Long-Term Care

This May 2008 presentation by Mary DeRoo of the Elder Services of Merrimack Valley in Massachusetts describes the risk management system they use that manages risk while maximizing consumer choice and control.

Recognizing caregivers' needs, many federal and state lawmakers have spent the past several years introducing legislation to provide supports to caregiving families. Unfortunately, fiscal crises and other pressing social concerns have meant that few of these proposals have actually passed or been enacted. Trends in caregiver legislation introduced in 2007 and 2008 are summarized and those that have been successful are highlighted.

CA’s In-Home Supportive Services (IHSS) aims to keep people in their homes by paying for personal care services approved by social workers. SB 1104 was introduced in 2004 to ensure and measure delivery of services and program integrity. The report examines whether the elements of the bill were enacted. It also describes alternative models for in-home service delivery, including the Cash & Counseling model and one wherein private companies provide IHSS. Sample timecards and handbooks are given.

The presenters lead a discussion on the importance of local strategies for building affordable, accessible housing. They touch on how to identify key partners and opportunities, create a transition support network, and advocate for prioritizing housing in local programs. Examples of Money Follows the Person grantee activities are given, with a focus on Maryland’s experiences. Resources for conducting a local housing market assessment are also given.

Here is a snapshot of the program , seven years after implementation. The report introduces the grants, their assessment process, profiles funding recipients, and measures how well the program protects workers’ benefits and increases employment. Finally, recommendations for improving outcomes are provided.

This report describes recent progress in moving state developmental disability systems using HCBS 1915 (c) waivers toward greater efficiency and equity, in the context of pressing issues in the field. It is important to note that these initiatives could be equally well applied to other Medicaid waiver populations.

Via IHSS Plus, participants are able to receive certain expanded in-home services as part of Medi-Cal. Before, payments for these services were not matched by a federal contribution and were administered through a separate program. The analysis looks at implementation and service use in 2005, compares recipients’ outcomes and institutionalization rates to those in the original IHSS program, and complements the State’s evaluation and other research on paying family caregivers.

This paper summarizes the strategic framework HSRI has developed to achieve needed system improvements; and ten common issues or concerns that states have encountered throughout the process to develop individual or level-based budget allocation models, and examples of how states have addressed each issue.

Follow the link for a comprehensive listing of state statutes, regulations, policies, and procedures regarding the use of emergency or planned physical, chemical, mechanical, or other restraints. Additional documents offer information on positive behavior support guidelines, training manuals, and other policy-related materials. Many emphasize the use of positive or non-aversive interventions. Links are provided to access documents on many state DD agency websites.

Here are resources used to educate consumers about MN’s Consumer Directed Community Supports, Personal Care Assistance, and Road to Independence programs. The first handbook gives guidance on the processes and protections of consumer direction and also provides sample care plans and assessments. The handbook on personal care assistance is available in English, Somali and Vietnamese and reviews eligibility, management, and use of services. The last guide assists in moving out of an institution.