Long-Term Care

States vary greatly in the proportion of Medicaid long-term care funds expended on home and community-based services. In 2005, Oregon and New Mexico spent over two-thirds of their Medicaid LTC dollars on HCBS while Washington, D.C. and Mississippi spent less than 20 percent on HCBS. To overcome the “imbalance” states, at varying rates, have been “rebalancing” the way that Medicaid LTC services are delivered and financed to allocate a higher proportion of dollars to HCBS.

As part of the 2004 Real Choice grants, New Hampshire and Wisconsin proposed to complete a feasibility study and then develop LIFE Account programs. With no federal legislation creating a savings program, grantees are restricted to modified program that works under existing law. This paper considers six options: Section 1115 Demonstrations, Waivers under Section 1915(c) & 1915(b), Section 1915(i) & 1915(j) State Plan programs, and Section 1937 Benchmark programs and suggests some next steps.

In an effort to improve the quality of care provided in long-term care settings, as well as ensure a committed and qualified workforce, ASPE funded a study of the efficacy of various approaches to pre-employment screening and on-the-job monitoring of nurse assistants to prevent resident abuse in nursing homes. This study is intended to inform policymakers, providers and consumers about the contributions and effectiveness of existing federal mandates and state and provider based strategies.

The Alabama Medicaid Agency contracted with The Lewin Group to conduct a single point of entry feasibility study. Lewin and the Alabama Medicaid Agency staffed a single point of entry work group composed of Alabama consumers and other long term care stakeholders; this work group guided the study. A literature search on SPE best practices and national initiatives was used to develop three possible models for the state, each of which presents an array of pros and cons.

A new survey shows overwhelming support for giving residents choices for long-term care in the home and community. Tennessee is last in the nation in providing options in long-term care. AARP commissioned this survey to determine where voters stand on key issues. Voters say they are more likely to vote for state candidates who support allowing funds now used only for nursing homes to also be available for alternative services which help older and disabled Tennesseans remain independent.

This Discussion Paper summarizes selected approaches for analyzing the cost effectiveness of nursing home transition/MFP projects. It identifies questions that should be asked about the cost effectiveness of nursing home transition projects, discusses each question, identifies available national and state data pertinent to the question, and shows how states have answered these questions.

This tool box is intended to synthesize information that is available from multiple sources about nursing home transition and Money Follows the Person (MFP) initiatives to help states prepare for the MFP Demonstration program created by the Deficit Reduction Act. Each chapter summarizes the state of the field in a particular MFP design component, such as identifying consumers, planning and implementing transitions from an institution, financing MFP, and evaluating programs and progress.

The Montana Choice program created this booklet for individuals receiving personal assistance services in their home or would like to begin receiving services. The handout provides users with the resources needed to manage their care under the self-directed personal assistance program.

This booklet can assist individuals when they need help to remain in their own homes as a result of an accident, prolonged illness, disability or frailty that comes with age. It also provides individuals with the basic tips designed to walk through the many facets of hiring in-home help or what many consider a \"consumer-buying guide\" for a certain type of care.

This booklet was created by the Montana Choice program for people who are either receiving personal assistance services in their home or those persons who deliver personal assistance services in the home setting. The content focuses on the relationship between the personal assistant and the consumer. The booklet is divided into two sections: What is Personal Assistance and Am I a Good Personal Assistant?