All States/Territories

In 2004, Congress requested that HHS conduct a study on the shortage of direct support professionals (DSPs) supporting persons with intellectual disabilities and other developmental disabilities (ID/DD). The study includes an examination of the causes associated with high vacancy and turnover rates, and an examination of the impact this shortage may be having on services for people with ID/DD. The report offers figures on projected needs and future demands of worker recruitment and retention.

In the past decade consumer-directed (CD) services have proliferated in public programs. AARP has developed a two page Fact Sheet that offers an short overview of consumer preferences, program characteristics, the role of fiscal agents, and the ways consumer direction is expanding.

A growing number of states are turning to managed long-term care in their Medicaid programs for younger adults and elderly people with disabilities, including those with Alzheimer’s disease and other forms of dementia. This issue brief describes how two states, Massachusetts and Wisconsin, have addressed the special needs of beneficiaries with dementia in the design of their programs and makes policy recommendations for states that are considering implementing or modifying programs.

This groundbreaking two-part report calls for significant improvement in health care and long-term care that relies too much on families without recognizing and assessing family caregivers' own support and health needs. Volume II provides four background papers and two personal accounts. Chronic illness and disability, as these accounts reveal, affects not only the lives of the individual, but also of family members who provide the care and support.

This two-part report calls for significant improvement in health care and long-term care that relies too much on families without recognizing and assessing family caregivers' own support and health needs. Volume I reflects the professional consensus achieved among experts and stakeholders on fundamental principles and practice guidelines that apply to a range of practitioners in a variety of settings. The strategies focus on stimulating caregiver assessment as a basic component of practice.

This manual is intended to address two identified training needs for consultants/support brokers working with participants in self-directed care. MODULE ONE: Facilitating the Paradigm Shift for Consultants and MODULE TWO: The Dynamics of Choice and Decision-Making for Participants. The program identifies training needs by addressing the philosophical framework necessary for successful implementation of a participant-directed service and was designed to be delivered in two half-day sessions.

Managed by the Home Care Quality Authority (HCQA), a public agency in Washington, this Registry is a customized internet-based system designed to match the needs of publicly funded in-home consumers/employers with pre-qualified individual providers. The day-to-day operations are administered by Referral and Workforce Resource Centers (RWRCs). Local sites offer programs and services including referral searches, a Resource Clearinghouse and outreach materials such as the attached newsletter.

This paper discusses the activities of 11 grantees and the program and policy issues they have encountered. The paper’s primary purpose is to provide information that states and stakeholders will find useful when planning or implementing consumer-directed initiatives, whether through solely state-funded programs or the Medicaid program. In particular, the report highlights program and state and federal policy challenges and how Grantees are addressing them.

The Department of Mental Retardation (DMR) has established a system of reporting and monitoring incidents that occur with individuals served by the department in order to identify, manage and reduce overall risk for the individual. This procedure delineates a standardized process for reporting, documentation and follow-up of reportable incidents as defined, involving individuals served by the department. This reporting system helps implement individual plans and assists in quality oversight.

One of the greatest challenges facing every state Medicaid program is devising an appropriate and effective delivery system for its most resource-intensive beneficiaries. Several pilot programs called Disability Care Coordination Organizations are taking the best attributes of managed care and reconfiguring them to improve the lives of Medicaid beneficiaries with disabilities. This paper synthesizes the programs’ key components and describes the challenges they face.