All States/Territories

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.

Existing national disability-related survey & administrative data are limited in their ability to meet needs of federal programs & policy makers. One potential response to these shortcomings is the fielding of a national disability survey. This report was prepared to assess the need for developing & fielding another national disability survey data collection effort. It presents findings from one of the project’s major activities designed to review the disability-related information.

As state and federal agencies strive to meet the growing needs of people with disabilities while using fewer resources, better disability data are needed for monitoring and improving the health, economic status, and overall well-being of this population. The report identifies limitations in national survey data on disability and outlines a wide range of potential short- and long-term options for addressing them, including developing and fielding a national disability survey.

This report examines state policies that are needed to help older adults age in place. These policies include integrating land use, housing and transportation; efficiently delivering services in the home; providing more transportation choices, particularly for older adults who no longer drive; and improving affordable, accessible housing to prevent social isolation.

This policy brief provides information on Washington, DC and the 37 states that are planning to better integrate care for participants who are dually eligible for Medicare and Medicaid. The Center for Medicaid and Medicare Services (CMS) will allow states to select a capitated model, or a managed fee-for-service model, or they can use both models. Included is a chart explaining the main differences between the two models.

Developing home & community-based service (HCBS) alternatives to institutional care has been a priority for many state Medicaid programs over the last three decades. While the majority of Medicaid long-term care dollars still go toward institutional care, the national percentage of Medicaid spending on HCBS has more than doubled from 19% in 1995 to 43% in 2008. More than 3 million people were served by Medicaid HCBS programs in 2008 and hundreds of thousands of people are on waiting lists.

A new technical assistance brief from the Center for Health Care Strategies provides a brief outline of the Money Follows the Person, Balanced Incentives Payment Program, the Community First Choice Option, and the modified Home and Community-Based State Plan option. For each program, the authors outline the budget impact/FMAP opportunity, application process, participant eligibility, care coordination/plans, and data reporting/evaluation.

In an effort to improve care & reduce costs, states & the federal government are seeking new ways to provide services to people eligible for both Medicare & Medicaid. Missing from the discourse are the voices of these dual eligibles. Changes to the way their care is organized & delivered could have profound effects on their health, quality of life, & satisfaction. This project aims to complement state & federal efforts by offering perspectives on what duals want from their models of care.

This policy brief is part of Center for Health Care Strategies’ Technical Assistance for Dual Eligible Integrated Care Demonstrations program, made possible through The SCAN Foundation and The Commonwealth Fund. Through this program, CHCS is helping demonstration states develop and implement integrated-care models for individuals eligible for both Medicare and Medicaid services.