All States/Territories

This comprehensive web-based resource contains detailed information about how states have used public funds to pay a portion of the cost of employer-sponsored insurance for Medicaid and SCHIP enrollees. This website is designed to help states decide whether premium assistance is right for them and, if so, to assist them in thinking through design and implementation issues. It includes detailed sections on initial design considerations; costs; benefits and cost-sharing; and eligibility redesign.

Individuals with certain combinations of needs who enroll in both the state-administered Medicaid program and the federally-administered Medicare program are referred to as dual eligibles. Currently, they receive prescription drugs and most LTC benefits from Medicaid, while they are covered by Medicare for acute benefits. Because dual eligibles receive benefits from both programs, many care coordination challenges arise in delivering high-quality, cost effective, & comprehensive benefits.

Despite preference for community-based long-term care, spending & policy is biased toward institutional services. More flexible policies were passed in 1981, when coverage was extended to non-medical services for people who meet criteria. States still must obtain a waiver for community-based services, and the law requires that Medicaid programs provide institutional care. As a result, policymakers face challenges when creating balanced systems that offer access to quality service choices.

This November 2004 issue brief addresses how states can control costs of the Medicaid program, often the second largest item in state budgets, after education. Every state has taken cost containment actions, & all plan to take additional measures to constrain growth. Enrollment has increased as a result of declining household incomes and declining rates of employer-sponsored insurance. Other factors such as the aging of the population will continue to affect the whole health care system.

This November 2004 issue brief addresses the federal medical assistance percentage (FMAP). The reimbursement percent is calculated according to a formula established in the Medicaid statute & based on the per capita income in each state. The fact that the FMAP is based on historical data is sometimes of concern to states. Additionally, the current system makes no specific provision for changes in the economy, leaving states confronted with increased costs when they can least afford them.

This November 2004 issue brief on Premium Assistance, a strategy in which a state uses public funds (e.g.,Medicaid dollars) to pay for a portion of the cost of private coverage (usually employer-sponsored insurance). Current use of premium assistance by states is minimal; only about one-third operate such programs, and recent reports indicate that enrollment in these programs is modest in most of these states. Nonetheless, state interest remains high due to the potential benefits.

All CMS Real Choice housing grantee were invited to participate in this conference call in an effort to share the model of integrating services within a public housing setting. The call included presenters from the Housing Authority of City of Milwaukee & the Milwaukee County Department on Aging. The presentation focused on the Lapham Park Venture, a collaboration of partner agencies who provide a continuum of care for residents. This entry contains meeting notes and questions & answers.

The Minnesota Finance Authority has made available guides on their website to assist consumers on how to design accessible home modifications and provide details on what funding programs are available from federal, state and local levels. The website provides connection to two distinct guides: The Home Accessibility Remodeling Series and The Home Accessibility Remodeling Funding Resource

The National Low Income Housing Coalition (NLIHC) recently released Out of Reach 2004: America’s Housing Wage Climbs, their annual study of wages and rents in the United States. The study shows as housing costs increase faster than wages, decent, modest housing is increasingly out of reach for millions of Americans. Out of Reach is a side-by-side of wages and rents in every county, Metropolitan Statistical Area (MSA), combined non-metropolitan area, and state in the United States.

Identifying available affordable and accessible housing is a difficult task for many consumers wishing to relocate to community based living settings. In the past few years, many states have instituted accessible housing registries in an effort to provide a one-stop location for consumers to search for housing in their communities. In January 2005, the State of Virginia launched its newly developed online accessible housing registry.