All States/Territories

The Affordable Care Act of 2010 offers options & financial incentives for states seeking to expand systems of long-term services and supports. Many of these opportunities work together & build on existing initiatives, resulting in a strengthened infrastructure for service provision & an LTSS system that meets the needs of Medicaid beneficiaries. Key provisions of the ACA are summarized in this issue brief, followed by considerations for states seeking to take advantage of new opportunities.

With the growing role of home and community-based services in Medicaid long-term services & supports, an understanding of the different characteristics of the population transitioning from institutional care to HCBS, the trends occurring in LTSS & the effect of the different programs is needed. Hilltop developed a series of metrics to present to the Maryland Money Follows the Person Stakeholder Advisory Group now in the form of chart books. These metrics can be tailored for any state.

This report, which was presented at the Long-Term Care Interest Group Colloquium at the June 2011 AcademyHealth Annual Research Meeting in Seattle, Washington, discusses progress in rebalancing Medicaid long-term services and supports (LTSS) spending, how the Affordable Care Act can support states’ continued efforts to rebalance LTSS, and opportunities for future research to support continued system transformation.

Individuals who are aging or living with chronic illness or disability, along with their families, face multiple challenges in defining and creating a network of supports. There is no easy path to figuring out how to support loved ones or how to navigate a maze of medical & community supports. This manual provides a set of tools to help professionals and families navigate complex issues. An 11"x 17" fold out Drexler/Sibbet Team Performance Model® adapted to person-centered planning is included.

Shared decision-making provides an approach through which providers and consumers of health care come together as collaborators in determining the course of care. Research has shown that SDM increases consumers’ knowledge about and comfort with the health care decisions they make. By placing mental health consumers at the center of the decision-making process, SDM provides a model through which multiple calls for transformation of the mental health field might be answered.

This website is part of a joint initiative of the National Association of State Directors of Developmental Disabilities Services and the Association of University Centers on Disabilities. The Initiative integrates sound research into policy and program decisions that affect the independence, inclusion, productivity, self-determination, health and well-being of individuals with developmental disabilities. The partnership is developing products and activities promoting evidence-based policymaking.

Older Americans Adults (OAA) reauthorization presents a unique opportunity to make significant improvements to the advocacy provisions under the Act. This paper presents three dimensions and five principles that form the basis of advocacy under the OAA, and it offers seven recommendations to strengthen advocacy within the next OAA reauthorization. Virtually every program and funding stream created by the OAA requires that the entire aging network advocate on behalf of older Americans.

Most Medicaid beneficiaries are enrolled in some form of managed care. States are expected to increase their reliance on managed care to deliver services in their Medicaid programs. This 50-state survey provides a comprehensive look at state Medicaid managed care programs, documenting their diversity, examining how states monitor access and quality, and exploring emerging efforts to improve care, including managed long-term care and initiatives targeted toward dual eligibles.

Certain states significantly outperform others in the delivery of long-term services and supports (LTSS) to older adults and people with disabilities. The report examines four key dimensions of state LTSS system performance: affordability and access; choice of setting and provider; quality of life and quality of care; support for family caregivers. It assesses each state's performance overall as well as on 25 indicators, some of which measured for the first time. Compare data on the website.

The state-by-state charts can be downloaded, and feature information on workforce size and projected employment growth, trends in wages for each direct-care occupation, and information on health insurance coverage rates and reliance on public assistance. The PHI Data Center also features short write-ups and links to legislation and regulatory developments pertaining to workforce, notable state-based initiatives, employer best practices, and resources.