Long-Term Care

The majority of public funding in the US for home and community-based care comes from Medicaid. Yet we know relatively little about how and in what ways Medicaid HCBS waiver programs support family caregivers or how such waiver services coordinate with other federal or state-funded caregiver programs. This descriptive study is the first to characterize and analyze the role of Medicaid HCBS waiver programs in supporting family and informal caregivers of frail elders and adults with disabilities.

Although consumer direction is a growing trend in publicly supported HCBS programs across the states, we know relatively little about how this approach is implemented in the states. This national study aims to describe the role of consumer direction in publicly funded family caregiver support services and HCBS programs with a family caregiving component. This report addresses three questions with the intent of informing policy discussions.

Rutgers Center for State Health Policy/National Academy for State Health Policy Community Living Exchange Collaborative organized a site visit for Money Follows the Person grantees to learn about the Pennsylvania Community Choice Initiative. The initiative was designed to expedite access to home and community based services to avoid admission to a nursing home. The site visit was attended by grantees from California, Idaho, Michigan, Nevada, New Jersey and Texas.

A key component of consumer-direction includes methods to ensure that essential supports are provided. This State Policy in Practice technical assistance document offers a practical example from the State of South Carolina. Care Call is a system developed to help South Carolina monitor service delivery provided though South Carolina Choice, an Independence Plus waiver that enables self-direction, and its other traditional home and community-based services (HCBS) waiver programs.

On September 1, 2005, The Bush administration's Medicaid Commission released its recommendations for reducing the growth in Medicaid spending by $11 billion over the next five years. The report provides a history and overview of the program, explains the purpose of the commission, and offers six recommendations for savings.

Informal caregivers play an increasingly important role in the health care system; in 2003, nearly one of 10 working-age adults was caring for a sick or disabled family member. Yet a new Commonwealth Fund study says more than half of the 16 million caregivers, or 9 million adults have health problems of their own. As a result, many are financially vulnerable and struggle to obtain needed care. The report suggests possible policy reforms to ease their burdens.

This report describes the FY 2002 and FY 2003 Grantees’ challenges and progress using information provided by the Grantees during the reporting period October 1, 2003 to September 30, 2004. The report describes grant activities in four major LTC systems areas: Access to Long-Term Care Services and Supports, Services, Supports, and Housing, Administrative and Monitoring Infrastructure and Long-Term Care Service and Support Workforce

This paper assesses the effect of consumer-directed care on the emotional, physical, and financial well-being of the primary informal caregivers of the Medicaid beneficiaries who voluntarily joined Arkansas's Cash and Counseling demonstration. The implications of the demonstration find that permitting interested Medicaid beneficiaries to direct their own in-home supportive services reduces burden on informal caregivers, which may help reduce beneficiaries' nursing home use.

This is the fourth in a series of <i>Data Profiles, Family Caregivers of Older Persons</i>. This Data Profile (Number 4, August 2005) examines primary family caregivers age 25 to 64 who are working and those who are not working. Review the statistics, demographics and other characteristic differences between working and non-working caregivers.

This fact sheet issued by the AARP Public Policy Institute examines recently published data shedding light on the characteristics of direct care workers, their working conditions, future demand for their services, and efforts to improve recruitment and retention of these workers.