Caregivers

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.

How is the state of Maryland providing necessary information on Medicaid waiver programs to consumers, families, and professionals? Attached find a presentation from a 2010 training presentation as well as a case study. May be replicable by other states wanting to disseminate similar information.

The limited research in the area of elder abuse suggests that the problem is widespread and largely unreported. Over the next several decades, the problem of elder abuse is expected to grow as the population of Americans age 65+ rapidly expands. This report provides both data on these issues as well as recommendations for future data collection and funding.

View the Federal Tax Changes for Fiscal/Employer Agents in 2011, compiled by the National Resource Center for Participant-Directed Services, noting that the Advanced Earned Income Credit must no longer be paid by employers, and Federal tax deposits must be made by electronic funds transfer. Read about these changes and more.

Families have always borne the burden of long-term care, and struggle with feelings of grief, loss, despair, anger and hopelessness. In this powerful first person account, the author points out some of the sad consequences of the American health care system's emphasis on the treatment of acute episodic illness or injury and its relative neglect of chronic illness long-term care. This essay, written for the New England Journal of Medicine’s “Sounding Board” series, is considered a seminal work.

View a four-part series that comprehensively examines the physical, mental, emotional, and lifestyle adjustments associated with caregiving. The show underscores the urgent need for understanding the stressful relationships that can evolve and offers guidance on how to manage expectations, providing insight into what support is already in place.