Long-Term Care

This policy brief examines the program created to provide financial support for home care, adult day care or a nursing home stay, and highlights how policy-makers could make the program sustainable. Options range from changing the premium structure and lengthening the vesting period, to incentivizing employers and more. The Obama administration acknowledges the program’s shortcomings and will ensure the program remains solvent and self-financing for at least 75 years, as the law requires.

To improve beneficiary care and reduce unnecessary expenditures, a number of states have developed programs and initiatives aimed at improving the coordination and management of care for dual eligibles—beneficiaries enrolled in both Medicaid and Medicare for their health care services. This report reviews the experiences in nine states to determine the lessons that can be learned from experience.

Third Annual Report builds on findings from the first two Annual Reports and focuses on the progress grantees made during the 2008-2009 grant period, representing slightly different stages of implementation for the FY05 grantees (Year 4) and the FY06 grantees (Year 3). Across grantees, data on outcomes during 2008-2009 grant period remained limited and changes in system infrastructure continue to be difficult to assess at this time.

Nursing home use declined among older adults (65+) in more than 2/3 of states but increased among older working-age adults (31-64) in all but 2 states. This article examines the associations between programmatic characteristics and rates of use. Although greater investment in Medicaid HCBS coupled with reduced nursing home capacity was associated with reduced rates of nursing home care for adults aged 65+, neither characteristic was associated among older working-age adults.

The estimated economic value of family caregivers’ unpaid contributions contribution was approximately $450 billion in 2009. If family caregivers were no longer available, the economic cost to the U.S. health care and long-term services and supports systems would increase astronomically. This report updates national and individual state estimates of the economic value of family care using the most current available data, and provides recommendations for taking care of the caregivers.

The Veterans Directed Home and Community Based Services program, sometimes referred to as Cash and Counseling for Veterans is designed to allow veterans who are potential candidates for nursing home placement to receive that level of care in their homes. The program provides veterans with a budget and allows them to choose their own care providers in place of receiving care services from the VA health care system. To learn more, explore this website.

The Utah Medicaid Work Incentive (MWI) Program began in 2001 as a way to encourage low income people with disabilities to work without fear of losing needed health care services. The program allows people with disabilities to earn above the poverty level to have access to Medicaid as long as their income remains low. The purpose of this study was to assess the impact of MWI policy on recipients’ earnings, Medicaid expenditures, and use of other public benefits.

Long-term services and supports (LTSS) for the elderly and younger populations with disabilities are a significant component of national health care spending. In 2009, spending for these services was $203.2 billion (almost 10 percent of all U.S. personal health care spending), most of it paid by the federal-state Medicaid program. This publication presents data on LTSS spending by major public and private sources.

Serving as a single point of entry, the Project SEARCH program provides a comprehensive approach to employment, retention, and career advancement for individuals with disabilities transitioning from high school. New Hampshires' goal is to begin training the first Project SEARCH group of 12 student interns for the full school year starting in September 2011 and graduating that group in June 2012.

Find two examples of quarterly newsletters produced by the state of Minnesota and directed at consumers with disabilities. Within the newsletters are personal stories from individuals with disabilities regarding employment, rehabilitation, finances and more as well as important information and resources for consumers. May be replicable by other states seeking to provide similar MIG outreach materials.