Caregivers

This critical essay examines how effectively the Patient Protection and Affordable Care Act (ACA) addresses prevailing deficiencies in the nation's long-term care system and whether the ACA will result in meaningful reform. This article also reviews the basic problems plaguing the long-term care sector and the provisions within the ACA meant to address them, including incentives/options for expanding home- and community-based care and a number of research and demonstration projects.

The coordination of Medicare and Medicaid benefits and services for dually eligible enrollees has been a longstanding policy challenge. Several provisions of the Affordable Care Act (ACA) attempt to address this lack of coordination. This paper reviews the major changes under the ACA directed at care coordination for the dually eligible population and then concludes with a discussion of the continuing legislative and legal challenges in integrating care for the dually eligible.

This is the second “year in review” of developments in family caregiving, and there remains considerable room for improvement in how this nation supports the over 42 million family caregivers (and growing) who provide an estimated $450 billion in “free” care annually. The guide provides an overview of key developments in 2011. Two shorter versions, "45 Facts About Family Caregivers" and "27 Things You May not Know about Women and Caregiving" are also available.

Residential care facilities, such as assisted living facilities and personal care homes provide housing & supportive services to persons who cannot live independently but do not require the level of care provided by nursing homes. RCFs are not federally regulated; state approaches to regulation vary. Using data from the first nationally representative survey of RCFs with four or more beds, this report presents national estimates of RCFs comparing characteristics and services by facility size.

Risk factors associated with the incidence of recipient injuries, bedsores and contractures, and health care use among aged and non-aged adult personal care recipients are investigated. Data are from a statewide survey of aged and non-aged adult personal assistance service (PAS) recipients in California's In-Home Supportive Services (IHSS) program. Outcomes among recipients using relatives as paid providers are compared with those of recipients having non-relatives as providers.

Developing home & community-based service (HCBS) alternatives to institutional care has been a priority for many state Medicaid programs over the last three decades. While the majority of Medicaid long-term care dollars still go toward institutional care, the national percentage of Medicaid spending on HCBS has more than doubled from 19% in 1995 to 43% in 2008. More than 3 million people were served by Medicaid HCBS programs in 2008 and hundreds of thousands of people are on waiting lists.

The Texas Department of Aging and Disability Quality Monitoring Program for home and community-based services providers serves as a resource for these service providers. DADS Quality Assurance and Improvement (QAI) unit has implemented a Quality Monitoring Program in Home and Community Based Services Provider facilities. The purpose of TexasQualityMatters.org is to increase positive outcomes and to improve the quality of services.

The estimated economic value of family caregivers’ unpaid contributions contribution was approximately $450 billion in 2009. If family caregivers were no longer available, the economic cost to the U.S. health care and long-term services and supports systems would increase astronomically. This report updates national and individual state estimates of the economic value of family care using the most current available data, and provides recommendations for taking care of the caregivers.

Looking to better understand how states pay for adult day services through the Medicaid program? Comparing adult day services to other LTC provider types, adult day tends to be the most cost effective providers within the waiver or State Plan. This report looks at the scope of services provided by adult day and relates the clinical complexity of the care provided with the Medicaid reimbursement. Analyze the growth of programs in relation to the reimbursement and scope of services provided.

The Veterans Directed Home and Community Based Services program, sometimes referred to as Cash and Counseling for Veterans is designed to allow veterans who are potential candidates for nursing home placement to receive that level of care in their homes. The program provides veterans with a budget and allows them to choose their own care providers in place of receiving care services from the VA health care system. To learn more, explore this website.