to fully understand how available options relate to their particular needs, as well as streamlined access to all publicly supported long-term services and support programs.



Funding under this Program will help states further develop and strengthen their statewide systems of person-centered information, counseling and access.

Through this grant program, states and local aging and disability programs will receive funds to provide outreach and assistance to Medicare beneficiaries on their Medicare benefits including prevention; use additional funds through a competitive process, to provide Options Counseling on health and long term care through ADRCs; use additional funds through a competitive process in existing Money Follows the Person states for Nursing Home Transitions and Diversions; and finally, AoA and CMS will be funding states, through a competitive process, to strengthen the role of ADRCs in the implementation of Evidence-Based Care Transition models that integrate the medical and social service systems to help older individuals and those with disabilities remain in their own homes and communities after a hospital, rehabilitation or skilled nursing facility visit and avoid unnecessary readmission.


(A) to serve as visible and trusted sources of information on the full range of long-term care options that are available in the community, including both institutional and home and community-based care;

(B) to provide personalized and consumer friendly assistance to empower people to make informed decisions about their care options;

(C ) to provide coordinated and streamlined access to all publicly supported long-term care options so that consumers can obtain the care they need through a single intake, assessment and eligibility determination process;

(D) to help people to plan ahead for their future long-term care needs; and

(E) to assist, in coordination with the State Health Insurance Assistance Program, Medicare benefi