North Dakota

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.

States play among the most critical roles in responding to and ameliorating disability unemployment. Find examples of state policy related to disabilities, a selection of state programs and initiatives, descriptions of select federal policy, and primary source documents. Topics covered include housing, employment, community integration, long-term care, health, disability awareness and benefits counseling.

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 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.

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.