States now have more tools available to rebalance the provision of long-term services and supports towards more home- and community-based services and away from institutionally based care. In addition to the Money Follows the Person demonstration program, the Affordable Care Act created the Balancing Incentive Payments program, the state plan Community First
Choice Options program, and the modified Home- and Community-Based State Plan option (1915(i)). Selecting the appropriate program(s) to implement is made complicated by the sometimes overlapping and differing requirements of these options.
This technical assistance brief describes the different LTSS program options available to states with particular emphasis on their budget impacts;
application processes; and requirements for participant eligibility, care coordination, and data reporting. It also discusses the ways in which the different options for providing LTSS interact with each other and with existing state LTSS structures.