All States/Territories

This GAO report examines 1) the extent to which states have Supplemental Security Income/Disability Insurance (SSI/DI) advocacy contracts with private organizations; 2) how SSI/DI advocacy practices compare across selected sites; and 3) the key controls the Social Security Administration has to ensure these organizations follow SSI/DI program rules and regulations. The GAO identified 16 states with some type of SSI/DI advocacy contract in 2014.

As almost half of the States have implemented MLTSS programs, community-based organizations, will be significantly impacted. At the 2013 HCBS conference, ADvancing States, with support from the SCAN Foundation, held a day-long intensive to discuss these impacts. This report outlines 5 discrete roles that CBOs are well-suited to play in MLTSS programs using as a reference point CMS’ 2013 guidance on MLTSS program design and implementation. To request a hard copy version, email Ali Diaz at adiaz@advancingstates.org.

Community-based organizations will be notably impacted by States' implementation of MLTSS programs. Case studies on ombudsman programs and care/service coordination–culled from the MLTSS intensive at the 2013 HCBS Conference–complement the issue brief on CBO readiness. The ombudsman case studies highlight activities in Wisconsin, Hawaii, & Minnesota, while the care/service coordination case studies discuss CBO experiences in Massachusetts & Ohio. Both studies feature successful CBO practices.

The lack of recognized standards for what constitutes sufficient monitoring has hindered efforts to assess the effectiveness of state oversight of managed care plans. This brief describes an approach used to evaluate state oversight of a new Medicaid managed care program for individuals with disabilities in Washington. The approach evaluates both the type and vigor of monitoring activities by the state and the degree to which the state's activities achieved their desired program outcomes.

Better integration of physical and behavioral health is a critical component of improving outcomes and reducing costs for Medicaid beneficiaries, especially those with high levels of need. This report profiles four examples where the safety net community – health plans, community health centers, community mental health centers, and the centers’ primary care and behavioral health clinicians – have collaborated to develop programs to integrate care for this population.

This study focuses on understanding the rates and patterns of enrollment in Medicaid among individuals already enrolled in Medicare, the factors that predict this transition to dual coverage, and those that predict nursing home entry. This volume of this report is a descriptive examination of the number and characteristics of Medicare beneficiaries who transition to dual coverage in the coming year.

Recent interest among policymakers in helping Social Security Disability Insurance (SSDI) beneficiaries return to work has increased the desire for knowledge about the employment activities of people with disabilities before they apply for benefits. This brief summarizes results from a working paper, conducted through the Social Security Administration's Disability Research Consortium, on the experiences of SSDI applicants before they apply for SSDI.

Despite states' rebalance of long-term care (LTC) systems with greater emphasis on home and community-based services (HCBS), many low-income elderly, persons with physical disabilities, and persons with intellectual/developmental disabilities continue to reside in institutions. Through an analysis of Medicaid enrollment and LTC claims data, this report provides information on the characteristics of institutionalized enrollees, their stays, and the interaction of institutional services and HCBS.

To answer questions on what services and barriers people with psychiatric disorders face, the authors conducted two targeted literature reviews: (1) employment programs and outcomes for people with psychiatric disorders; and (2) employment programs for people with other disabilities. The authors also examined literature and policy documents that outlined funding options for employment services for people with psychiatric disorders and other disabilities.

In this issue brief, the authors explore the provisions of the Affordable Care Act that may enable Americans with mental illness to obtain the mental health treatment and support services they need to continue working or get back to work.