California

This document is the latest in a series of reports on Medicaid long-term services and supports (LTSS) spending. This year’s report contains newly available data and changes in the services that are included within LTSS. The report explains the changes, summarizes the data, and describes national trends.

The latest in a series provides background on the landscape of home- and community-based long-term care services funded by Medi-Cal, California's Medicaid program. In-Home Supportive Services (IHSS) is the largest personal care program in the nation.

Review this policy brief which summarizes 15 states' preliminary proposals to better coordinate care for people who are in the Medicare and Medicaid programs. The design contracts are an outgrowth of new efforts under the health reform law to develop service delivery and payment models that integrate care for the nation’s nearly 9 million "dual eligibles," whose medical needs and health care costs typically exceed those of other Medicare and Medicaid beneficiaries.

Third Annual Report builds on findings from the first two Annual Reports and focuses on the progress grantees made during the 2008-2009 grant period, representing slightly different stages of implementation for the FY05 grantees (Year 4) and the FY06 grantees (Year 3). Across grantees, data on outcomes during 2008-2009 grant period remained limited and changes in system infrastructure continue to be difficult to assess at this time.

The estimated economic value of family caregivers’ unpaid contributions contribution was approximately $450 billion in 2009. If family caregivers were no longer available, the economic cost to the U.S. health care and long-term services and supports systems would increase astronomically. This report updates national and individual state estimates of the economic value of family care using the most current available data, and provides recommendations for taking care of the caregivers.

By 2015, more than 15.5 million Americans 65 and older will live in communities where public transportation service is poor or non-existent. That number is expected to continue to grow rapidly as the baby boom generation “ages in place” in suburbs and exurbs with few mobility options for those who do not drive. This report ranks metro areas by the percentage of seniors with poor access to public transportation, now and in the coming years, and presents other data on aging and transportation.

Since 1988, Thomson Reuters has produced annual reports on state Medicaid spending for long-term services and supports (LTSS). One limitation to the reports has been that LTSS spending provided through Medicaid managed care programs often is not identified. This report presents estimated Federal Fiscal Year 2008 and 2009 managed care spending not included in previous LTSS expenditures reports. These estimates are based on data provided by states with managed LTSS programs.

When Congress created SSDI in 1956, disability and employability were viewed as mutually exclusive states. As a result, the 1956 law defines disability as the “inability to engage in a substantial gainful activity in the U.S. economy”—in other words, the inability to work. This proposal would assist workers with work-limiting disabilities to remain in their current jobs or to transition to more suitable jobs and would assist employers to accommodate workers to perform their jobs.

How is California educating relevant parties on this important new health care reform law? Please see two examples of state-wide outreach, a presentation on the changes that the Act will result in as well as a six month summary on the changes that have occurred thus far.

How is California helping youths with disabilities to connect with needed supports and services as they transition to work or postsecondary education? Explore several presentations and toolkits put out by the California Health Incentives Improvement Project (CHIIP) that aim to facilitate the transition process for these youth. May be replicable by other states seeking to assist similar populations.