Improving Care for Populations Disproportionally Affected by Alzheimer’s Disease and Related Dementias : Table 4


: Table 4

Federal AgencyProgram NameCategoryProgram DescriptionSpecial Considerations for Early Onset, Minorities, Intellectual DisabilitiesOpportunities for Improvement
ACL/AoA/ HHSHome and Community-Based Supportive ServicesHCBSProvides support for community living for older adults including transportation services for critical daily activities; personal care, homemaker, and chore services to seniors unable to perform daily activities or instrumental activities of daily living; adult day care/day health services for dependent adults; and case management services to assist in assessing needs, developing care plans, and arranging services for older persons or their caregivers.  
ACL/AoA/ HHSNational Family Caregiver Support ProgramHCBSFunds a range of supports that assist family and informal caregivers to care for their loved ones at home for as long as possible. The program supports five services: information to caregivers about available services; assistance to caregivers in gaining access to the services; individual counseling, organization of support groups, and caregiver training; respite care; and supplemental services.  
ACL/AoA/ HHSLifespan Respite Care ProgramHCBSSupport, expands, and streamlines the delivery of planned and emergency respite services while also providing for the recruitment and training of respite workers and caregiver training and empowerment.  
ACL/AoA/ HHSTitle IV Community Living Discretionary GrantsPlanning for LTSSFunds Aging and Disability Resource Center and the Veteran-Directed HCBS programs to support older adults and persons with disabilities to live independently in their communities. Aging and Disability Resource Center networks serve as sources of information on the range of LTSS options for persons regardless of age, income, or disability with one-on-one help in understanding and accessing services and supports. See VA below for additional information on the Veterans-Directed HCBS Program.  
ACL/AoA/ HHSModel Approaches to Statewide Legal Systems/ National Legal Assistance and Support ProjectsPlanning for Long-Term CareProtect older persons from direct challenges to independence, choice and financial security. These programs help older individuals understand their rights, exercise options through informed decision-making, and achieve optimal benefit from the support and opportunities promised by law.  
ACL/AoA/ HHSPrevention of Elder Abuse, Neglect, and Exploitation ProgramQuality and SafetyStrengthens elder justice strategic planning and direction for programs, activities, and research related to elder abuse awareness and prevention. Trains law enforcement officers, health care providers, and other professionals on how to recognize and respond to elder abuse; supports outreach and education campaigns to increase public awareness of elder abuse and how to prevent it; and supports the efforts of elder abuse prevention coalitions and multi-disciplinary teams.  
ACL/AoA/ HHSLong-Term Care Ombudsman ProgramQuality and SafetyAdvocates for residents of nursing homes, board and care homes, assisted living facilities, and similar adult care facilities. Resolves problems of individual residents and advocates for changes at the local, state, and national levels that will improve residents' care and quality of life. Assists residents and their families and provides a voice for those unable to speak for themselves.  
CMS/HHSMedicaid 1915(c) Home and Community-Based WaiversHCBSWaiver authority permits a state to offer a wide range of Medicaid HCBS to individuals who require a level of institutional care including nursing facility. Services include adult day care, respite, personal care, chore services, a personal emergency response system, environmental adaptations, home delivered meals, nursing care, transportation, and medical equipment.  
CMS/HHSState Plan Personal Care ServicesHCBSStates may cover personal care as a Medicaid optional service. Personal care includes help with daily activities, such as eating, bathing and dressing. For the personal care state option, beneficiaries must have a disability, but are not required to need an institutional level of care. As a regular Medicaid optional service, normal Medicaid financial eligibility rules apply; states may not limit the number of people receiving services; and there is no federal expenditure limit in terms of average expenditures  
CMS/HHSSection 1915(I) State Plan AmendmentHCBSThis Medicaid state plan option is similar to Medicaid HCBS waivers. However, this option does not require individuals to meet an institutional level of care and provides states an opportunity to offer services and supports before individuals need institutional care.  
CMS/HHSMoney Follows the PersonHCBS; Residential Care SettingsDemonstration designed to shift Medicaid LTSS spending from institutional care to HCBS. The program transitions people living in nursing homes and other institutions to homes, apartments, or group homes. Approximately 24 states provide transitional services to individuals who have Alzheimer's disease.  
CMS/HHSNursing HomesResidential Care SettingsNursing home care is a mandatory service under Medicaid. Short-term nursing home care is covered under Medicare for people needing skilled care.  
VAAdult Day Health Care (ADHC)HCBSPart of the VA Standard Benefits Package, provides health maintenance and rehabilitative services to veterans in a congregate group setting during daytime hours. Social or medical/rehabilitative services are provided depending on the individual program.  
VAHome-based Primary CareHCBSHome-based Primary Care, part of the VA Standard Benefits Package, is a unique home care program that provides comprehensive, longitudinal, primary care by an interdisciplinary team of VA staff in the homes of veterans with complex, chronic, disabling disease for whom routine clinic-based care is not effective.  
VAHomemaker/ Home Health AideHCBSPart of the VA Standard Benefits Package. These services provide personal care services in the home using public and private agencies for certain patients who meet the criteria for nursing home placement. These services are provided in the community under a system of case management provided directly by VA staff.  
VAPurchased Skilled Home CareHCBSPart of the VA Standard Benefits Package. Provided in the home through contract agencies to veterans who are homebound and in need of skilled services such as nursing, physical, occupational, and speech therapy, or social services.  
VARespiteHCBS; Residential Care SettingsPart of the VA Standard Benefits Package. Services temporarily relieve the spouse or other caregiver from the burden of caring for a chronically ill or disabled veteran at home. In-home or institutional respite care can be arranged.  
VAVeteran Directed HCBSHCBSProvides veterans of all ages the opportunity to receive HCBS in a consumer-directed fashion that enables them to avoid nursing home placement. Offered in collaboration with the AoA.  
VAProgram for All-inclusive Care of the ElderlyHCBS; Residential Care SettingsThe Program for All-inclusive Care of the Elderly is a managed care model of care for nursing home certifiable individuals living where the program receives a capitated payment for all acute care and LTSS. The program is heavily dependent on adult day care services.  
VACaregiver SupportsHCBSVA medical centers caregiver support coordinators assist caregivers with access to VA and community support services, such as respite care, adult day health services, in-home aide services, and support groups. The supports include a Caregiver Support Line, which is a toll-free number, answered by a clinician 24 hours a day/7 days a week.