State/Agency Information

Massachusetts assesses the service providers it licenses and certifies based on quality of life areas (such as the degree to which consumer choice and control is supported) and organizational outcomes. The reports can be used to understand quality of services and to inform consumers of the array of options available. Agencies are listed alphabetically by region and each report’s executive summary describes services offered.

Are we on the brink of a revival of interest in managed long-term care for people with intellectual and developmental disabilities? Four states’ experiences in experimenting with managed care are examined here, along with stakeholders’ views on these efforts. The report looks at goals, methodologies, and similarities and differences between programs. It concludes by looking at implications for other states.

New York has 12 long-term care (LTC) programs: two residential and ten community-based. Data from all are compiled here with the goal of informing policymaking and addressing challenges to the state’s Medicaid LTC programs. An overview of current programs and a snapshot of data such as enrollment and spending are also presented. The first chapter takes a look at the whole system and four other chapters offer data on the largest programs in terms of people served and dollars spent.

Planning documents show how Connecticut will use a Cash & Counseling model to provide flexible service choices to keep people out of institutions. The narrative gives details such as the state’s current rebalancing status, goals and objectives, approach, challenges, service options, training and eligibility. The work plan details “Choices at Home” key tasks, lead person and time frame associated with each major objective.

Through this interactive training, family caregivers can learn about available resources and train themselves on how to deal with common challenges. Some of the resources featured are links to agencies and senior centers, care locator tools, and descriptions of helpful programs. Trainings cover how to recognize and prevent stress, improve communications with family members and service providers, and address conflicts.

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 study compares monthly income for people receiving Supplemental Security Income (SSI) to local median incomes and Fair Market Rent rates for modest units across the U.S. In 2008, there were 219 housing markets in 41 states where recipients of SSI, people with long-term disabilities and virtually no assets, would have to pay 100% of their income for a modest one-bedroom unit. Ten years ago there were 44 such markets in 13 states. Policy recommendations are given to reverse this trend.

The Demonstration aims to provide 75 to 100 low-income residents with rental assistance for up to 3 years as they wait for permanent housing assistance. A process map showing how a subsidy is provided, marketing materials, sample contracts, and several worksheets for gathering unit and participant information and determining assistance eligibility and amount are given here.