Real Choice Systems Change

Tips on how to develop successful relationships with independent providers are offered here for people with developmental disabilities and their families. The tool box provides advice around establishing relationships and expectations, recruiting and hiring workers, and problem solving.

In Empowering Arizona’s Individuals with Developmental Disabilities (EAzI), consumers actively contribute to quality improvement as interviewers, interviewees, and focus group participants. Four focus groups were used to learn what criteria consumers use to judge the quality of HCBS. Aside from the report, there is also a flyer and website used in recruiting EAzI participants. The website has a way to get information in Spanish and an online application.

The Older Americans Act (OAA) requires states to submit a Plan on Aging every 1-4 years focused on reforming long-term care to help keep older people independent. Arkansas presents information on their organization, programs, goals, funding, and people served. Their plan covers areas including Cash & Counseling, Money Follows the Person, transportation planning, disaster preparedness, and others.

States can use this in the development or improvement of their own protocol for reviewing sites that deliver Medicaid and grant funded services. The purposes of the reviews are to ensure compliance with regulations, assist in development of policies and procedures, and identify potential areas for training and program improvement. Protocols are organized by review method and specify which indicators are measured, source of data to be gathered, and example inquiries.

The purpose of this report is to inform the efforts of states that are trying to develop and improve QA/QI systems by describing and analyzing how selected Systems Change Grantees went through this process. The initiatives examined fall into six categories: administrative technology and information technology; standards for services; discovery; remediation; workforce; and public information.

Seven states received a share of over $8 million in federal grants to increase awareness of home-and community-based long-term care options for people leaving hospitals who otherwise may enter a nursing home. Over $7 million of the awards will be used to develop person-centered hospital discharge planning models. An additional $574,613 will supplement grants from FY07 to Wisconsin and Alaska so they can continue their Person-Centered Planning Implementation programs for another two years.

Centers for Independent Living (CILs) have been providing important services to individuals with disabilities since the 1970s. State Medicaid programs have contracted with CILs to provide Medicaid-funded services. This paper examines four important home and community-based services (HCBS) provided by CILs and funded by Medicaid: case management/support coordination; personal assistance services; nursing facility transition services; and equipment and home modification.

A broad coalition of stakeholders created this example of a comprehensive state-level workforce development plan. The document suggests solutions to the following workforce challenges: recruitment and retention; education, training and development; data gathering and monitoring; status and awareness of profession; and mentoring and supervision. An executive summary and 1-page call to action targeted at key stakeholders are included.

This report compares strategies of eight states engaged in strengthening consumer participation in long-term care (LTC) policy advocacy. The authors identify several tips for states to encourage consumer advocacy with the goals of increasing the efficacy and accountability of programs. This paper is part of a project funded by CMS to study ways to create a more equitable balance between Medicaid funds for LTC going to institutional services versus community-based supports.

This book and corresponding materials present a strategy for improving the health care workforce serving older adults via expanded education and training, models of care, and public/private programs. The committee proposes a three-prong approach: 1)Enhance the geriatric competence of the entire workforce; 2)Increase the recruitment and retention of geriatric specialists and caregivers; 3)Improve the way care is delivered. The book is available free online or for sale in PDF or hard copy format.