CMS Funds Ombudsman Program for Duals: Falls Short of Addressing Other Stakeholder Requests
July 12, 2013 09:45 AM
On June 27, the Centers for Medicare & Medicaid Services (CMS) issued a press release (the Press Release) declaring that it would financially support ombudsman programs (Ombudsman Programs) for the dual demonstrations (Demonstrations).
Specifically, CMS projected that the total amount of funds allocated will be $12 million over three years, with funds per state estimated from $275,000 to $3 million over that same period. This followed at least two stakeholder letters to Melanie Bella, and stakeholder Senate testimony in 2012 calling for Ombudsman Programs.
According to the National Long-Term Care Ombudsman Resource Center, a long-term care ombudsman (LTCO) is defined as an advocate for residents of assisted living facilities, nursing homes, and board and care homes. LTCOs are mandatory in every state, where each LTCO "addresses complaints and advocates for improvements in the long-term care system." For a full list of LTCO duties, click here.
In the context of the Demonstrations in Ohio, Illinois, Virginia, and California, the ombudsmen at issue are advocates for recipients of home and community based services. The National Council on Medicaid Home Care – a NAHC Affiliate – analysis supports stakeholder concerns that the Ombudsman Programs still lack sufficient contractual frameworks as stipulated in the Demonstrations' Memorandums of Understanding (MOUs).
To read the Council’s full report, please click here.