Community Inclusion

What are some of the essential components of Medicaid long-term care programs? This brief, geared towards people working in Medicaid or disability employment, discusses payment for long-term care, range of services, administration, eligibility, functional assessment and rebalancing of long-term care systems. Also find examples of how some states have incorporated aspects of long-term care services and supports (LTSS) into their Medicaid Buy-In (MBI) programs.

Find a user-friendly toolkit outlining a community-based planning process to promote healthy aging. The guide includes an overview with key elements of an aging well planning process, step-by-step guides for data gathering activities, case studies of communities addressing these needs, and a resource list of web sites and organizations offering information. Also attached is a related article co-authored by the Center for Civic Partnerships staff.

First in a series, this brief presents findings from AoA’s National Survey of Older Americans Act Program Participants. Findings indicated that Title III participants were at a higher risk of entering a nursing home compared to others in their age group. The authors conclude that AoA, however, is effectively reaching those most at risk of institutionalization, and that Title III services play an important role in helping elderly adults remain living independently in the community.

Find case studies and articles related to organizational change from traditional facility and group-based services to individualized supports. Reports present learned lessons and challenges based on site visits to organizations which offer supports for community living, employment and are engaged in change initiatives. New reports from 2011 include "Organizational Change: Approaches & Strategies" and "Stepping out of the Organizational Comfort Zone."

The Benjamin Rose Institute on Aging sponsored PPAR’s Winter/Spring 2010 issue. It includes seven articles written by national experts describing recent and notable changes in LTC policy, with its increasing emphasis on HCBS services. An introductory essay provides a 30-year review of the evolutionary process of LTC. Consumer-directed initiatives, caregiver and workforce issues, maturation of the service delivery system, and a review of recent state-level initiatives are discussed.

Health Affairs has published a special issue devoted entirely to long-term care. Review articles on providers, issues related to Medicare and Medicaid, transition and diversion programs, new state strategies to meet LTC needs, quality of care, demographic issues, policy and financing, health spending, caregivers and the workforce, and palliative care and end-of-life.

Recently enacted health care reform has a number of implications for PAS users. The Center for Personal Assistance Services has compiled a number of publications on this topic. The information is divided into the categories of: overall, long-term care, Medicaid, Other and Implications. A link to the full text of the Act is included as well as a summary and timeline of the Act

Explore the use of social marketing principles to enhance enrollment in the C&C Demonstration and Evaluation (CCDE). In this study, focus groups were conducted in Arkansas and Florida. Several lessons emerged from the findings including the importance of conducting process evaluation activities early during program implementation, carefully selecting and training personnel to conduct outreach and enrollment activities, and developing specific messages to include in marketing the cash option.

Predictors of service use was examined among four in-home and two community-based services. Results showed that race did not have a significant effect on service use, but gender had a significant effect for some services. The results indicated the importance of social supports and structural factors in predicting use. Implications for policies and practice to improve community outreach, access and utilization of services by different racial groups of elders are discussed.

Since the inception of the HCBS waivers, Minnesota has experienced an increased demand to provide services to individuals living in the community. Review a report on county and state use of available resources for the following waiver programs in MN: Community Alternative Care (CAC), Community Alternatives for Disabled Individuals (CADI), Developmental Disabilities (DD), Traumatic Brain Injury (TBI). Overviews of each waiver are provided as well as enrollment and expenditure data.