Expenditures

Over the last four years, the Kaiser Commission on Medicaid and the Uninsured has been tracking the national development of the three main Medicaid HCBS programs that states can operate: (1) optional 1915(c) HCBS waivers, (2) the mandatory home health benefit, and (3) the optional state plan personal care services benefit. This brief presents expenditures and participant data on all three Medicaid HCBS programs and findings from the survey of policies on 1915(c) waivers.

This issue brief will present several approaches that attempt to tackle the underlying challenge of reducing nursing facility utilization and expenditures. These range from modifying the nursing facility reimbursement methodology; to converting nursing facilities to assisted living centers, paying nursing facilities to take beds off-line, and using capitated managed long-term care; to approaches with theoretical promise that have yet to be adopted in any state.

In consumer-directed care, few state aging networks have been more involved than Vermont. For the past 20 years, Vermont has undertaken considerable effort developing its consumer-directed approach to health and long-term care, including significant supports to consumers and their families who choose to participate in consumer-directed programs. This report is one of 5 in a series called Case Studies from the Aging Network: Health and Social Support Systems Integration.

This report reviews the initiatives of five states and highlights ongoing efforts to create a more balanced financing and delivery system. A table summarizes the home and community-based services system in each of the states. The case studies suggest at least five key issues for other states, Area Agencies on Aging, providers and consumers that are interested in reform. This report is one of 5 in a series called Case Studies from the Aging Network: Health and Social Support Systems Integration.

The Sacramento Healthcare Decisions (SHD) engaged Medi-Cal beneficiaries in a project to identify their individual and collective health care priorities. SHD had beneficiaries use \"Choosing Healthplans All Together\" (CHAT), a computerized tool and interactive group. CHAT participants designed their Medi-Cal benefits by making choices from 14 categories of services, each with two or three tiers of benefits. Findings and policy recommendations can be found in this report.

The Formative Evaluation of the Real Choice Systems Change Grants evaluates how the Systems Change grantees are progressing towards meeting their goals. The Formative Evaluation identifies problems faced by the grantees and ways that they deal with the problems. This document provides summary information about each of the FY2003 Grantees.

Financing long-term care (LTC) is a key policy and budget issue both in New Hampshire and nationally. Debates focus on who should bear the financial burden of LTC or how the burden should be distributed. This brief looks at what LTC is, its importance to people with disabilities, LTC financing mechanisms, the economy and LTC, and recommendations for change.

Notice of invitation to participate in the Housing Work Group.The Housing Work Group will provide a means for grantees to network with peers and to engage in open a discussion on how to develop affordable, accessible, and integrated housing choices for persons with disabilities. Each monthly call will focus on a specific issue or challenge and may include an expert presenter.

In these reports, the National Conference of State Legislatures (NCSL) traces the budget issues that states confronted in 2002 & 2003 and examines how they addressed those issues. The report also describes long-term care legislation enacted in 2002 & 2003 and long-term care planning work that is under way in many states.

The data presented in Tables A through N are derived from HCFA 64 reports submitted by states to the Health Care Financing Administration. The HCFA 64 is the form used by states to claim Federal Financial Participation (FFP) for state Medicaid outlays, and is audited by the Federal government. It is thus considered to be one of the most reliable sources of information on state Medicaid spending.