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

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Updated March 18, 2021
Connecting Older Adults and Individuals with Disabilities to
Health Services: Resources for Constituents

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 to states for the
adults and individuals with disabilities may face additional
following activities, which facilitate connections to
challenges in identifying and accessing needed health care
programs and 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 options counseling and assistance with
made in response to an emergency or crisis. Older adults
accessing a wide range of publicly and privately financed
and individuals with disabilities, as well as their family
LTSS and caregiver supports. Examples of ADRC services
members, may have limited understanding of available
include application assistance, screenings and needs
options for home care versus institutional care, either for
assessments, care coordination, support services for
short-term rehabilitation or extended care needs. Moreover,
individuals transitioning from hospital-to-home and nursing
public programs may be financed through different funding
home-to-home, and services to mitigate social isolation.
streams (e.g., Medicare, Medicaid, Older Americans Act
ADRCs are part of the NWD system, which aims to
[OAA]), and some are state or locally administered. As a
streamline and make seamless the navigation of LTSS.
result, eligibility for certain public programs can vary by
state or local entity and may be limited only to individuals
State Health Insurance Assistance Programs
with low-incomes or high levels of care need. Private
State Health Insurance Assistance Programs (SHIPs) offer
funding, such as long-term care insurance, for example,
one-on-one health insurance counseling to Medicare
may be one option for individuals to offset the potential
beneficiaries. SHIPs assist constituents with joining,
high costs associated with needed long-term care.
leaving, or switching their Medicare Advantage health
plans and/or Medicare Part D Prescription Drug Plans.
In an effort to simplify access to information about health
SHIPs assist Medicare beneficiaries with issues related to
care and LTSS options for older adults and individuals with
their other health coverage, such as retiree health benefits,
disabilities, many states have developed No Wrong Door
Medicaid, long-term care insurance, and Medigap
(NWD) systems, which are collaborations between the
(Medicare supplemental insurance). SHIPs answer
Administration for Community Living (ACL), the Centers
constituents’ questions about covered benefits, premiums,
for Medicare & Medicaid Services (CMS) within the
cost-sharing (such as deductibles and coinsurance), and
Department of Health and Human Services (HHS), and the
complaints and appeals (e.g., about denials of coverage).
Veterans Health Administration (VHA) within the
Department of Veterans Affairs. State-administered NWD
Benefits Enrollment Centers
systems assist individuals and families needing information
Benefits Enrollment Centers (BECs) assist Medicare
about public programs or private resources and can assist
beneficiaries, including older adults and younger
with counseling and future planning for LTSS options.
individuals with disabilities, to identify and apply for
NWD systems also serve as the entry point to publicly
programs for which they may be eligible. Such programs
financed LTSS, including programs and services funded
may include Medicaid, the Supplemental Nutrition
under Medicaid, OAA, and VHA, as well as other state or
Assistance Program (SNAP), the Low-Income Home
locally funded programs.
Energy Assistance Program, Supplemental Security
Income, and pharmaceutical assistance programs. BECs are
This In Focus describes federally funded resources that
supported in part by the National Council on Aging’s
provide information, outreach, and assistance for
Center for Benefits Access.
constituents to find, navigate, and access available public
and private health care and LTSS. It is organized into three
BenefitsCheckUp
groups of resources: (1) health programs and benefits, (2)
BenefitsCheckUp is an online tool and hotline that assists
home and community-based services, and (3) health care
older adults in identifying benefit programs for which they
providers and facilities. Table 1 lists the websites and
may be eligible for. Constituents answer a confidential
contact information for the 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,
prescription drugs, and health care. The site is operated by
National Council on Aging.
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Connect to Home and
and other adult care homes. These programs also advocate
Community-Based Services
for residents and educate residents and their families about
ACL also administers and provides funding to states for the
their rights, how to find a long-term care facility, and how
following activities to assist individuals in connecting with
to receive quality care. State LTCOPs are funded and
home and community-based services:
administered by ACL.
Area Agencies on Aging
Websites and Contact Information
Area Agencies on Aging (AAAs) serve as local entities
Table 1 lists the websites and contact information for the
that, either directly or through contracts with local service
programs and resources described in this In Focus.
providers, oversee a comprehensive and coordinated service
Table 1. Resources: Websites and Contact
system for the delivery of social, nutrition, and long-term
Information
services and supports to older adults.
Resource
Contact information
Eldercare Locator
The Eldercare Locator is an information and referral service
Connect to Health Programs and Benefits
that connects older adults and caregivers with local
Aging and Disability
1-800-677-1116 and ask to be
resources, benefits, and services. Examples of such services
Resource Centers
connected to the local ADRC, or
include meals, housing, rides to medical appointments,
https://acl.gov/programs/aging-and-
home and community-based LTSS, caregiver training,
disability-networks/aging-and-
health insurance counseling, legal services, elder abuse
disability-resource-centers
prevention, and adult protective services.
State Health Insurance
https://www.shiptacenter.org/
Centers for Independent Living
Assistance Programs
Centers for Independent Living (CILs) are operated by and
for community members with disabilities. Core services
Benefits Enrol ment
https://www.ncoa.org/article/meet-
include information and referral, independent living skills
Centers
our-benefits-enrol ment-centers
training, peer counseling, individual and systems advocacy,
BenefitsCheckUp
1-800-794-6559 or
assisting those at risk of entering nursing homes and other
https://www.benefitscheckup.org
institutions, and facilitating transition of youth to
postsecondary life. Examples of CIL services include
No Wrong Door
https://nwd.acl.gov/
service coordination, services that facilitate transition from
System
institutions to the community, assisting with accessible
Connect to Home and Community-Based Services
housing and food insecurity issues, and advocating for
health equity in medical settings.
Area Agencies on Aging 1-800-677-1116 and ask to be
connected to the local AAA, or
Connect to Health Care Providers
https://eldercare.acl.gov
and Facilities
Eldercare Locator
1-800-677-1116 or
Find Doctors and Medical Facilities
https://eldercare.acl.gov
Find Doctors and Medical Facilities is a compilation of
Centers for
Includes list of CILs: https://acl.gov/
tools and tips for finding providers (such as physicians) and
Independent Living
programs/centers-independent-
health care facilities (such as hospitals). Some of the listed
living/list-cils-and-spils
directories incorporate quality measures. Health plan
Connect to Health Care Providers and Facilities
enrollees should also check their health plan’s website for a
provider directory. The website is administered by the U.S.
Find Doctors and
https://www.usa.gov/doctors
General Services Administration.
Medical Facilities
Care Compare
Care Compare website
https://www.medicare.gov/care-
CMS’s Care Compare has detailed information about
compare/
individual hospitals, home health services providers,
Long-Term Care
https://theconsumervoice.org/
Medicare- and Medicaid-certified nursing homes,
Ombudsman Programs get_help
Medicare-participating physicians and clinicians, hospice
providers, long-term care hospitals, and dialysis facilities.
Source: Compiled by CRS.
The database includes certain quality measures.
Kirsten J. Colello, Specialist in Health and Aging Policy
Long-Term Care Ombudsman Programs
Michele L. Malloy, Research Librarian
State Long-Term Care Ombudsman Programs (LTCOP)
Angela Napili, Senior Research Librarian
investigate and resolve complaints of residents in nursing
facilities, board and care facilities, assisted living facilities,
IF11694


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


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