CLASS Technical Assistance Briefs
The SCAN Foundation presents the CLASS Technical Assistance Brief Series, a comprehensive body of work that makes a major contribution to the design and workability of the Community Living Assistance Services and Supports (CLASS) Plan. CLASS creates a voluntary, federally-administered insurance program to help individuals pay for needed assistance in a place they call home if they become functionally limited.
These in-depth analyses from a broad set of industry and academic experts shed light on critical issues that will make CLASS work for real people and are pivotal for successful marketing and uptake of the program.
The introductory brief, "Paving the Way for Successful CLASS Implementation: An Overview of the CLASS Technical Assistance Brief Series," by Lisa Shugarman of The SCAN Foundation, provides a comprehensive overview of CLASS and the series.
The Landscape of Services and Supports (#1)
- Supporting Individuals with Disability Across the Lifespan at Home: Social Services, Technologies, and the Built Environment by Laura N. Gitlin, Sarah L. Szanton, and Eva H. DuGoff (Johns Hopkins)
This brief describes the broad needs of individuals with disabilities and the wide range of supportive and environmental solutions that can allow for the most independent living possible. Using the evidence from research, the brief suggests how findings on social and environmental supports for individuals with disability can inform implementation of CLASS.
Beneficiary Assessment in the Private and Public Markets (#2-7)
- The Historical Development of Benefit Eligibility Triggers Underlying the CLASS Plan by Marc Cohen, Jocelyn Gordon and Jessica Miller (Life Plans, Inc.)
This brief provides background on the historical development of benefit eligibility triggers in the private long-term care (LTC) insurance market. Such a review is important because understanding how these triggers came into being, and the intent and forces that shaped their development, can provide important information to those charged with implementing the CLASS Plan.
- Understanding Long-Term Care Benefit Triggers: Contract and Implementation by Marc Cohen, Jocelyn Gordon and Jessica Miller (Life Plans, Inc.)
This brief provides information about how long-term care (LTC) insurers implement benefit eligibility triggers in the private insurance market both from a contractual and process perspective. The way in which companies have operationalized benefit eligibility triggers can inform the development of regulations for CLASS.
- The Independent In-Person Assessment Process by Jocelyn Gordon, Marc Cohen, and Jessica Miller (Life Plans, Inc.)
This brief provides information on the benefit eligibility assessment process in the private long term care (LTC) insurance industry. It focuses on how long-term care insurers use the information in the adjudication process, who is involved in the process and how Activities of Daily Living (ADLs) and cognition are assessed. This is particularly important because one of the first responsibilities of those charged with implementing CLASS is to develop an assessment system for eligibility for CLASS benefits.
- Elements of a Functional Assessment for Medicaid Personal Care Services by Marshall E. Kelley and Susan M. Tucker (Health Management Associates)
This brief discusses the results of the identification and analysis of the assessment instruments and data elements states use for determining medical conditions, activities of daily living and cognitive functional ability within Medicaid-funded personal care services programs. It identifies the elements states use for an assessment of a person’s physical and cognitive limitations and need and compares these elements to the requirements of the CLASS Plan.
- Determining Need for Medicaid Personal Care Services by Susan M. Tucker and Marshall E. Kelley (Health Management Associates)
This brief focuses on the ranking and scoring criteria and mechanisms that state Medicaid programs use to determine functional need and the level of services provided for Medicaid-funded personal care services programs. Because CLASS requires a determination of need and must identify a benefit level for which regulations must be promulgated, this information can be very useful for the development of the CLASS Plan.
- Functional Assessment Processes for Medicaid Personal Care Services by Susan M. Tucker and Marshall E. Kelley (Health Management Associates)
This brief focuses on components of states’ Medicaid functional assessment processes with an eye toward how these processes could potentially inform the development of regulations for CLASS. We explore how states handle the assessment process and determine who performs the assessment and where it is performed. Each of these components is important to the design of CLASS so that those determined eligible can receive appropriate benefits.
Pathways for Successful Use of a Cash Benefit (#8-12)
- How Did Cash and Counseling Participants Spend Their Budgets, and Why Does That Matter for CLASS by Lori Simon-Rusinowitz, Dawn Loughlin, Kevin Mahoney (Boston College)
This brief addresses some similarities between the Cash and Counseling (C&C) model and CLASS, including participant control over a cash benefit, the ability to develop an individualized spending plan, the ability to hire family members as workers, and the availability of a range of programmatic supports to help participants manage their responsibilities. This brief describes how C&C participants have used their cash allowance, and suggests how these findings can inform CLASS implementation.
- Debit Card Fundamentals and Their Use in Government Programs by Cathy Corby Parker, James Wironen, Mollie G. Murphy, and Kevin J. Mahone (Boston College)
This brief describes the history and operation of debit cards and provides examples of their use in government programs to inform the use of debit cards to access CLASS Plan benefits.
- Financial Management Services in Participant Direction Programs by Mollie G. Murphy, Isaac Selkow, and Kevin J. Mahoney: (Boston College)
This brief seeks to inform the design and implementation of the CLASS Plan using experience from the provision of Financial Management Services (FMS) in participant direction. Highlighting why FMS are used in participant direction and their challenges, this brief seeks to present strategies for maximizing their benefit in the CLASS Plan.
- Options for Getting Purchasing Power into the Hands of Participants: Lessons from Participant Direction Programs by Mollie G. Murphy, Lori Simon-Rusinowitz, Dawn Loughlin, Kevin J. Mahoney, and Isaac Selkow (Boston College)
This brief describes the use of cash, debit cards and third party payers in various participant-directed programs and suggests how these findings can inform the design and implementation of the CLASS Plan.
- Considerations for Debit Card and Cash Purchasing Mechanisms in the CLASS Plan by Mollie G. Murphy, Cathy Corby Parker, Isaac Selkow, and Kevin J. Mahoney (Boston College)
This issue brief describes the benefits and challenges of using debit cards and cash in CLASS and how they could be implemented and integrated into a Financial Management Services structure.
Strategies for a Successful Marketing of CLASS (#13-15)
- The “Own Your Future” Long-Term Care Awareness Campaign: Implications for the CLASS Plan by Eileen Tell (Univita)
This technical assistance brief describes lessons learned from the "Own Your Future" campaign in regard to the best means and messages to encourage long term care planning and how this information may be useful for communications outreach for the CLASS Plan.
- Employer Long-Term Care Insurance Market Participation Rates: Implications for the CLASS Plan by Eileen Tell (Univita):
This brief looks at best practices in gaining strong participation rates in employer-sponsored long-term care insurance offerings to help inform strategies for the success of the CLASS Plan.
- Long-Term Care Insurance Buyer Profiles: Implications for CLASS by Eileen Tell (Univita)
This brief provides background on the demographics and key attitudes that differentiate long-term care insurance buyers from those who do not buy. This information can help the CLASS Plan to develop a more cost-effective targeted marketing strategy, reaching out first to those most receptive to the product.
Workforce Readiness (#16)
- Building Infrastructure to Support CLASS: The Potential of Matching Service Registries by Dorie Seavey and Abby Marquard (Paraprofessional Healthcare Institute – PHI)
This brief examines the “service fulfillment” challenges posed by the prospect of a fully operational CLASS Plan. If in-home services and supports are to be deployed in millions of consumer homes on a daily basis, then efficient and effective mechanisms are needed to connect consumers with workers. The potential of “matching service registries” for building needed infrastructure is explored. Findings from a recent PHI 50-state study identifying registries across the country are reported, and key design issues for bringing these labor market intermediaries to scale are identified.