All States/Territories

The authors present evidence in support of states investing in HCBS and nursing home diversion as strategies to deal with declining revenue. They review research reports illustrating how the balance of spending on institutional versus HCBS spending affects future long-term care costs. Using these data and case studies of Washington and Vermont programs, they conclude that HCBS is indeed cost-effective.

The question posed in the title is answered by analyzing state spending data from 1995-2005. The report shows that, for two distinct populations receiving long-term care services, spending growth was greater for states offering limited noninstitutional services than for states with large, well-established noninstitutional programs. Expansion of HCBS appears to entail a short-term increase in spending, followed by a reduction in institutional spending and long-term cost savings.

The trends in state Medicaid HCBS programs, target groups, participants, and expenditures are summarized and policy recommendations are made. The paper shows the progress in providing Medicaid HCBS but also identifies many current problems and policies. Inequities in access to services and limited funds result in unmet needs. Cost issues have been a primary focus of policy makers and quality problems are largely not addressed.

The Handbook was developed to provide state staff, policymakers, service providers, program participants, and other stakeholders with a comprehensive source of information about participant direction programs and policies. Its primary purpose is to explain how States can increase program participants’ choice of and control over their services and supports. In addition to providing detailed information, the Handbook also provides links to additional web resources on the selected topics.

The authors advise Congress on how to meet the growing demand for long-term care and cope with rising health care costs by supporting HCBS. The main recommendations are: promote care coordination and disease prevention; strengthen the nonprofit home health nurse workforce; and ensure the financial viability of home-based care.

Trends of population, economics, health status, health risks and behaviors and health care are drawn from several governmental statistics sources. Over 38 indicators are complemented by a one-time special feature on health literacy. This is the fourth chart book prepared since 2000. Detailed tables are available as excel spreadsheets.

This White Paper recommends minimum data sets that states should collect to help assess the magnitude of workforce issues they face and to design and evaluate policy responses. The three basic data elements include: numbers of workers (full time and part time); stability of workforce (turnover and vacancies); and average compensation (wages and benefits). The authors also offer guidance on how to implement data collection.

This website is designed to increase transportation options for older adults and enhance their ability to live more independently within their communities throughout the United States. It features the development, collection and distribution of information and resources for use by communities, transportation providers, state and local governments, aging and human service providers, and older adults and their caregivers.

When states are unable to serve all those eligible for vocational rehabilitation services, they are obligated to use an “order of selection” and first serve people with the most significant disabilities. The paper informs policymakers, agencies, providers, and consumers about the frameworks used by the federal government and selected states to deal with this issue.

Florida created tools to gather information essential to measuring quality from consumers in programs serving people with developmental disabilities and their families. The “Road Map” summarizes the quality assurance process and informs people of their rights. “My Personal Compass” assists in evaluating services received. The last link connects to other resources from the Florida Statewide Quality Assurance Program.