Glossary — Elder care

These are the jargon, acronyms, and constructs a non-expert hits in the Elder care whitepaper. Use this as a reading companion; the filing remains the source of truth.

• HCBS
  Home- and community-based services — Medicaid-funded care outside nursing homes.
• LTSS / LTC
  Long-term services and supports / long-term care — the broader care category spanning home care and facilities.
• Direct-care workforce
  Aides and related roles; this filing tests whether their supply — not Medicaid dollars — is the binding constraint.
• Medicaid HCBS waiver / waiting list
  State waiver programs and queues; many users and waiters are under 65 — a scope trap the filing owns.
• PACE
  Program of All-Inclusive Care for the Elderly — integrated Medicare/Medicaid model for frail adults.
• Nursing-home staffing rule / HPRD
  2024 federal minimum-staffing (hours-per-resident-day) rule later vacated/mooted — a moving regulatory target.
• CLASS Act
  Prior federal long-term-care insurance attempt; cited as a cautionary architecture.
• ARPA HCBS FMAP bump
  2021 funding surge routed largely toward workforce — the natural experiment scored INDETERMINATE vs wage inflation.
• Cash & counseling / self-direction
  Beneficiary-directed payment models that change who hires and manages aides.
• ASPE / KFF baselines
  HHS ASPE and KFF figures that dominate prevalence and spending claims — check vintage and population.
• Medicare vs Medicaid roles
  Medicare covers limited post-acute care; Medicaid is the primary public LTSS payer for the long stay.
• INDETERMINATE stamp
  Desk verdict when evidence is consistent with the hypothesis and with a rival explanation — not a soft yes.

Scope note: docs/glossary-scope.md. Challenge a definition: [email protected].