AT states are paying for to support people living at home. Click here to read the results of the survey.
Transportation and Bus Pass Policies and Procedures
For many older adults, due to deteriorating health and vision, driving is no longer a viable mode of transportation. Access to public or senior-specific transportation is a crucial piece of the home and community based services puzzle and helping seniors to remain independent. Title III of the Older Americans Act (OAA) funds transportation services for individuals age 60 and older, targeting the most vulnerable in that population, through the Aging Services Network. In November of 2012, NASUAD sent a survey to its members asking questions about OAA funded modes of transportation and the methods that state agencies use to purchase these services. In addition, NASUAD asked specific questions covering unlimited/multi-ride bus passes. Click here to read the results of the survey.
SNAP Eligibility for HCBS Waiver Participants Receiving Supported Living Services
In August of 2012, NASUAD sent a survey to the state agencies regarding SNAP (formerly Food Stamps)eligibility for Medicaid Home and Community-Based Services (HCBS) waiver participants who receive individualized supported living services, which the requesting state defines as private homes with up to three unrelated housemates. Click here to read the results of the survey.
Taking Informal Supports into Account when Developing Service Plans/Plans of Care
In August of 2012, NASUAD sent a survey to the state agencies in order to better understand what other states have encountered, developed for policy, or are considering for policy around informal supports and their inclusion in service plans/plans of care, especially for individuals being served by managed care organizations. Click here to read the results of the survey.
Increasing HCBS Provider Capacity in Rural Areas
In August of 2012, NASUAD sent a survey to the state agencies in order to better understand the strategies states use to increase provider capacity in rural areas. Click here to read the results of the survey.
Older Americans Act Intra-State Funding Formula
NASUAD surveyed its member about their Older Americans Act intra-state funding formulas and the factors used to soften impact of demographic shifts. Click here to read the results of the survey.
States may impose a co-payment, premium, deductible, or other charge for certain Medicaid services— known as cost-sharing—based on income. In July of 2012, NASUAD surveyed its member in order to gather greater detail from states about their use of cost-sharing in Medicaid state plan and waiver programs. Click here to read the results of the survey.
Medicaid Services Delivered Out of State
In June of 2012, NASUAD surveyed its members about their reimbursement of Medicaid providers for services delivered out of state. Click here to read the results of the survey.
State use of American Community Survey (ACS) data and the Aging Integrated Database (AGID)
In May of 2012, NASUAD surveyed its members about their use of the American Community Survey (ACS) and Aging Integrated Database (AGID; agidnet.org), which is operated by the Administration on Aging (AoA), and to seek for ideas for future improvement. Click here to read the results of the survey.
In March of 2012, NASUAD surveyed its members about their state's laws and roles in the use and dissemination of advanced directives. Click here to read the results of the survey.
Medicaid Funded Long-Term Services and Supports
In March of 2012, NASUAD surveyed its members about their state's Medicaid funded long-term services and supports, focusing on three topics: 1) consumer-directed services and related processes; 2) assessments, reassessments and care plans; and 3) case management. Read the results of each section of the survey: 1) Consumer Directed Personal Care Services, 2) Assessments, Reassessments, and Care Plans, and 3) Case Management.
Medicaid Provider Enrollment Process
In February of 2012, NASUAD surveyed its members about their state's enrollment of Medicaid providers of home and community based services. Click here to read the results of the survey.
Training Requirements for Personal Care Attendants
In February of 2012, NASUAD surveyed its members about their state's training requirements forMedicaid-funded personal care attendants. Click here to read the results of the survey.
*For more information or to discuss future survey topics, please contact Damon Terzaghi.