Participant-Directed Services in Managed Long-Term Services and Supports Programs: A Five State Comparison

As of the beginning of 2013, 16 states had Medicaid managed long-term services and supports (MLTSS) plans available, with enrollment being either mandatory or voluntary for target populations that varied by state (e.g., elderly, younger adults with adult-onset disabilities, persons with intellectual or other developmental disabilities). In 13 of these states, MLTSS plan members were afforded the choice to “participant-direct” (PD) at least some home and community-based services. Based on five in-depth state case studies, state expectations regarding availability and take-up of PD services in MLTSS varied as did states’ methods of communicating these expectations to managed care organizations. Take up of PD options varied from a low of 1.2% in Arizona to a high of 24% in New Mexico. [37 PDF pages]