Idaho

A series of PHI issue briefs describes the direct-care workforces in several states. Specifically, the briefs focus on Illinois, Pennsylvania, Michigan, Massachusetts, Iowa, Vermont and New York City. Despite growth in this industry, direct-care workers in all states face numerous challenges. In each of the states reviewed by PHI, direct-care jobs do not offer benefits or pay competitive wages. Review the facts and data for each of these states.

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.

How can states use debit cards in their consumer-directed purchasing programs? The Sept 2009 Community Living Partnership TA Call addressed this financial management question. States have used pre-paid plans as part of their MFP and CLP grants. Review a matrix of pre-paid card companies and their methods for spending. Also included is a Proposed Procedure for Debit Card Purchases developed for the Veterans-Directed Home and Community Based Services Programs.

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.

This second report in a series focuses on how state variation in level of experience and infrastructure to undertake large-scale transition programs can affect implementation. The authors describe differences in strategies to 1) expand transition coordination capacity 2) locate appropriate housing 3) enhance long-term supports & services 4) change Medicaid HCBS programs/policies to ensure that those who transition can remain in the community after the MFP eligibility period ends.

The Network consists of 10 regional centers funded by the National Institute on Disability and Rehabilitation Research (NIDRR), a division of the U.S. Department of Education. The mission is to provide information and Technical Assistance on the Americans with Disabilities Act (ADA) to individuals, organizations and employers. They provide training materials, referrals, and a searchable database of legal documents, fact sheets and checklists.

Nearly every state provides at least some funds for services for low-income older adults or people with disabilities who have too many assets to qualify for Medicaid. AARP reports on how much each state spends on both multiservice and single-service programs. It also compares funding sources, eligibility criteria, services, cost management strategies, consumer direction, and other characteristics.

Medicaid currently fills in the gaps in Medicare’s benefit package for 8.8 million enrollees with limited income and resources (dual eligibles). Shifting aspects of this financing to the Federal government could save states money and create opportunities for better care management and coordination. Data tables show how much each state could save if certain financing roles were shifted.