Indiana

This publication provides a summary overview of the accomplishments and enduring changes brought about by all of the Systems Change NFT Grantees Despite bringing about many enduring systems improvements, Grantees reported that many transition barriers remain. Grantees made recommendations to help states address continuing barriers to nursing facility transition and diversion so that no one need live in a nursing home simply because sufficient community services and supports are unavailable.

Since 2001, the U.S. Department of Labor has funded 20 Customized Employment and 6 Workforce Action demonstration projects to identify policy mechanisms that effectively support customized employment. This report gives the background, key findings, successful strategies, obstacles, and analysis of the different projects. The main work product is a set of local, state, and federal policy recommendations generated by the initiative.

Mathematica researchers examine the effects that the Medicaid Buy-In program has had on participants’ earnings. The first brief looks at whether earnings increase after enrollment. The second profiles the workers that earn the highest wages. The last brief profiles all Buy-In participants and compares earnings data by state. Each brief analyzes the traits of the workers and different state programs to identify successful strategies.

How many people served by home and community-based mental health services in your state are employed? This DataNote explores this question and illustrates a wide variance in outcomes between states, suggesting the need for further research to identify and implement best practices.

Thanks to the steadily increasing demand for home care, the second fastest-growing occupation in the country is that of personal and home care aides (PHCAs). Yet PHCA wages - which were low to begin with - are failing to keep up with inflation nationwide. A new publication looks at the decline in inflation-adjusted wages. Based on data from the Bureau of Labor Statistics, it charts the wages received by personal and home care aides in all 50 states and the nation over a seven-year period.

States are ranked in this report based on the outcomes of Medicaid services provided to people with intellectual and developmental disabilities. The key outcomes measured are the promotion of independence and meaningful employment, tracking quality and safety, keeping families together, and reaching those in need. Each state’s progress is measured by comparing data from the previous year. This report is issued annually with past editions available on the included website.

This comprehensive report provides data and macro level analyses on public and private residential services. The Executive Summary and Section 3 compare Medicaid utilization and expenditures for home and community-based services with services provided in institutional settings. Data are also presented in state-by-state profiles. Past editions of this annual report dating from 2000 are available at the website provided.

This paper examines the extent to which states have balanced the delivery of Medicaid-funded LTC services and supports to people in their homes and in institutions. What is unique about this report is its primary focus on older people and adults with physical disabilities separate from other LTC populations, such as people with developmental disabilities. Explore what has been accomplished under current Medicaid law and review how federal policies impact the ability to balance service delivery.

The authors offer recommendations for providing successful career preparation support to youth with mental health needs. They studied five successful programs to identify common design features that address frequently identified challenges in transitioning to an independent adulthood. They also offer analysis of systems level factors affecting program design and sustainability, in addition to recommendations for staff and policymakers.

This paper models the effect of occupancy rates on nursing home reimbursement. It surveys nursing home methodologies generally and specifically models the rate setting systems of California, Indiana and Pennsylvania. The modeling indicates that much of “the fixed costs” would not get calculated back into the rates. The costs that do would be allocated across all resident days used in rate setting regardless of payer source, including Medicare and private pay, limiting the Medicaid impact.