California

This is the third report in a series, from Mathematica's five-year evaluation of the Money Follows Person demonstration, aimed at helping Medicaid enrollees transition, from long-term care institutions to the community. It describes states’ early implementation experiences and state transition activity as of December 2008. Also discussed, are the challenges that states have encountered in trying to launch the program, and implications for making fundamental changes in the long-term care system.

The California Community Choices (Choices) project is designed to increase consumer access to home and community-based long-term care services and to provide additional centralized sources of information and referral. The Choices project includes a study to improve the state’s understanding of the financial and structural barriers to increasing consumer access to these services, and to provide recommendations to the state to more effectively manage funding for long-term care.

In this report, the authors present the results of an assessment that involved review of the literature on emergency preparedness risk communication and public health messaging strategies; the compilation of educational and outreach materials for emergency preparedness communication with vulnerable populations; and site visits in three states and the Washington DC area to identify gaps in the practice of risk communication with vulnerable populations.

The CMS website has been updated with the new 508 compliant MSIS Medicaid eligibility and claims tables for federal fiscal years 2005 through 2008 for 31 states. Individual or groups of tables may be selected using the identified dynamic list options. The standard MSIS fiscal year tables will be updated periodically as additional states submit their data for the full fiscal year.

The Stories and Guides demonstrate Think–Plan–Do: how to think about what you want, create a plan to get there, and take action to be successful. These online guides and videos help people with developmental disabilities live self-determined lives. There are 15 topics including Planning and Decision Making, Taking Care of Yourself, Listening and Speaking, and Making Goals Happen.

The Medicaid Buy-In program is a key component of the federal effort to make it easier for people with disabilities to work without losing health benefits. This issue brief, the ninth in a series on workers with disabilities, examines the prevalence and characteristics of Medicaid Buy-In participants who leave the program as well as their participation status in other public programs and their employment outcomes after disenrollment.

The purpose of this report is fourfold: 1) to present a brief overview of the results of the Systems Change grants awarded from FY 2001 through FY 2004, 2) to describe the remaining challenges to community living that Grantees identified, 3) to provide Grantees’ recommendations for actions needed at the state and federal level to further improve their long-term care systems, and 4) to discuss the key lessons learned regarding factors that are needed to improve states’ long-term care systems.

This updated resource provides a state-by-state look at wages and wage trends for PHCAs, the second fastest growing occupation in the country, and a key job title within the direct-care workforce. Review wages over a 9-year period. Prepared as a resource guide on wages for advocates and policymakers concerned with the direct-care workforce, the data underscore the problem of low and declining real wages for PHCAs, factors which contribute to workforce.

This issue brief examines the early successes and challenges of MFP. A 2008 survey of 29 states receiving MFP grants turned up several key findings, including that several hundred people have moved from institutional to community settings; that states are providing a broad range of services to facilitate transition; that housing issues for MFP participants are a major challenge for states; and that the severe economic downturn had not yet prompted states to scale back their efforts.

RTI is preparing a series of reports to document outcomes from the Systems Change grants. Divided into six parts, the first four provide an overview of the enduring improvements, continuing challenges, lessons learned, and recommendations of the 48 Research & Demonstration Grantees, organized by the four types of grants: CPASS, MFP, IP, & QA/QI. Part 5 provides summaries of the FTF Grants. Part 6 reviews the Respite for Adults and Children and Community-Based Treatment Alternatives for Children.