Physical Disabilities

Access to affordable health insurance is essential to the ability of people with disabilities to seek and maintain employment. As their income fluctuates, people may migrate between Medicaid and Marketplace coverage, and they may face changes in their benefits and out-of-pocket responsibilities as a consequence. This issue brief uses hypothetical examples of working people with disabilities to illustrate the experiences they might have with Medicaid and Marketplace coverage in four states.

The state-federal vocational rehabilitation program serves approximately one million individuals a year and spends about $3 billion annually. This article looks at evidence-based best practices from the program.

This white paper provides an inventory of all current MLTSS programs and a projection of future programs as of July 2012. The report includes state-by-state results and synthesizes findings across states, reporting national enrollment, characteristics of contractors and multiple program features.

This State Long-Term Services and Supports (LTSS) Scorecard is a multidimensional approach to measure state-level performance of LTSS systems that assist older people, adults with disabilities, and their family caregivers. This second edition of the State LTSS Scorecard measures LTSS system performance across five key dimensions: affordability and access; choice of setting and provider; quality of life and quality of care; support for family caregivers; and effective transitions.

Medicaid LTSS is not a system that was purposefully built, but rather one that evolved over time out of legacy programs that were designed to meet the needs of different populations, differing state approaches to policy, court decisions, client advocacy, and changing ideas about where and how LTSS should be provided. MACPAC’s future work on Medicaid LTSS will focus on building a better understanding and moving policy in the direction of a more efficient and effective system of LTSS.

The supports and resources around the Section 503 new rules are mainly directed toward employers who are federal contractors. Yet, these new rules could also have significant impacts on employment service providers (ESPs) who work with individuals with disabilities, offering new opportunities for them to build partnerships, expand services, and create talent pipelines. The purpose of this article is to enable ESPs to prepare for the implementation of the new Section 503 rules.

A systematic review was conducted to review the effectiveness of workplace accommodation (WA) regarding employment, work ability, and cost-benefit among disabled people. There was moderate evidence that specific types of WA (vocational counselling and guidance, education and self-advocacy, help of others, changes in work schedules, work organization, and special transportation) promote employment among physically disabled persons and reduce costs.

Using data from 360 health care providers and 540 Medicaid eligible people with disabilities (PWD), the authors compared perceived barriers to care from the perspective of both providers and PWD. The results indicated major variations in provider and PWD perceptions. Policy responses to these findings should address the specific needs of people with different types of disabling conditions rather than assuming all PWD face similar challenges in accessing and utilizing health care.

This study evaluates the outcomes of the disability applications submitted to the Social Security Administration (SSA) through the Benefits Entitlement Services Team (B.E.S.T) Demonstration Project. B.E.S.T was a collaborative effort to locate homeless adults and assist them in applying for Supplemental Security Income (SSI) payments and/or Disability Insurance (DI). The findings show that B.E.S.T contributed to increased access to disability benefits for applicants.

The employment rate among persons with disabilities is less than half the rate among persons without disabilities. Broad innovations are needed to reduce this disparity.These authors examined employers' perspective related to: a) challenges they face when hiring people with disabilities, b) advantages (i.e. the business case) to employing people with disabilities, and c) their recommendations for innovations in both the public disability employment services systems and their own hiring practices