Medicaid Home and Community-Based Services in the Wake of the COVID-19 Pandemic.

The need to bolster Medicaid home and community-based services (HCBS) became more evident during the COVID-19 pandemic. This recognition stemmed from the challenges of keeping people safe in nursing homes and the acute workforce shortages in the HCBS sector. This article examines two major federal developments and state responses in HCBS options as a result of the pandemic.

Decrease in wearable-based nocturnal sleep efficiency precedes epileptic seizures.

Introduction: While it is known that poor sleep is a seizure precipitant, this association remains poorly quantified. This study investigated whether seizures are preceded by significant changes in sleep efficiency as measured by a wearable equipped with an electrocardiogram, respiratory bands, and an accelerometer.

Methods: Nocturnal recordings from 47 people with epilepsy hospitalized at our epilepsy monitoring unit were analyzed (304 nights).

A Comparative Analysis of State Implementation of the Community First Choice Program.

The Patient Protection and Affordable Care Act included Community First Choice (CFC), a new optional Medicaid home and community-based services (HCBS) state plan benefit which states could adopt. Through the CFC program, states can provide expanded home and community-based attendant services and supports to older adults and persons with disabilities. A benefit of CFC is that states receive a higher federal match rate than other HCBS programs.

Enhancing Federal Revenue under the American Rescue Plan Act: An Opportunity to Bolster State Medicaid Home and Community-Based Services Programs.

The American Rescue Plan Act (ARPA) includes a one-year 10 percentage point increase in the Federal Medical Assistance Percentage for Medicaid-funded home and community-based services (HCBS). The goal is to strengthen state efforts to help older adults and people with disabilities live safely in their homes and communities rather than in institutional settings during the COVID-19 pandemic. This essay provides a detailed description and analysis of this provision, including issues state governments need to consider when expending the additional federal revenue provided.

A comparative analysis of state adoption of the Community First Choice program.

Over the last several decades, policymakers have focused on rebalancing Medicaid-funded long-term services and supports toward home and community-based services (HCBS). The Patient Protection and Affordable Care Act (ACA) included several opportunities for states to further promote HCBS options. One optional opportunity for states to expand Medicaid HCBS was the 1915(k) Community First Choice (CFC) program.