Connecting Older Adults and Individuals with Disabilities to Health Services: Resources for Congressional Offices

Connecting Older Adults and Individuals with Disabilities to Health Services: Resources for Congressional Offices

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Updated May 31, 2024
Connecting Older Adults and Individuals with Disabilities to
Health Services: Resources for Congressional Offices
Overview
Connect to Health Programs
Navigating the U.S. health and long-term care systems can
and Benefits
be confusing and complex for some constituents. Older
ACL funds and administers grants for the following
adults and individuals with disabilities may face additional
activities that facilitate connections to programs and
challenges in identifying and accessing needed health care
benefits:
and long-term services and supports (LTSS), such as home
and community-based services that can assist individuals in
Aging and Disability Resource Centers
maintaining their quality of life and living independently.
Local Aging and Disability Resource Centers (ADRCs)
Decisions about rehabilitative services or LTSS may be
provide one-on-one counseling on LTSS options, and
made in response to an emergency or crisis. Older adults
assistance with accessing a wide range of publicly and
and individuals with disabilities, as well as their family
privately financed LTSS and caregiver supports. Examples
members, may have limited understanding of available
of ADRC services include application assistance,
options for home care versus institutional care, either for
screenings and needs assessments, care coordination,
short-term rehabilitation or extended care needs. Moreover,
support services for individuals transitioning from hospital-
public programs may be financed through different funding
to-home and nursing home-to-home, and services to
streams (e.g., Medicare, Medicaid, Older Americans Act
mitigate social isolation. ADRCs are part of the NWD
[OAA]), and some are state or locally administered. As a
system, which aims to streamline and make seamless the
result, eligibility for certain public programs can vary by
navigation of LTSS.
state or local entity and may be limited only to individuals
with low-incomes or high levels of care need. Private
State Health Insurance Assistance Programs
funding, such as long-term care insurance, for example,
State Health Insurance Assistance Programs (SHIPs) offer
may be one option for individuals to offset the potential
one-on-one health insurance counseling to Medicare
high costs associated with needed long-term care.
beneficiaries. SHIPs assist individuals with joining, leaving,
or switching their Medicare Advantage health plans and/or
In an effort to simplify access to information about health
Medicare Part D Prescription Drug Plans. SHIPs assist
care and LTSS options for older adults and individuals with
Medicare beneficiaries with issues related to their other
disabilities, many states have developed No Wrong Door
health coverage, such as retiree health benefits, Medicaid,
(NWD) systems, which are collaborations between the
long-term care insurance, and Medigap (Medicare
Administration for Community Living (ACL), the Centers
supplemental insurance). SHIPs answer questions about
for Medicare & Medicaid Services (CMS) within the
covered benefits, premiums, cost-sharing (such as
Department of Health and Human Services (HHS), and the
deductibles and coinsurance), and complaints and appeals
Veterans Health Administration (VHA) within the
(e.g., about denials of coverage).
Department of Veterans Affairs. State-administered NWD
systems assist individuals and families needing information
Benefits Enrollment Centers
about public programs or private resources and can assist
Benefits Enrollment Centers (BECs) assist Medicare
with counseling and future planning for LTSS options.
beneficiaries, including older adults and younger
NWD systems also serve as the entry point to publicly
individuals with disabilities, to identify and apply for
financed LTSS, including programs and services funded
programs for which they may be eligible. Such programs
under Medicaid, OAA, and VHA, as well as other state or
may include Medicaid, the Supplemental Nutrition
locally funded programs.
Assistance Program (SNAP), the Low-Income Home
Energy Assistance Program, Supplemental Security
This In Focus describes federally funded resources that
Income, and pharmaceutical assistance programs. BECs are
provide information, outreach, and assistance for
supported in part by the National Council on Aging’s
congressional offices helping their constituents to find,
Center for Benefits Access.
navigate, and access available public and private health care
and LTSS. It is organized into three groups of resources: (1)
BenefitsCheckUp
health programs and benefits, (2) home and community-
BenefitsCheckUp is an online tool and hotline that assists
based services, and (3) health care providers and facilities.
older adults in identifying benefit programs for which they
Table 1 lists the websites and contact information for the
may be eligible. Constituents answer a confidential
various resources described.
questionnaire, then they receive a contact list for potential
programs. These programs may address issues such as tax
relief, food, housing, utilities, discounts, employment,
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prescription drugs, and health care. The National Council
and other adult care homes. LTCOPs also advocate for and
on Aging operates the site.
educate residents and their families about their rights, how
to find a long-term care facility, and how to receive quality
Connect to Home and
care. ACL funds and administers state LTCOPs.
Community-Based Services
ACL also administers and provides funding to states for the
Disability Information and Access Line
following activities to assist individuals in connecting with
ACL’s Disability Information and Access Line hotline, chat
home and community-based services:
service, and website connect individuals to accessible
transportation, housing support, disability rights services,
Area Agencies on Aging
and COVID-19 tests and vaccinations. Trained staff can
Area Agencies on Aging (AAAs) serve as local entities
assist people with various communications abilities,
that, either directly or through contracts with local service
including those who are deaf or hard-of-hearing.
providers, oversee a comprehensive and coordinated service
system for the delivery of social, nutrition, and long-term
Websites and Contact Information
services and supports to older adults.
Table 1 lists the websites and contact information for the
programs and resources described in this In Focus.
Eldercare Locator
Table 1. Websites and Contact Information
The Eldercare Locator is an information and referral service
that connects older adults and caregivers with local
Resource
Contact Information
resources, benefits, and services. Examples of such services
Connect to Health Programs and Benefits
include meals, housing, rides to medical appointments,
Aging and Disability
1-800-677-1116 and ask to be
home and community-based LTSS, caregiver training,
Resource Centers
connected to the local ADRC.
health insurance counseling, legal services, elder abuse
ADRCs are also listed in the
prevention, and adult protective services.
Eldercare Locator directory
https://eldercare.acl.gov
Centers for Independent Living
State Health Insurance https://www.shiphelp.org/
Centers for Independent Living (CILs) are operated by and
Assistance Programs
for community members with disabilities. Core services
include information and referral, independent living skills
Benefits Enrol ment
https://benefitscheckup.org/article/m
training, peer counseling, individual and systems advocacy,
Centers
eet-our-benefits-enrol ment-centers
assisting those at risk of entering nursing homes and other
BenefitsCheckUp
1-800-794-6559 or
institutions, and facilitating transition of youth to
https://www.benefitscheckup.org
postsecondary education and employment. Examples of
No Wrong Door
https://nwd.acl.gov/
CIL services include service coordination, services that
System
facilitate transition from institutions to the community,
Connect to Home and Community-Based Services
assisting with accessible housing and food insecurity issues,
Area Agencies on
1-800-677-1116 and ask to be
and advocating for health equity in medical settings.
Aging
connected to the local AAA, or
Connect to Health Care Providers
https://eldercare.acl.gov
Eldercare Locator
1-800-677-1116 or
and Facilities
https://eldercare.acl.gov
Centers for
https://acl.gov/programs/centers-
Choosing a Doctor or Health Care Service
Independent Living
independent-living/list-cils-and-spils
The National Library of Medicine’s Choosing a Doctor or
Connect to Health Care Providers and Facilities
Health Care Service is a compilation of tools for finding
Choosing a Doctor or https://medlineplus.gov/
and choosing providers (such as physicians) and health care
Health Care Service
choosingadoctororhealthcareservice.
facilities (such as hospitals). The “Find an Expert” section
html
includes directories. Health plan enrollees should also
check their plan’s website for a provider directory.
Care Compare
https://www.medicare.gov/care-
website
compare/
Care Compare
Long-Term Care
https://theconsumervoice.org/
CMS’s Care Compare has detailed information, including
Ombudsman
get_help
selected quality measures, about hospitals, home health
Programs
services providers, Medicare- and Medicaid-certified
Disability Information
888-677-1199 or email
nursing homes, Medicare-participating physicians and
and Access Line
DIAL@usaginganddisability.org or
clinicians, hospice providers, long-term care hospitals,
https://dial.acl.gov/
rehabilitation facilities, dialysis facilities, and medical
Source: Compiled by CRS.
equipment suppliers.
Kirsten J. Colello, Specialist in Health and Aging Policy
Long-Term Care Ombudsman Programs
Angela Napili, Senior Research Librarian
State Long-Term Care Ombudsman Programs (LTCOPs)
Michele L. Malloy, Senior Research Librarian
investigate and resolve complaints of residents in nursing
facilities, board and care facilities, assisted living facilities,
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Connecting Older Adults and Individuals with Disabilities to Health Services: Resources for Congressional Offices

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