South Carolina

South Carolina hired an environmental modifications specialist to improve the quality of home modifications funded by its Medicaid HCBS waivers. The specialist trains case managers to develop specifications for ramps, and develops specifications for other home modifications so contractors can quickly make an informed bid. South Carolina also leveraged a state-funded home modification program to expand the types of modifications available in its waivers.

This report describes grant activities (accomplishments and progress) in three major LTC systems areas: Access to LTC Services and Supports, Services, Supports, and Housing, Administrative and Monitoring Infrastructure. The report also provides illustrative examples of the challenges Grantees have faced as they implement grant activities, and consumers’ roles in the implementation and evaluation of these activities.

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home and community services; workforce shortages; lack of affordable and accessible housing and transportation; and outdated or inflexible administrative, statutory, and regulatory provisions.

States are increasingly interested in the individual budget model for older Medicaid beneficiaries as a mechanism to improve responsiveness of benefits to beneficiaries’ needs and preferences and to increase their ability to remain outside or leave nursing homes. This report describes 10 operating individual budget model programs that serve older persons and identifies four areas of program design that are of particular importance to the success of the individual budget model.

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.)

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.

One objective of the Texas’s QA/QI grant was to develop a uniform and automated critical incident reporting process. Information was collected on critical incidents reported most often by other states to be used with the Quality Assurance and Improvement (QAI) Data Mart. The QA/QI task force reviewed and used this information to develop a list of critical incident definitions and recommendations.

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 is the latest newsletter of the National Core Indicators (NCI) program. The publication is designed to keep you abreast of developments and best practices in performance and outcome measurement as exemplified in initiatives among NCI participants. Issue 1, Volume 4 is a special issue dedicated to Member Profiles. Review the summaries for twenty-three states plus the Regional Center of Orange County in California.