All States/Territories

This technical assistance document is the first in a series of papers that examines issues pertaining to respite services as part of the Medicaid program. By reviewing the prevalent definitions of respite in the published literature and federal documents, we seek a consistent view of respite services that can be used in the development of administrative policies to support respite for Medicaid HCBS beneficiaries and their informal caregivers.

This issue brief will present several approaches that attempt to tackle the underlying challenge of reducing nursing facility utilization and expenditures. These range from modifying the nursing facility reimbursement methodology; to converting nursing facilities to assisted living centers, paying nursing facilities to take beds off-line, and using capitated managed long-term care; to approaches with theoretical promise that have yet to be adopted in any state.

These briefs have been developed to assist the CMS Real Choice grantees who are focusing on strengthening systems of care for children and adolescents with severe emotional disturbances. Five briefs are included in the set. The briefs focus on assessment of children, therapeutic foster care, wraparound services, flexible funding, and multisystemic therapy.

The sixth biennial edition of the AARP Public Policy Institute's databook, presents an overview of long-term care in each state plus the District of Columbia by using numbers, graphs, charts, and maps. Data includes each state's demographics, need for LTC and HCBS services, the number of LTC workers per thousand people aged 65 and over, urban average for private-pay home health aide wages, and CNA hours per resident day. Each state is compared with others through rankings and national averages.

The survey results highlight inconsistencies and gaps in training, testing, and other pre-employment requirements for nursing assistants. The results from the nurse aide registries are presented in a series of charts. The survey notes who pays for pre-certification training in each state, whether candidates are allowed to become certified by passing the test without undergoing training, whether nurse aides pay a fee to be licensed or certified, who does criminal background checks, and more.

This issue explores the theory that improving pre-employment training and continuing education reduces turnover by giving workers the competence and confidence they need to do the job well. The brief describe federal and state pre-employment and on-the job training requirements; examine the costs involved and how to pay for it; summarizes the research on the impact of training programs on recruitment, retention, care quality; and identifies key questions in developing initiatives.

Handouts, attendee lists, reports presentations and speaker bios from a national symposium on the direct-care workforce are now available through the U.S. Department of Health and Human Services (HHS) Office of Disability, Aging and Long-Term Care Policy website. Hosted last May by the HHS and the U.S. Department of Labor, convened policymakers, workers, and practitioners from the fields of long-term care and workforce development to meet and learn from each other.

A two-year study in Los Angeles County showed that offering health care coverage improves retention rates. This study tracked workers in the city’s In-Home Support Services program, which offers home-based care and services to consumers who direct their own care. The report includes many findings, including an initial study done showing that workers who enrolled in the health benefits program were more likely to be in the workforce at month 12 than workers who did not enroll.

Informal caregivers, primarily family, but also friends and volunteers, have been and continue to be integral to the system of providing critical assistance to persons age 65 or older who need long-term care. This Data Profile provides an overview of informal caregivers today compared to caregivers a decade ago. This brief also offers excellent data and charts that offer a pictorial overview of the changes.

This guide explains the critical role Medicare and Medicaid have come to play in the lives and the futures of roughly 20 million children, adults, and seniors with disabilities - and gives people new information. This guides answers many questions such as: How do people with disabilities apply and can they get help with the process? What is the policy for covering durable medical equipment? How to appeal coverage decisions? Can a person be employed and still keep their coverage?