Physical Disabilities

This report draws on interviews with state Medicaid program officials for insight into the issues that arise in establishing programs to move individuals with significant long-term care needs from institutional to community settings. The five states that participated in this study—Florida, Louisiana, New Jersey, Ohio and Washington—each received federal grants for nursing home transition activities and had varied experiences.

Due to concern that wealthy elderly Americans were transferring assets to gain Medicaid coverage for nursing home care, the Deficit Reduction Act tightened Medicaid eligibility rules. About 43 percent of all nursing home residents eventually become Medicaid eligible. Over the six-year period examined, the authors estimate that, when applying the DRA asset transfer rules, federal savings to Medicaid could amount to $1.87 billion.

The Bangor Eastern Agency on Aging ADRC project has shared a number of resources involving the Intake and Referral Process. The first is their policies which provide staff guidelines for consistency. The second resource is their intake questions to help record and collect information. Lastly, they have shared their feedback referral process and how to make this simple and accessible by the consumers.

Curious about the ADRCs, a Joint Program of the Administration on Aging and Centers for Medicare & Medicaid Services – this Fact Sheet provides a short overview and a map illustrating where and what kinds of activities are taking place across the country. Find out about the efforts to develop “one-stop-shop” programs.

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.

The Colorado Department of Health Care Policy & Financing contracted with an independent consultant to organize and facilitate six focus groups with consumers of Medicaid waiver services, family members or representatives, and consumer-directed program participants. The focus groups discussed consumer experiences with existing emergency backup and critical incident management systems and identified strengths and potential weaknesses. This report provides results from the focus groups.

Recommendations for a Research Agenda on Asset Development for People with Disabilities-Previous work indicates that people with disabilities have significantly fewer assets than people without disabilities. Research suggests that individuals in lower income tiers are able to save and that holding assets has a positive relationship with personal well being, economic security and community involvement. This paper recommends four significant areas in developing a research agenda.

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.

This monograph discusses program design considerations to assist as states move toward greater individuality and flexibility in the provision of services and supports. The paper outlines topics to consider when expanding opportunities for participants to choose and direct individual who provide assistance, including the risks/benefits arrangements, provider qualifications, training, person-centered planning, the case manager role, and safeguards to prevent abuse, neglect and exploitation.

HCBS.org News CLIPS highlights the important work of Real Choice Systems Change Grantees. In this issue, we have interviewed Dawn Lambert in Connecticut to discuss the key strengths and challenges faced during program implementation of their Nursing Facility Transitions to Independent Living Program. Find out the program basics, success strategies, stakeholder involvement techniques and the options for sustainability.