Florida

This report describes grant activities (accomplishments and progress) in three major LTC systems areas: Access to LTC Services and Supports, Services, Supports, and Housing, Administrative and Monitoring Infrastructure. The report also provides illustrative examples of the challenges Grantees have faced as they implement grant activities, and consumers’ roles in the implementation and evaluation of these activities.

Need an overview of the basic components of the nation’s largest health coverage program? Medicaid covers 55 million low-income individuals and is the dominant source of long-term care financing. Examine the structure of the program, who it covers, what services it provides, and spending. Because Medicaid is jointly financed by the federal and state governments programs vary across states. Tables examining the state-to-state variation in eligibility, enrollment, and spending are included.

This project was funded to a) gather descriptive information on HCBS waivers, both comprehensive and supports, operated for people with I&DD in 17 states with the supports waivers b) determine how supports waivers have emerged as separate and distinct HCBS waivers c) better understand the range of participant characteristics and experiences that distinguish supports waivers from other HCBS waivers d) more fully appreciate how states view supports waivers as a way to address demand for HCBS.

This report provides an overview of 35 states’ initiatives to improve their LTC systems and includes lessons learned and recommendations that can guide states undertaking similar initiatives. Despite accomplishments and improvements, Grantees described continuing barriers including insufficient funding for home and community services; workforce shortages; lack of affordable and accessible housing and transportation; and outdated or inflexible administrative, statutory, and regulatory provisions.

States are increasingly interested in the individual budget model for older Medicaid beneficiaries as a mechanism to improve responsiveness of benefits to beneficiaries’ needs and preferences and to increase their ability to remain outside or leave nursing homes. This report describes 10 operating individual budget model programs that serve older persons and identifies four areas of program design that are of particular importance to the success of the individual budget model.

This Issue Brief by the Alliance for Health Reform provides a short overview of the Cash & Counseling program. Sections include How the program came about, Access, health outcomes, and satisfaction with service, Five steps in getting started, Cost comparisons, Outstanding issues, Fast facts and Expert sources.

A new Health Services Research Journal is a dedicated issue to Cash & Counseling. Review the summary of 15 articles; topics include public/private partnerships, research design and methodological issues, evaluation, consumer enrollment and experiences, costs, worker issues and case histories. Also find two commentaries on Cash & Counseling, one on the international context and the other about social experimentation.

This study examines how a new service delivery model of consumer direction affected Medicaid and Medicare service use and costs. Of particular interest were the program's effects on expenditures for the services that the program \"costed-out\" (that is, those services for which an allowance was provided instead) and on total expenditures for all Medicaid services.

In light of this major change and assuming that states may want to learn more about Cash & Counseling, this publication offers an in-depth description of the option, a discussion of key findings from the three-state demonstration, and preliminary information about the program’s expansion into 12 more states. At the end is a list of resources—both Web sites and published materials—for further information. Stories about consumers who have first-hand experience appear throughout this publication.

To help States build the infrastructure needed to remove barriers and create more consumer responsive LTC systems, CMS awarded $70 million in Real Choice Systems Change Grants. Fifty-two Grants were awarded in Sept. 2001 (25 Real Choice, 10 Community-Integrated Personal Assistance Services & Supports, 17 Nursing Facility Transition). This report describes the progress FY01 Grantees have made on their activities during the first year of the three-year Grant period (Oct 1, 2001-Sept 30, 2002.)