Texas

As part of Research on Program Management Techniques by States to Rebalance their Long Term Care Systems, Final Case Studies were conducted in each State for the time period ending December 2007. These Case Studies focus particularly on the reflections of State government officials on rebalancing goals, accomplishments, and next steps as they reflect on all the State’s experiences in moving towards more community-based services.

This report is the result of a study exploring management techniques and programs States have put in place to rebalance their Medicaid long-term supportive services. It summarizes the methods, products and findings of this project then suggests conclusions and recommendations for State officials, legislators, advocates, and providers and CMS on ways to increase and improve LTSS systems for people with disabilities, enhance participant choice, and reduce reliance on institutions.

The CMS website has been updated with the new 508 compliant MSIS Medicaid eligibility and claims tables for federal fiscal years 2005 through 2008 for 31 states. Individual or groups of tables may be selected using the identified dynamic list options. The standard MSIS fiscal year tables will be updated periodically as additional states submit their data for the full fiscal year.

The purpose of this report is fourfold: 1) to present a brief overview of the results of the Systems Change grants awarded from FY 2001 through FY 2004, 2) to describe the remaining challenges to community living that Grantees identified, 3) to provide Grantees’ recommendations for actions needed at the state and federal level to further improve their long-term care systems, and 4) to discuss the key lessons learned regarding factors that are needed to improve states’ long-term care systems.

How do consumers interactions with agencies change when an ADRC is added to the community. The following two examples show how consumer’s flow before and after implementation. Refer to the descriptions and diagrams from Texas, one from Lubbock County and the other from Harris.

This updated resource provides a state-by-state look at wages and wage trends for PHCAs, the second fastest growing occupation in the country, and a key job title within the direct-care workforce. Review wages over a 9-year period. Prepared as a resource guide on wages for advocates and policymakers concerned with the direct-care workforce, the data underscore the problem of low and declining real wages for PHCAs, factors which contribute to workforce.

This issue brief examines the early successes and challenges of MFP. A 2008 survey of 29 states receiving MFP grants turned up several key findings, including that several hundred people have moved from institutional to community settings; that states are providing a broad range of services to facilitate transition; that housing issues for MFP participants are a major challenge for states; and that the severe economic downturn had not yet prompted states to scale back their efforts.

RTI is preparing a series of reports to document outcomes from the Systems Change grants. Divided into six parts, the first four provide an overview of the enduring improvements, continuing challenges, lessons learned, and recommendations of the 48 Research & Demonstration Grantees, organized by the four types of grants: CPASS, MFP, IP, & QA/QI. Part 5 provides summaries of the FTF Grants. Part 6 reviews the Respite for Adults and Children and Community-Based Treatment Alternatives for Children.

This issue of "In Focus" explores health technology especially how it relates to Transformation Grants. States that received grants from the Centers for Medicare and Medicaid Services (CMS) to advance the use of electronic health records and e-prescribing programs confronted challenges other states are likely to face as they implement health information technology initiatives using funds from the Stimulus Bill.

This second report in a series focuses on how state variation in level of experience and infrastructure to undertake large-scale transition programs can affect implementation. The authors describe differences in strategies to 1) expand transition coordination capacity 2) locate appropriate housing 3) enhance long-term supports & services 4) change Medicaid HCBS programs/policies to ensure that those who transition can remain in the community after the MFP eligibility period ends.