Louisiana

Fiscal year 2010 presented the most difficult challenge for states' financial management since the Great Depression, according to this biannual state fiscal report. With a big drop in revenues from income taxes and other sources, the states are facing their worst fiscal squeeze in decades, as they try to keep programs running for more people, but have fewer dollars to spend. Budget cuts threaten health and social service programs, including the delivery of long-term services and supports.

Medicaid finances nearly half of all LTSS spending. Review an update to existing data on Medicaid financial eligibility standards for nursing home and HCBS waiver services for older persons and adults with disability. 2009 data were obtained on state selection of optional pathways for eligibility, income and asset standards, cost-sharing and other post-eligibility financial requirements. A copy of the survey instrument and accompanying letter to state Medicaid Directors are included.

Findings in this report focus on what has been learned about the status of grant implementation and factors that facilitate progress early and throughout the implementation period, and progress on grantees’ goals and achievement of Systems Transformation (ST). It presents results for both FY05 and FY06 ST Grantees, builds on findings from the first annual report and focuses on two different stages of implementation for the FY05 grantees (Year 3) and the FY06 grantees(initial 15-months).

This updated resource, the first reflecting a ten year perspective, provides a state-by-state look at wages and wage trends for PHCAs, the fourth fastest growing occupation in the country, and a key job title within the direct care workforce. Prepared as a resource guide on wages for advocates and policymakers concerned with this workforce, the data underscore the problem of low wages for PHCAs, factors contributing to workforce instability and near poverty incomes for this workforce.

This report is the latest in a series of annual reports that present expenditures data for Medicaid Home and Community-Based Services (HCBS) waivers authorized under Section 1915(c) of the Social Security Act. Table 1 presents reported Federal Fiscal Year (FY) 2009 expenditures for each HCBS waiver in effect during that year. Table 2 presents HCBS waiver expenditures data from FY 2004 through FY 2009 by state. The remaining tables present data according to the populations served in waivers.

This report is the latest in a series of annual reports on Medicaid long-term care expenditures. Table 1 presents national expenditures data for FY 1997–FY 2009. Tables A through T present state-by-state expenditures data for FY 2004–FY 2009 for specific categories of service. Tables U, V, and W present the distribution of each state’s LTC expenditures among institutional and community-based services.

Innovative applications of technology in Medicaid are highlighted in this series of profiles from varying states. Louisiana, a pioneer in using “Express Lane Eligibility” (ELE) is examined in this report. ELE allows Medicaid and CHIP agencies to use eligibility findings from other public programs to identify, enroll, and recertify participants. Despite a 12% reduction in the Medicaid workforce over the last two years, the volume and quality of service has remained consistent.

Are MIGs assisting individuals with disabilities to become employed? An annual GPRA report has been produced since 2007. This report builds on previous work, and shows the continued impact of MIG funding in 2008 on programs and services that facilitate employment among individuals with disabilities. As the MIG program approaches the end of its authorized period, many states are committing to evaluating the programs, documenting their impacts, and sustaining the efforts beyond 2011.

Integral to the coverage framework laid out in the reform law is a dramatic expansion of the Medicaid program. This primer provides key information about the program today, including a definition of what it is, who and what services are covered, Medicaid expenditures and how they are financed, and information of how health reform reshapes the program for the future.

Find a synopsis of how state coordinating councils operate, including a 50-state reference table, and profiles of the 25 existing state coordinating councils. Focused on improving coordination at the state and local levels, the Councils are a key to successfully keeping people in the community. Some of these states have created their Councils by state statute, some by state executive order or governor initiative.