Community Inclusion

Health reform will bring important improvements in health care coverage for people with spinal cord injuries and people with disabilities in general. This brief summarizes insurance market reforms, HCBS options, mandatory health plan coverage provisions, Medicaid, Medicare, prevention and wellness, workforce issues and more.

The MFP/Community Reintegration Program is part of a statewide, multi-department demonstration program with the goal of increasing the use of HCBS long-term care services and eliminating barriers that prevent or restrict flexible use of Medicaid funds for necessary services in settings reflecting individual choice. Their website includes outreach materials, program descriptions and qualifications, and numerous related links.

The North Carolina MFP demonstration project assists Medicaid-eligible individuals who live in inpatient facilities to move into their own homes and communities, and to help identify and address barriers to receiving quality, community-based care. Their website includes historical information, forms, contact information, presentations and outreach materials that can be used as templates for other states seeking to develop similar materials.

Medicaid finances nearly half of all LTSS spending. Review an update to existing data on Medicaid financial eligibility standards for nursing home and HCBS waiver services for older persons and adults with disability. 2009 data were obtained on state selection of optional pathways for eligibility, income and asset standards, cost-sharing and other post-eligibility financial requirements. A copy of the survey instrument and accompanying letter to state Medicaid Directors are included.

Check out New Mexico’s Medicaid Buy-in Program (WDI) website. The program was created in 1999. Collaborative efforts of agencies, employers and consumers statewide continue to build upon the MIG initiatives for a sustainable, streamlined employment support system. See their website which includes marketing materials in both Spanish and English, applications, employment survey, policies, and much more.

Statistics show a significant percentage increase in older persons able to receive LTSS outside of nursing homes, however unnecessary institutionalization is still a routine problem. This report clearly delineates the limitations on progress, including differences in Medicaid structure around nursing home vs. HCBS waiver coverage. The authors recommend specific steps that federal and state governments should take to reduce unnecessary institutionalization.

Dual eligibles comprise only 17% of the Medicare population but represent 28% of Medicare beneficiaries with five or more chronic conditions. Find key facts and analyses on older Americans and long-term care issues. DataBriefs examine health and supportive services and the people who use them, while exploring opportunities to improve care through the implementation of health reform. Each Databrief is offered in the form of a Powerpoint presentation and one page PDF.

A number of health reform provisions give states additional options for financing HCBS services. This brief analyzes scenarios whereby states, which have significant roles in implementing many aspects of the ACA, might implement a combination of new Medicaid state plan options, enhanced Medicaid matching payments, and demonstration projects to expand HCBS care. In determining whether to adopt these options, states will assess whether they improve upon the current Medicaid authorities they use.

What are the goals of consumer direction? Does mental illness affect consumer direction of community-based care? This presentation addresses these and other tough questions faced in planning and implementing participant-directed programs. Information on consumer assessments, representatives, and common sense approaches and intervention are discussed, as well as additional tools and resources.

Are you looking for training materials for a nursing home diversion program? Arkansas created this Care Coordinator manual, Fact Sheet and Counseling Checklist for use at the beginning of their Nursing Home Diversion Program/Community Living Program. Also find consumer narratives and letters. The Arkansas Division of Aging and Adult Services was one of 12 state units on aging to be awarded a grant from the Administration on Aging for a new and innovative Nursing Home Diversion Program.