Long-Term Care

This report is the result of a study exploring management techniques and programs States have put in place to rebalance their Medicaid long-term supportive services. It summarizes the methods, products and findings of this project then suggests conclusions and recommendations for State officials, legislators, advocates, and providers and CMS on ways to increase and improve LTSS systems for people with disabilities, enhance participant choice, and reduce reliance on institutions.

In this survey, the MetLife Mature Market Institute found that private room nursing home rates rose 3.3% to $219 per day or $79,935 per year, while assisted living also rose 3.3% on average to $3,131 per month. Home health care aides now cost an average of $21 per hour; adult day services run $67 per day. The report includes average costs for each state, as well as for several individual cities, and includes other long-term care facts about provider training and available services.

This resource for long-term care researchers and policy analysts, allows users to create interactive maps and tables and download all data available on the site. The goal is to allow researchers to trace clear relationships between state policies and local market forces and the quality of long-term care. Policymakers will also be able to use the information to craft state and local guidelines that promote high-quality, cost-effective, equitable care to older Americans.

The California Community Choices (Choices) project is designed to increase consumer access to home and community-based long-term care services and to provide additional centralized sources of information and referral. The Choices project includes a study to improve the state’s understanding of the financial and structural barriers to increasing consumer access to these services, and to provide recommendations to the state to more effectively manage funding for long-term care.

Leading health reform proposals in both the House and Senate include a Medicaid expansion to help eliminate state variation in the current program and to broaden health coverage. Because Medicaid is jointly administered and financed by states and the federal government, changes will have direct impact on states. While health reform legislation could have many implications, this brief highlights some of the potential benefits and costs associated with Medicaid expansion in the reform proposals.

This fact sheet discusses the status of Medicaid and state budgets in light of the continuing recession and the federal fiscal relief provided to state Medicaid programs through the American Recovery and Reinvestment Act (ARRA). The ARRA money has helped address budget shortfalls, preserve Medicaid eligibility and soften program cuts. But ARRA funds are set to expire on Dec. 31, 2010, which may prompt some states to turn to cost-saving measures such as restrictions on Medicaid eligibility.

Looking for interesting on-line training opportunities? Train.org offers a number of web-based studies, webcasts and seminars. Topics include workforce development, disability, emergency management, evaluation, home care, mental health, program development. You can search by subject or course title such as Ready, Willing and Able, a seminar about assisting people with disabilities during disasters. Many on-line courses are offered at no charge.

The population is aging & the demand for long term care and services at home is increasing. Medicaid is the most critical program for individuals who are aged & disabled because it pays for almost 46% of all nursing home care & 38% of home health. Medicaid HCBS have been the focus of efforts by the federal & state governments to expand access for several reasons. The focus of this article is to examine issues of access, cost, & quality for Medicaid HCBS programs and to suggest policy changes.

The purpose of this report is fourfold: 1) to present a brief overview of the results of the Systems Change grants awarded from FY 2001 through FY 2004, 2) to describe the remaining challenges to community living that Grantees identified, 3) to provide Grantees’ recommendations for actions needed at the state and federal level to further improve their long-term care systems, and 4) to discuss the key lessons learned regarding factors that are needed to improve states’ long-term care systems.

CMS awarded the fourth round of 3-year grants for RCSC in Sept 2004. Three categories of grants were awarded: Research and Demonstration grants (40), Technical Assistance grants (10), and Feasibility Study and Development grants (2). This report focuses on the outcomes and Enduring Systems Improvements in Housing, Comprehensive Systems Reform, Mental Health Systems Transformation, Quality, Rebalancing, and Family to Family Grantees.