Specialized Information for:

Nursing HomesAssisted Living/Board & Care Home and Community Based Services

Ombudsman Program Funding

Medicaid Administrative Claiming

Medicaid Administrative Claiming for Activities Performed by State Long-Term Care Ombudsman Programs

On June 18, 2013, the Centers for Medicare and Medicaid Services (CMS) issued a clarification of its policy regarding Medicaid administrative claiming by State Medicaid Agencies related to the services of States’ Long – Term Care Ombudsman Program.  CMS worked with the Administration for Community Living/Administration on Aging (ACL/AOA) and the National Association of State LTC Ombudsman Programs (NASOP) on examples of LTCO activities that are eligible for claiming.  CMS has also provided guidance through a work plan to assist state Medicaid agencies and LTCOPs in developing proposals for claiming.  More information is available on the CMS Medicaid website.

Civil Monetary Penalty (CMP) Funding

Title VII Allocations

  • State Allocation Tables: Title VII
    The tables linked on AoA's website show the amount of Federal grant funds, provided to each state, under Title VII of the Older Americans Act—Vulnerable Elder Rights Protection Activities.

Ombudsman Program Examples

  • Wisconsin (2016)
    The State Ombudsman worked with the Governor and the Legislature in educating them about our work in managed care and our long term care facilities in the state. The demographics of older adults in Wisconsin are growing and their needs are increasing. The Governor and Legislature recognized the needs of the Ombudsman Program and provided support in new positions in 2015-2017 Biennial Budget. Three new Ombudsman position started in July of 2016. Effective January 2017 Wisconsin will have managed care statewide.
  • Hawaii (2017)
    In 2015, the Hawaii State Executive Office on Aging was reorganized, resulting in the loss of a regional Ombudsman Specialist position in Oahu. HB 610 and SB 530 were designed to restore this position as well as hire three contracted, part-time positions for Kauai, Maui, and Hawaii counties. These bills received high levels of support from both the public and legislators, with three neighbor island mayors having expressed public support for SB 530. The State Long-Term Care Ombudsman went to the Governor's Office, ACL, the media, the Legislature, various senior advocacy groups to complain about this and get their support. It took 2 years but in 2017 the legislature supported the State Long-Term Care Ombudsman and restored the Oahu position ($75,000) and provided $25,000 for a part-time ombudsman for Kauai, $25,000 for Maui and $25,000 for the Big Island. The funding is for 2 years.

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