Michigan

States are confronting challenging budgets along with the need to implement health reform. Many are looking to improve long-term care as a way to control costs and serve seniors and people with disabilities in settings they prefer. This newsletter describes provisions in the Affordable Care Act that assist states in expanding HCBS, the growing movement to improve facility-based care, and innovative programs in three states that seek to provide consumer-directed long-term care.

To better understand the dynamics of the workforce challenges that factor in to the implementation of health reform, an initiative was undertaken to examine the situation in five states (Connecticut, Michigan, Massachusetts, North Carolina and Washington). These states represented a range of geographic and political experiences as they continued to struggle with the lingering impacts of the recession and began preparing to implement health reform. Six key findings are summarized.

DB101 provides online tools, resources and information on health coverage, work and benefits for people with disabilities and those supporting them. Four states (California, Minnesota, Michigan and New Jersey) have their own sites, which include benefits calculators to help individuals understand how a job may affect total income and health coverage, or whether they may qualify for specific state programs. The resource is a product of the Employment and Disability Benefits Initiative.

Are you looking for state data on people who are simultaneously enrolled in Medicare and Medicaid? Find a number of useful interactive tables, charts, and graphs including Medicaid spending by service, spending per dual eligible, dual eligible enrollment, duals as a percentage of Medicaid enrollees, and more.

Unemployment of individuals with intellectual and developmental disabilities (ID/DD) continues to be a significant public policy concern. This report looks at statistics over a 20-year period from several national data sets that address the status of employment and economic self-sufficiency for this population, and contains an overview of national trends, an in-depth perspective on how states collect and use employment data, and an Appendix with individual state and national profiles.

Growth in the cost of long-term care services in the U.S. has slowed somewhat during the past two years. As home health care gains in popularity, however, costs are beginning to rise more rapidly and are expected to increase steadily over the next few years. Read about these trends and more in this 2010 study that looked at consumer perceptions and cost trends by state and key metropolitan areas.

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, the data underscore the problem of low wages for PHCAs, factors which contribute to workforce instability and near‐poverty incomes for this workforce.

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.

This report offers a cross-site analysis of the goals, objectives, outputs, outcomes, challenges and barriers of nine FY05 FTF grants. It discusses implementation of the grants, summarizes outputs reported by grantees, and concludes with a discussion of barriers and grantee recommendations for supporting FTF efforts at the state and federal level. Basic information about each grant is included, i.e. title, grantee agency, subcontractors, activities, impacts, outcomes, and accomplishments.