Tennessee

In June 2008, Tennessee passed legislation restructuring LTC service delivery, including the expansion of HCBS services by integrating LTC within a managed care environment and providing consumer direction options. In March 2010, the state implemented the CHOICES program, wherein persons enrolled in TennCare that needed LTC services would receive them through a managed care organization. Review a presentation given at the 2010 HCBS conference and the CHOICES website.

This report provides the latest national and state data on enrollment and spending for individuals enrolled in both Medicaid and Medicare, also known as dual eligibles. There were about 8.9 million dual eligibles in 2007. Dual eligibles are among the sickest and poorest individuals covered by either program. Although they comprised 15% of Medicaid enrollment, dual eligibles accounted for 39% ($121 billion) of Medicaid spending for medical services & for more than a quarter of Medicare spending.

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.

Five innovative states (Arizona, Hawaii, Tennessee, Texas, and Wisconsin) with demonstrated expertise in managed care approaches for individuals with long-term care needs are featured in this report. The resulting “roadmap” outlines 10 critical mileposts for successfully designing models for managed LTSS. It also identifies key ACA provisions that support state efforts to improve long-term care delivery.

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.