Affordable Care Act (ACA)

State aging and disability agencies have operated within a tumultuous environment for the past several years. It has become increasingly more difficult to reconcile the needs of older adults and people with disabilities with the resources available to address those needs. Five themes are identified from the 2012 state of aging and disabilities surveys, which include the acceleration of Medicaid managed long term services and supports and continuing loss of historical knowledge around the nation.

The recession continues to affect state programs for older individuals and adults with physical disabilities. Demand for publicly funded services has grown, and resources, including staff, are stretched thin, according to this new 50-state study. 31 states have cut non-Medicaid aging and disability services programs in FY 2010, and 28 states were expecting to cut these programs in FY 2011. Find the research report, brief, video and compiled State profiles.

Review a summary report of the Patient Protection and Affordable Care Act (ACA) provisions that have a direct or indirect impact on the workforce caring for the elder population, explores the challenges to developing the workforce, and critiques the adequacy of the ACA provisions in meeting those challenges. The ACA acknowledges gaps in the workforce caring for the elder population. Still, its provisions are inadequate given insufficient supply in the number and types of workers.

What has the ACA achieved over the past two years? According to the report, the ACA provides important insurance consumer protections, such as prohibitions on pre-existing condition exclusions, lifetime limits, and annual limits on certain benefits. Review a highlight of other key achievements.

This issue of Fundamentals describes Medicaid waivers and how they are generally used by states. It also describes the various types of waivers currently operational in California. The paper offers a broad overview of Research and Demonstration Projects—Section 1115 Waivers; Program Waivers— Section 1915(b) and 1915(c) Waivers and Section 1915 (b) and (c). Review the matrix which summarizes the difference.

This chart book compiles the median wages for personal care aides (PCAs) in each state between 2000 and 2010. It reports that PCA wages declined in 17 states between 2009 and 2010; overall, PCA wages for the entire U.S. crept downward slightly. The chart book also finds that real median wages for PCAs declined in 26 states between 2000 and 2010. Data for the chart book was gathered from the U.S. Bureau of Labor Statistics.

A new resource for organizations within the Aging Network that are interested in developing a care transitions program, providing information, tools and case studies. Chapters for the toolkit include: Getting Started, Taking Time to Plan, Developing Effective Partnerships with Health Care Providers, Measuring for Success, Building Organizational Capacity, Implementation and Day-to-Day Operations. The toolkit can be downloaded by sections or in its entirety.

To date, published information about person-centered care in assisted living has been sparse. This paper presents a comprehensive framework about what is needed to support person-centered care outcomes based on evidence-based practices obtained through a broad review of peer-reviewed and grey literature. This informational guide is an important resource for consumers, caregivers, and professionals.

This issue brief uses the most recent comprehensive data, from 2009, to examine the characteristics and costs of dual-eligible beneficiaries. The report also examines the different payment systems that Medicare and Medicaid use to fund care for dual-eligible beneficiaries and recent efforts at the federal and state levels to integrate those payment systems and coordinate the care between both programs. Given the high cost of dual-eligibles, legislative solutions are reviewed.

Few employer-sponsored and private insurance plans offer the range of services that workers with disabilities may need. Medicaid Buy-In programs are a viable option that allows these workers to receive needed services without spending down for Medicaid. This report describes findings from a study of characteristics and service utilization of higher-income enrollees compared to regular Medicaid enrollees. Providing these programs may keep higher-income workers with disabilities employed.