Long-Term Services and Supports Technical Assistance Center - Start Planning Module

Guidance for community officials and advocates planning to start a LTSS program.

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: June 09, 2016

Native Health, in Phoenix, AZ, coordinates with local senior centers to provide meals delivered to seniors at home, such as this home visit in the Salt River Pima Maricopa Indian Community.

If you're beginning to plan for an LTSS program in your community, there are a few important things to consider. It's best to know your financing options and what types of program models are available before you create an in-depth plan.

LTSS Models

There are two main LTSS models to choose from:

HCBS which are provided at a person's home or in a community setting
Facility-Based Care, which is provided in a nursing home, assisted living residence, or adult family home

Home- and community-based services are often the more affordable and community-focused option. Also consider transitional care, which happens when patients move from facility-based care back into the community (or, more rarely, from the community into a facility).

In addition to considering the LTSS models, it's important to decide the level and type of involvement your tribe will have in your LTSS program. You should also examine financing options.

LTSS Financing

Financing your LTSS program can be complex. Financing options vary from state to state. You will want to consider how you will plan out your finances, what types of funding are available, whether they are a good fit for your program, and how you can successfully partner with your state for reimbursement. On the TA Center's Financing page, you can learn more about:

Next Steps

Once you become familiar with your options for LTSS models and financing, you can move on to advanced planning, which includes guidance for evaluating your program, as well as a step-by-step roadmap for planning.

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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.