Aging/Older Adults

For people who have disabilities and consequent difficulty living independently, living in the community requires not only medical and support services, but also housing. This paper explores one approach to merging the worlds of housing and long-term care clustered housing-care. Clustered housing-care arrangements make it possible for individuals to age in place in secure, comfortable, residential-like settings. The paper defines, discusses the impact and questions the futures of this concept.

One of two mini-projects aimed at engaging Medicaid-eligible consumers in an experiment with options of self-direction, the purpose of Community Access was to test creative methods that increase the opportunity of children and adults with disabilities to exercise self-determination. The project met the three objectives of supporting at least 12 individuals, develop a community advisor model to identify core competencies, and to identify barriers to full responses for requested services.

This policy development paper was written as part of the C-PASS demonstration project. The paper offers an overview and definition of self-determination plus three overall recommendations that are critical to making self-direction a reality. The challenge of moving self-direction from a relatively small scale to the foundation upon which all services to people with disabilities and older persons are built remains but the MASS-CPASS initiative, along with others, will help create that path.

This plan describes fundamental changes that states have implemented and found effective in controlling the public costs of long-term care while insuring that people receive quality services of the type, and in the settings, that they choose.

What do people considering enrolling in a self-directed program need to consider? This presentation describes many of the considerations in detail for those living in Louisiana. The New Opportunities Waiver (NOW) is the service delivery option offered by the Office for Citizens with Developmental Disabilities. The slides offer an overview of key components and responsibilities of self-direction.

This final evaluation report reviews the Maine ADRC project which began with three sites designed to demonstrate the \"no wrong door\" concept. Part I of this report describes the experience of, and recommendations from, the DASH Network in Bangor. Part II of the report focuses on the experience of the 3 local coalitions and their member organizations and highlights coalitions' community development activities and recommendations for future development.

ADRCs have used a number of strategies to streamline access to long-term services and supports. One key strategy, used by many ADRCs, is to provide online applications for Medicaid or screening tools to assess eligibility for benefits. This issue brief provides details about ADRC grant efforts related to online applications. The report details both advantages and challenges plus provides a case example for South Carolina.

Whether by establishing strong referral protocols with local or state veterans agencies or by serving veterans directly, ADRC staff should be trained to assist veterans who come to ADRCs for information, assistance, or referral. This Issue Brief includes an overview of veterans, the services and benefits offered by the VA, examples of productive collaborations between veterans agencies and ADRCs, and resources for ADRCs.

South Carolina hired an environmental modifications specialist to improve the quality of home modifications funded by its Medicaid HCBS waivers. The specialist trains case managers to develop specifications for ramps, and develops specifications for other home modifications so contractors can quickly make an informed bid. South Carolina also leveraged a state-funded home modification program to expand the types of modifications available in its waivers.

This report focuses on individuals with Alzheimer's and other dementias. The project instituted a comprehensive system to support enduring changes in the delivery of community-based assistance for Medicaid eligible persons with dementia. The projects two goals: facilitate hospital-to-home transitions for individuals wishing to stay in the community; and field test a nursing home-to-community transition program for eligible individuals. The workbook used in discharge planner training is included.