Iowa

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 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for home and community services; workforce shortages; lack of affordable and accessible housing and transportation; and outdated or inflexible administrative, statutory, and regulatory provisions.

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.)

This paper explores and analyzes selected state approaches to engage nursing facility operators to be part of systems change activities that offer individuals additional, less restrictive choices to live more independently with appropriate supports. The strategies described offer other states lessons learned that may be replicated as part of a broader approach to meet changing and growing demand for home and community-based services. Efforts in IN, IA, MI, MN, NE, ND, NY, and WI are described.

The Compendium contains basic information about each of the Real Choice Systems Change Grant awards in FY03–FY04 plus the Family to Family and Systems Transformation Grantees awarded in FY05 and FY06. The Compendium will help Grantees identify others with similar goals and activities. Learn more about how the grants will be used to allow more people of all ages with a disability or long term illness to live and participate in their communities. The sixth edition replaces all previous editions.

A new database showcases the efforts of many of the TA providers serving CMS’ grantees. The database allows users to see the wide range of activities that support and enrich the grantees under the New Freedom Initiative. The database contains important information regarding existing and upcoming research products, conferences, and significant meetings as well as a wide variety of toolkits, surveys, and policy briefs, intended to be of interested to the disability and long-term care community.

This report describes examples of more narrowly focused state legislation that is setting the policy and infrastructure for consumer direction, expanding the direct care workforce, and supporting persons who return to the community after living in institutions. The Appendix includes the specific legislative language of selected bills covered in the report.

A public voice for caregivers, the Family Caregiver Alliance (FCA) offers information education, services, research and advocacy programs to support and sustain the vital work of families caring for loved ones. The website offers fact sheets, audio archives, referrals, newsletters, issue briefs and reports. A newly updated resource map called Caregiving Across the States allows state administrators, policy makers, and caregivers to access state-by-state data from an interactive database.

The annual 50-state survey of Medicaid officials finds an improved economy combined with the implementation of the new Medicare prescription drug benefit has contributed to the lowest rate of Medicaid spending growth in a decade and the fourth consecutive year in which Medicaid spending growth has slowed. Review the news release, read the report, or listen to conference materials and view the presentation slides.