Physical Disabilities

As part of this Act, requirements were instituted involving the state's ADRCs and the global budgeting process used to support them. The Act provides specific directives that address financing and management plans, implementation and operation of the Medicaid LTC expenditure reforms, and requires an annual report, one of which is also included here, that documents reallocation of funds to home and community based care.

The question posed in the title is answered by analyzing state spending data from 1995-2005. The report shows that, for two distinct populations receiving long-term care services, spending growth was greater for states offering limited noninstitutional services than for states with large, well-established noninstitutional programs. Expansion of HCBS appears to entail a short-term increase in spending, followed by a reduction in institutional spending and long-term cost savings.

Learn from 10 years of experience in administering the consumer-directed Cash & Counseling program in Arkansas. The report provides a candid history of the development, implementation, and lessons learned from the program. The author gives details on partnership development and use, changes in agency culture and operations, and data on outcomes, cost neutrality, and participant demographics. Also included are the 2003 and 2008 program budgets.

March 2-4, 2009 state program staff, CMS staff, and technical assistance providers met in Baltimore to discuss Money Follows the Person and other strategies for helping people move out of nursing homes. Speakers presented on topics ranging from service integration, housing finance strategies, mentoring, quality, and many others.

Program administrators, advocates, and researchers advise the Senate on ways to improve wellbeing and cost outcomes of long-term care by increasing access to HCBS. They speak on national demographics, successful HCBS programs of the past and present, state programs in Wisconsin and Florida, integrating acute and long-term care for dual eligibles, and program finance models. See “Video Contents Index” for time stamps and information on each testimony.

Long-term care services for the elderly and for younger populations with disabilities are a significant component of national health care spending. In 2006, long-term care spending was almost $174 billion, most of it paid by the federal-state Medicaid program. This report focuses on concerns about the financing, the already substantial public role, which presages rapid spending increases as the “baby boom” population ages may lead policymakers to revisit these issues.

View the forum session presentations to learn how Arkansas, Texas, and Virginia have created consumer-directed options. They discuss demographics, program details and histories, costs, challenges, and the future. The final presentation goes over Money Follows the Person and Cash and Counseling from the federal level, examining policy, demographics, and outcomes.

The Veterans Health Administration plans to partner with the Aging Network in order to be serving over 109,000 veterans using HCBS by 2011. February 25 and 26, 2009, these organizations met in Boston to develop the partnership, work out next steps, and identify challenges. Presentations provide details on existing infrastructure, Nursing Home Diversion, financial management services, and existing research on HCBS and self-direction.

The experience of the Cobb and Douglas Counties Community Services Boards in Georgia in shifting from a segregated traditional service system to an innovative system focusing on economic development for persons with disabilities illustrates some common aspects of system change. The 7-year organizational evolution is analyzed here. The main points that emerged are: staff development; partnerships and funding; sustainability; management and HR practices; and expanding coverage to new populations.

This report presents findings of a national review—or environmental scan—of caregiver training programs and curricula, conducted by the International Longevity Center (ILC) as an initiative of the Caregiving Project for Older Americans, a joint project of the ILC and the Schmieding Center for Senior Health and Education.