Psychiatric Disabilities/Mental Illness

This recently released report examines the reforms, policy changes, and initiatives that occurred in FY 2018 and those adopted for implementation for FY 2019. The report focuses on changes in eligibility, managed care and delivery system reforms, long-term services and supports, provider payment rates and taxes, covered benefits, and pharmacy and opioid strategies.

This study from Milliman highlights the success that MLTSS programs have had in reducing institutional care for older adults and people with disabilities compared to states operating a fee for service system, both in absolute numbers as well as the acuity level of consumers receiving services in nursing facilities.

This report explores the limited availability of supported employment despite the research demonstrating its success. It then presents strategies utilized by states when they expanded supported employment under settlement agreements; practical perspectives from employers, providers, and service users; and valuable lessons learned over the past decade. The paper concludes with a series of recommendations for ensuring that supported employment is widely available.

This report is a follow-up to NCD's 2012 report discussing Section 14(c) of the Fair Labor Standards Act. This 2018 report assesses the status of Section 14(c) employment, explores trends regarding American workers with disabilities being paid below minimum wage, and highlights recent policy changes impacting this employment model. NCD also makes recommendations for building capacity for supported employment services and changing pay structures.

While faced with new challenges, reduced budgets, and growing populations requiring more services, states are stronger than ever, and the work they do is more effective than ever in reaching individuals and addressing their needs. The National Home and Community Based Services (HCBS) Conference 2018 highlights these achievements, allowing states to share best practices, present unique partnerships, and recognize the work of their peers.

State Medicaid programs are increasingly opting to cover home and community-based services. This report looks at the efforts of various state Medicaid programs, examines their structure, and highlights the challenges encountered. From this review, GAO highlights three main challenges: 1) difficulty recruiting and retaining home care workers, 2) difficulty serving those with complex needs and, 3) limited funding for HCBS services.

This recently released white paper explains the barriers to employment faced by people with disabilities and highlights areas where governors can help people with disabilities overcome the challenges they may face in seeking employment. The strategies in this paper were developed following a learning lab meeting with states to discuss ways to take advantage of pools of untapped talent and ensure that workforce development and hiring policies are inclusive of people with disabilities.

Medicaid value-based payment (VBP) models tie payment to outcomes including quality of care, health status, and costs. This guide outlines considerations for adopting value-based payment (VBP) to promote high-quality MLTSS programs. It combines insights from five states - Minnesota, New York, Tennessee, Texas, and Virginia - with input from national health policy experts.

American Job Centers (AJCs) serve as destinations for people in search of career counseling, job connections, and employment-related services. This brief examines actions that (AJC) staff can take to make their services more accessible to autistic people and others with psychosocial, cognitive, intellectual, and developmental disabilities (DD). It outlines six specific recommendations for AJCs to promote equal opportunity and increase access for job seekers.

The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing state-based, random-digit-dialed telephone survey of noninstitutionalized U.S. adults. The 2016 BRFSS survey included questions about six disability types; hearing, vision, cognition, mobility, self-care, and independent living. One in four (61 million) U.S. adults reported a disability. Disability-specific disparities in health care access were prevalent, particularly among young and middle-aged adults.