1915c

States provide long-term care services in homes and community-based settings through 1915(c) home and community-based services (HCBS) waiver programs. To ensure strong oversight of waiver programs, this report reviews documents from CMS's most recent quality review of waiver programs from 25 States, as well as information gathered from structured interviews with staff from the 10 CMS regional offices. The report also identify five recommendations to meet assurances related to quality of care.

Autism spectrum disorders are among the fastest-growing developmental disability diagnosis in the US. This growing number highlights the need to learn more about the services & supports that are currently available for adults with ASD, & consider those that will be needed throughout their adult lifespan. The purpose of the study was to investigate how people with ASD are being served across states in HCBS, including service eligibility, state trends specific to autism services & lessons learned.

This report describes the process of assembling and integrating Medicaid and Medicare data to study recipients of HCBS in California. Subsequent reports will describe disability levels and service use of HCBS users in Medi-Cal only and dual eligibles between 2005 and 2008.

State Medicaid agencies fund supports & services for individuals with disabilities. As national public policy recognizes & emphasizes the ability of individuals with disabilities to work, states are integrating employment supports into the continuum of long-term care in Medicaid. This brief discusses federal legislative & regulatory framework for funding employment supports in Medicaid, highlights examples of state innovations & best practices to promote positive employment outcomes.

State aging & disability agencies are operating in an era of state agency reorganization, re-conceptualization of state government, & restructuring of long-term services & supports delivery systems & financing. Key elements driving continued change include the economic environment, ACA implementation, uncertainty in the federal budget particularly with the failure of the Congressional Super Committee, changes in state level leadership, & the 2012 elections.

The latest HCBS data from The Kaiser Commission on Medicaid and the Uninsured and the University of California at San Francisco analysis of The Centers for Medicare & Medicaid Services (CMS) Form 372 have been added and are available for all states and the nation for 2008. This website allows you to do an interactive search. Review the updated topics including total HCBS waivers, participants by waiver type, home health expenditures, and personal care participants.

This report is the latest in a series on expenditures for Medicaid waivers authorized under Section 1915(c) of the Social Security Act, also known as home and community-based services waivers. For the first time, the tables include state-reported data for 1915(c) waiver services provided through managed care programs that are not identifiable in the state CMS 64 reports. Thomson Reuters collected these data for FY 2008 and FY 2009.

A review of the federal financing mechanisms used by state agencies to implement the evidence-based employment models ( IPS and CE) come with the recognition that the federal financing of employment services for people with serious mental illness is a shared responsibility across multiple federal agencies. Improvements in this shared responsibility can lead to more effective support for these evidence-based employment models at the state and local levels.

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.

National policymakers and state Medicaid leaders are paying greater attention to better management of long-term supports and services (LTSS). A combination of factors presents state purchasers with significant opportunities to improve care and control costs by better coordinating and managing the full continuum of long-term care services. In this new publication series, states explore and understand emerging options. Review data and options for transforming long-term-care programs.