California

This report is the latest in a series of annual reports that present expenditures data for Medicaid Home and Community-Based Services (HCBS) waivers authorized under Section 1915(c) of the Social Security Act. Table 1 presents reported Federal Fiscal Year (FY) 2009 expenditures for each HCBS waiver in effect during that year. Table 2 presents HCBS waiver expenditures data from FY 2004 through FY 2009 by state. The remaining tables present data according to the populations served in waivers.

This report is the latest in a series of annual reports on Medicaid long-term care expenditures. Table 1 presents national expenditures data for FY 1997–FY 2009. Tables A through T present state-by-state expenditures data for FY 2004–FY 2009 for specific categories of service. Tables U, V, and W present the distribution of each state’s LTC expenditures among institutional and community-based services.

Read about the implementation of the Workforce Inclusion Act of 2002 in CA. This study examined the use of In Home Supportive Services (IHSS) in the workplace and barriers to its use. Information was collected on the impact of state budget cuts and program changes made for fiscal year 2009-10. A policy recommendation was made to modify IHSS by giving consumers more flexibility in using their IHSS hours with less task-specificity, and increasing consumer-direction of their authorized hours.

Examine factors associated with the use of personal care services (PCS) and the amount of authorized hours in California in 2004-2005. Of those Medicaid-eligible individuals with developmental disabilities living at home, 31% received PCS. When this study controlled for client need, gender, and age, those who were Asian/Pacific Islanders, African Americans, Hispanics, and other races had higher odds of receiving PCS than Whites but were authorized between 16 and 39 hours fewer than Whites.

Are MIGs assisting individuals with disabilities to become employed? An annual GPRA report has been produced since 2007. This report builds on previous work, and shows the continued impact of MIG funding in 2008 on programs and services that facilitate employment among individuals with disabilities. As the MIG program approaches the end of its authorized period, many states are committing to evaluating the programs, documenting their impacts, and sustaining the efforts beyond 2011.

Integral to the coverage framework laid out in the reform law is a dramatic expansion of the Medicaid program. This primer provides key information about the program today, including a definition of what it is, who and what services are covered, Medicaid expenditures and how they are financed, and information of how health reform reshapes the program for the future.

According to the authors, transforming Medicaid’s LTC programs is an urgent priority given states’ challenging fiscal environment. Based on this paper’s model, more than 35 percent of a state’s budget will be needed for Medicaid by 2030, of which half will be for LTC services. The brief examines Medicaid expenditures for LTC, in both institutional and community settings, and presents ideas for consideration for states to transform their programs to help address budget constraints.

Explore Medicaid expansion under health care reform and savings for states through Medicaid “modernization.” This report examines three broad categories of savings opportunities including the greater use of coordinated care techniques, the greater use of managed care for LTC, and the upgrading of Medicaid’s administrative processes. Find national and state-specific projections of increases in Medicaid enrollees as a result of health reform legislation and of the associated Medicaid costs.

Review an analysis of the size and characteristics of the PAS workforce during the period 2005-07. Data is available by state and nationwide and is based on a three-year combined sample of data from the U.S. Census Bureau's American Community Survey. Data include gender, age, ethnicity, birthplace, income, and type of employment.

Review an early assessment of the balance of state LTC systems before the implementation of the MFP demonstration. The authors’ goal was to develop a baseline against which the impacts could be measured as the program matures and evolves. This baseline information is used to identify key differences in the makeup of states’ LTC systems, and the observations suggest that the impacts of the program are likely to differ across states.