State/Agency Information

In 2004, Congress requested that HHS conduct a study on the shortage of direct support professionals (DSPs) supporting persons with intellectual disabilities and other developmental disabilities (ID/DD). The study includes an examination of the causes associated with high vacancy and turnover rates, and an examination of the impact this shortage may be having on services for people with ID/DD. The report offers figures on projected needs and future demands of worker recruitment and retention.

A growing number of states are turning to managed long-term care in their Medicaid programs for younger adults and elderly people with disabilities, including those with Alzheimer’s disease and other forms of dementia. This issue brief describes how two states, Massachusetts and Wisconsin, have addressed the special needs of beneficiaries with dementia in the design of their programs and makes policy recommendations for states that are considering implementing or modifying programs.

The CMS Systems Change conference, Transforming Systems: Keys to Success was held April 10-12 in Baltimore. Presentations from the 2006 sessions are available in both PDF and text formats. Topics range from ideas on system transformation, stakeholder involvement, coalition building, strategic planning, sustaining systems change, and the Deficit Reduction Act. Full titles are listed in the keywords section.

The second in the series, this paper identifies the features of high-quality integrated community services and the systems that support them and serves as the foundation work for additional exploration. The paper will undergo continuing development in discussions with representatives of projects and consumer leaders, will augment assessment of existing systems and planning of new or improved systems, and ideally become an even more useful tool for those involved in systems transformation.

First of Three Papers on Unlocking the Code of Effective Systems Change - This paper attempts to create an overall framework for the discussion of systems change and to give a summary of the concepts. Several specific recommendations from other successful programs and the recommendations and guidance of the colloquium participants, can be applied now by any grantee, state, or program to enhance prospects of achieving enduring change in home- and community-based services.

This summary of the Home and Community Based Services (HCBS) State Plan Amendment (SPA) option is based on a review of the Deficit Reduction Act (DRA) and discussion from the April 3, 2006 conference call with CMS staff and Real Choice grantees. The content reflects the Rutgers/NASHP TA collaborations understanding of the legislation and questions raised by grantees. The intent is to highlight what is known about the DRA and some questions about how it will affect States that elect this option.

The statehealthfacts.org had recently added a data on states who offer Individual Budget programs. Use this interactive guide to compare and review activities related to participant-directed care. Data includes the program type, program name, CMS waiver authority, includes elderly, and a status update. Current as of January 2006.

On March 31, 2006, HHS Secretary Michael Leavitt outlined new flexibilities available to states under the Deficit Reduction Act (DRA) of 2005 (Pub.L. No. 109-171). Find out how the new DRA provisions may link with other options available under Medicaid to transform long-term care to person-centered care and to expand coverage for individuals with disabilities, increase access to community supports, and promote personal responsibility, independence, and choice.

What applications can states use to measure home and community based services? The purpose of this report is to outline the key components of performance measurement and to discuss their relevance and potential use in HCBS.The paper also offers practical approaches for states to gradually build a HCBS performance measurement set to serve as the foundation for their quality management activities and CMS required reporting.

With this funding for Systems Transformation, CMS will be awarding several states and non-profit agencies with small supplemental grants. States and other eligible organizations, in partnership with their disability and aging communities, may submit proposals to design and construct systems infrastructure that will result in effective and enduring improvements in community long-term support systems.