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Many obstacles impede states from rebalancing their long-term supports and services (LTSS) programs toward greater emphasis on HCBS alternatives. This brief outlines policy recommendations for reforming the Medicaid-funded LTSS system to support more cost-effective and consumer-oriented long-term care options. The authors discuss the current LTC environment, barriers and promising solutions to rebalancing LTSS, and policy recommendations for improving the Medicaid LTSS system.

How is benefits planning & assistance being incorporated into Nevada's Disability Employment Education Project? To fight the fear of losing benefits, which prevents many individuals with disabilities from seeking work or returning to work, Nevada created a benefits planning and assistance program. A sample of the marketing material, which includes services offered, eligibility and contact information, is attached. It could be a useful sample for other MIG states.

How is Nevada using an online newsletter to keep consumers and service providers updated on all things pertaining to their MIG grant Program? EmployAbility is a monthly e-newsletter which covers programs, policies, resources and events related to the Nevada Disability Employment Education Project. Event announcements often include registration forms needed. Samples are included which might be useful to other states.

Find a sample Member's Guides to a MIG program. The state of Louisiana created the attached reference guide to help consumers understand the Medicaid Purchase Plan, its benefits and services. Some of the topics included are eligibility, Medicaid rights, responsibilities to Medicaid, covered services and helpful contacts. This can serve as an example that could be useful to other states interested in providing similar information to consumers.

How is Louisiana's Family Opportunity Act keeping parents or guardians of children waiting for services informed about new MIG services they could be getting immediately? Attached is a sample of a letter sent out to parents or guardians to inform them of the Family Opportunity Act (FOA). In this program, there are no resource limits, and the family can be covered by other health insurance programs. This approach to marketing new MIG programs could be useful to other states.

Service use as a barrier to employment for people with disabilities is an obstacle for many MIG programs. The state of North Carolina addressed this issue with this presentation at the 2009 annual meeting of the American Public Health Association. The presentation, including data and their implications, addresses intensive and irregular service use as possible barriers to employment. It is information that could be useful to other states.

How is Maryland marketing its Employed Individuals with Disabilities (EID) Program, which offers Medical Assistance (Medicaid) coverage to Marylanders with disabilities who work for pay? Attached are samples of the many marketing materials for this program, including a reminder card, article and posters. Informing consumers about this option is vital to a successful program and Maryland’s approach could be useful to other MIG grantees wishing to do the same.

Do you need personal assistance services at your workplace? Personal assistance services can be a big incentive for people with disabilities who want to work, and for those whose employers do not supply their own. South Dakota created the attached brochure explaining eligibility and services to consumers. This sample could be useful to MIG grantees interested in personal assistance services.

How are states getting the facts out to consumers about their MIG program? South Dakota is providing readers with information about SSA Work Incentives, Taxes, Medicaid Buy In, Self Employment, Asset Development, Looking for a Job, Knowing Your Rights, and the Ticket To Work Program through fact sheets that outline the program and resources. Samples are attached and could serve as a guide to other MIG grantees.

What are states doing to address language barriers in implementing their MIG programs? The state of Michigan created a Supported Self-Employment Training Manual in Spanish that extensively covers the history, details and resources of their program. This manual also includes forms in Spanish. It is available for download and could serve as a helpful template or outline for other MIG states.