Rutgers/NASHP

This comprehensive web-based resource contains detailed information about how states have used public funds to pay a portion of the cost of employer-sponsored insurance for Medicaid and SCHIP enrollees. This website is designed to help states decide whether premium assistance is right for them and, if so, to assist them in thinking through design and implementation issues. It includes detailed sections on initial design considerations; costs; benefits and cost-sharing; and eligibility redesign.

Individuals with certain combinations of needs who enroll in both the state-administered Medicaid program and the federally-administered Medicare program are referred to as dual eligibles. Currently, they receive prescription drugs and most LTC benefits from Medicaid, while they are covered by Medicare for acute benefits. Because dual eligibles receive benefits from both programs, many care coordination challenges arise in delivering high-quality, cost effective, & comprehensive benefits.

Despite preference for community-based long-term care, spending & policy is biased toward institutional services. More flexible policies were passed in 1981, when coverage was extended to non-medical services for people who meet criteria. States still must obtain a waiver for community-based services, and the law requires that Medicaid programs provide institutional care. As a result, policymakers face challenges when creating balanced systems that offer access to quality service choices.

This November 2004 issue brief addresses how states can control costs of the Medicaid program, often the second largest item in state budgets, after education. Every state has taken cost containment actions, & all plan to take additional measures to constrain growth. Enrollment has increased as a result of declining household incomes and declining rates of employer-sponsored insurance. Other factors such as the aging of the population will continue to affect the whole health care system.

This November 2004 issue brief addresses the federal medical assistance percentage (FMAP). The reimbursement percent is calculated according to a formula established in the Medicaid statute & based on the per capita income in each state. The fact that the FMAP is based on historical data is sometimes of concern to states. Additionally, the current system makes no specific provision for changes in the economy, leaving states confronted with increased costs when they can least afford them.

This November 2004 issue brief on Premium Assistance, a strategy in which a state uses public funds (e.g.,Medicaid dollars) to pay for a portion of the cost of private coverage (usually employer-sponsored insurance). Current use of premium assistance by states is minimal; only about one-third operate such programs, and recent reports indicate that enrollment in these programs is modest in most of these states. Nonetheless, state interest remains high due to the potential benefits.

This paper reviews literature and provides a summary of CMS initiatives in the area of quality measurement and improvement over five years up until 2002. This review applied a wide lens to identify quality strategies in settings of care and delivery systems both within and outside long term care. This paper will serve as background for a meeting with policymakers and experts to assess the relevance and limitations of identified methods to improve the services and outcomes in HCBC programs.

The Department of Housing and Urban Development (HUD) has published final FY 2005 Fair Market Rents (FMRs) that reflect the estimated 40th and 50th percentile rent levels trended to April 1, 2005. The FMRs determine the Section 8 payment amounts established by HUD for counties. FMRs apply to both renewal rents and initial rents for vouched programs. HUD is legally required to publish FMRs at least annually, adjusted to be effective on the first of October of each year.

On 9/29/04, the Dept of Justice announced the settlement of a lawsuit alleging a pattern of discrimination by the Housing Authority of Baltimore City (HABC) against low-income people with disabilities. The agreement, the first of its kind, enforces Dept of Housing and Urban Development (HUD) regulations against a public housing authority. Under the agreement, HABC will change its housing facilities, programs, policies & practices; commit several million dollars to new housing; and pay damages.

This brief information update highlights the United States Department of Justice settlement of a housing discrimination suit that alleged disability discrimination by the Triumvera Tower Condominium Association in Glenview, IL. The complaint alleged the condominium association discriminated on the basis of disability by establishing a written policy prohibiting persons in wheelchairs from using the front door.