All States/Territories

This report describes examples of more narrowly focused state legislation that is setting the policy and infrastructure for consumer direction, expanding the direct care workforce, and supporting persons who return to the community after living in institutions. The Appendix includes the specific legislative language of selected bills covered in the report.

An advisory committee of consumers, providers, practitioners, advocates and experts worked collaboratively to identify the major challenges preventing people with mental illness from discharging out of nursing facilities and into less restrictive communities. This report is a result of their work and aims to make available a framework for successful transition programs. The best practices described are offered as a guide for service providers, advocates, and mental health clients themselves.

The Parent to Parent of New York State– Family to Family Healthcare Information and Education Center developed a number of fact sheets in Spanish to assist the parents they serve. Fact Sheet titles include: HCBS Waiver Programs, Navigating Doctors Appointments, Searching the Internet for Medical Information, Medication Tips, Record Keeping Suggestions, Relieving Stress. They have also developed a 34 page Care Notebook where families can keep a complete record of a child’s medical history.

This site provides quality ADHD/ADD information, resources, support and help. Attention Deficit Disorder Resources is a national non-profit organization that helps people with ADD or ADHD achieve their full potential through education, support and networking opportunities. The site offers reading material, teleclasses and membership information.

Explore the impact of consumer-directed support on the economic, health, and social outcomes between families enrolled in the program and those on a waiting list. Caregivers reported fewer out-of-pocket disability expenses, greater access to health care, engagement in more social activities, and greater leisure satisfaction. There also appeared to be greater impacts on lower income families; these caregivers reported better mental health and access to health care than did the waiting list group.

The Schwab Rehabilitation Hospital has shared a synopsis and tools they have developed as part of their peer mentoring program for people with recently acquired spinal cord injuries. Mentors also have spinal cord injuries and have similar backgrounds. This peer mentor model could be adapted to a variety of situations. Other more detailed tools (such as weekly and monthly reports) are also available by contacting the staff.

The Medicaid Home and Community-Based services waiver program is authorized in §1915(c) of the Social Security Act. The program permits a State to furnish an array of services that assist beneficiaries to live in the community and avoid institutionalization. CMS recognizes design and operation features of a waiver program will vary depending on the specific needs of the target population, the resources available, service delivery system structure, State goals and objectives, and other factors.

The Nurse Delegation Invitational Forum brought together 28 participants from seven states to discuss the involvement of unlicensed assistive personnel (UAP) in the provision of health care tasks to long-term care consumers through nurse delegation and consumer direction. The Oregon long-term care system served as the forum centerpiece, with presentations by staff from state programs, the board of nursing, practicing nurses who delegate and visits to several sites in the Portland area.

Rutgers Center for State Health Policy convened national and state thought leaders in nursing practice and regulation to develop consensus principles to guide the profession's collaboration with people who want to live in their homes and communities. The 2004 draft principles were revised and endorsed by the American Academy of Nursing's Expert Panel on Aging in November 2005. They are offered as a foundation for further dialogue within and across states.

SAMHSA has just released three new Requests for Applications (RFAs) related to the promotion of mental health consumer and family member networking and technical support. These include funding opportunities for Statewide Consumer and Family Network Grants and Grants for National Consumer and Consumer Supporter Technical Assistance Centers. Go to the following SAMHSA webpage for grants and look under Center for Mental Health Services to view the RFAs due Jan. 31-Feb. 2, 2007.