Medicaid Assessments for Long-Term Supports & Services (LTSS)

Executive Summary

Long-term care needs assessments serve a vital role in Medicaid. For individuals with disabilities and older adults, needs assessments are used to determine eligibility for both institutional and home and community-based services (HCBS). The assessment process establishes the type and extent of an individual’s care needs, which inform the person-centered care planning process. Assessments also play important roles in rate setting, data reporting, and measuring quality of care.

State needs assessments vary considerably in structure, process, and outcomes. Despite this wide variation, certain trends have emerged across a number of assessment tools that reflect consensus ?best practices? that promote reliability, validity, person-centered choice, transparency, and freedom from conflict-of-interest. This paper reviews some federal assessment requirements and highlights select states with innovative comprehensive assessment tools. It also identifies potential potholes in the application of assessment tools.