Long-term care eligibility backlog shrinks nearly 50% after process overhaul and contractor support

DHHS officials presented a multi-pronged effort that has cut the long-term care eligibility backlog and retooled how applications are processed. Associate Commissioner Christine Santanello and Melissa Hardy, director of long-term supports and services, credited a combination of internal process redesign, staff training and contract support from Public Consulting Group for measurable gains.

"Since January, we have seen a 47% reduction in backlog," project director Dave Hobson told the committee, describing operational changes: moving from a task-based to a case-based model so applicants are assigned a single staff contact, expanding electronic asset verification to reduce paperwork, and reducing the number of required statements for the five‑year lookback. Staff said DHHS received over 7,800 long-term care applications in calendar year 2025 and must also process roughly 7,300 annual redeterminations.

The team emphasized that improvements are partly sustained by the contractor’s on-site presence at about 40 nursing facilities, where staff can help families and facility staff assemble complete documentation before applications enter the queue. Officials also said they are exploring presumptive eligibility under the 1115 waiver but noted CMS must approve certain aspects before broader implementation.