All States/Territories

Market approaches must become flexible with broader access to alternate providers and services such as HCBS. In the past, HCBS networks have been expensive to build and at times unwieldy to manage without sufficient dedicated resources. This presentation, which was delivered as the keynote for the September 2010 Medicaid Management Care Congress in Washington, DC., reviews the critical challenges to overcome for success in using HCBS as a strategy to extend care access.

According to the results of this survey, the most significant factors that drive turnover among home care workers are wages, intrinsic rewards, age (older workers are less likely to leave their jobs), and education level (more years of education result in higher retention). The study involved a sample of 116 home care aides employed by three agencies.

Despite the current budget climate that has dampened the pace of some rebalancing efforts, 32 states expanded Medicaid long-term services and supports in FY 2010 (primarily expanding HCBS programs) and 32 states planned expansions for FY2011. This updated fact sheet provides an overview of long-term care services, delivery of such services, and the large role Medicaid plays in financing long-term care.

Arizona has issued reports detailing work the state has done in supporting individuals with disabilities transitioning to work,and self-sufficiency with work incentives, health care coverage, benefits planning, etc. Attached are documents regarding outreach done for the Medicaid Buy-In program including which individuals were trained to disseminate the information, and data on the increase in work incentive utilization for SSI recipients.

Key provisions of the reform law offer a blueprint for tightly-coordinated and consumer-friendly eligibility and enrollment systems with seamless coverage as their goal. This brief summarizes key requirements that states face to construct enrollment systems that help people understand their options, use electronic data-matching and online processes, ensure that people obtain appropriate coverage, and support seamless transitions between coverage in the Exchanges.

A new policy brief examines the ramifications of extending the American Recovery and Reinvestment Act on Medicaid. Without the extension states may have to take drastic measures to balance state budgets. Proponents of the extension say it is essential to support the safety net and that it stimulates economic growth. Others argue the extension should only be approved if the additional federal spending is fully offset by federal budget cuts or increased federal revenues.

Health reform will bring important improvements in health care coverage for people with spinal cord injuries and people with disabilities in general. This brief summarizes insurance market reforms, HCBS options, mandatory health plan coverage provisions, Medicaid, Medicare, prevention and wellness, workforce issues and more.

A large proportion of the population is facing the competing demands of working and caring for a loved one. This study investigates the impact of informal caregiving, employment, and the combination of these responsibilities on the overall well-being of the caregiver. Higher well-being reported by employed caregivers compared with non-employed counterparts suggests that the benefits of employment, such as financial security and social support, can ease the burden of the caregiving role.

This updated resource, the first reflecting a ten year perspective, provides a state‐by‐state look at wages and wage trends for PHCAs, the fourth fastest‐growing occupation in the country, and a key job title within the direct‐care workforce. Prepared as a resource guide on wages for advocates and policymakers, the data underscore the problem of low wages for PHCAs, factors which contribute to workforce instability and near‐poverty incomes for this workforce.

Two studies examine the need for HCBS services and the economic profiles of adults with disabilities in MA. The main study examines the unmet needs of adults age 18-59 with disabilities, and the caregiver study focuses on the perspective of informal caregivers, i.e., their unmet needs and those of the people for whom they provide care. A detailed description of the survey methodology and exact criteria for selection into the study is included, as well as copies of the surveys.