Sustainability

The authors present evidence in support of states investing in HCBS and nursing home diversion as strategies to deal with declining revenue. They review research reports illustrating how the balance of spending on institutional versus HCBS spending affects future long-term care costs. Using these data and case studies of Washington and Vermont programs, they conclude that HCBS is indeed cost-effective.

Program administrators, advocates, and researchers advise the Senate on ways to improve wellbeing and cost outcomes of long-term care by increasing access to HCBS. They speak on national demographics, successful HCBS programs of the past and present, state programs in Wisconsin and Florida, integrating acute and long-term care for dual eligibles, and program finance models. See “Video Contents Index” for time stamps and information on each testimony.

Methods for evaluating MFP are mapped out in detail. The report explains the design of the analyses of implementation, impact, and outcomes. It also describes research questions to be answered and methods for tracking the 31 programs. Finally, the synthesis of information and format of the presentation of findings is discussed.

In FY09, 27 states expect budget shortfalls at the same time that HCBS and other services administered by State Units on Aging nationwide experience increased demand. NASUA surveyed 44 states and the District of Columbia about their strategies for coping with this situation. These include creating or increasing waiting lists, cutting budgets, reduced staffing and travel, and adjusting program elements such as eligibility.

This report provides a summary of how long-term services and supports (LTSS) are financed and describes factors that contribute to uncertainty of the future costs for LTSS, including changes in how LTSS will be delivered. Three projections of future LTSS spending for senior populations under different scenarios are offered. These scenarios differ based on projecting the number of people with varying functional limitations and the resulting need for varying degrees of LTSS.

Determining how to optimally balance our demand for the best health care with limited funding represents one of the most challenging policy dilemmas facing the U.S. To help understand how to best accomplish this task, the document authors forecast Medicaid expenditures and enrollment for the next ten years. The data are organized by enrollment groups and service settings/categories.

This guide is a supplement to ABCs of Nursing Home Transition: An Orientation Manual for New Transition Facilitators. The two guides are meant to be used together. This second guide, gives greater detail on one of the most challenging aspects to the transition process—locating and securing housing that meets the individual’s needs and preferences so that the transition can be completed. The Appendix offers tools for housing specialist and consumers including checklists and how-to fact sheets.

Time-limited grants and categorical funding keep providers in the position of searching for funds to cover expenses. Sustainability is about maintaining programs after funding ends and ensuring the organization has become a permanent part of the community. This toolkit contains tips and planning worksheets within six booklets: strategic planning, organizational assessment & readiness, effective marketing strategies, financial management, fund raising & development, results-oriented evaluations.

Since 2001, the U.S. Department of Labor has funded 20 Customized Employment and 6 Workforce Action demonstration projects to identify policy mechanisms that effectively support customized employment. This report gives the background, key findings, successful strategies, obstacles, and analysis of the different projects. The main work product is a set of local, state, and federal policy recommendations generated by the initiative.

Health care experts from diverse fields give their opinions in this survey. The 196 leaders identified the most pressing long-term care (LTC) issues as development of the workforce, improving quality, and securing financing. 76% believe policymakers must urgently deal with the challenge of forming a sufficient supply of home and community-based services. Other themes dealt with include insurance, financial responsibility, a Medicare LTC benefit, and regulatory action.