Vermont

HHS announced an $8.8 million investment to help states provide more affordable choices to individuals struggling to remain in their homes and communities as they age. A total of $5.7 million in federal funding was awarded to 12 states for grants for this nursing home diversion program that will improve state efforts to assist individuals avoid unnecessary nursing home placement, impoverishment and spend-down to Medicaid.

This memorandum and tables present data on Medicaid 1915(c) Home and Community-Based Services (HCBS) waiver expenditures from Federal Fiscal Years 2001 through 2006. Each HCBS waiver is classified by population served in order to show the distribution of HCBS waiver expenditures across long term care populations. This year's memo also identifies which waivers exclusively serve children.

The majority of people who are elderly and/or people with disabilities live out their lives in independent housing. Many utilize medications to maintain optimal health and improve their quality of life. Unfortunately, adverse medication events cost about $120 billion annually and result in illness, hospitalizations, stress on the individuals and their families, and premature deaths. Vermont is attempting to do something about this problem through their CMS Real Choices Supportive Housing Grant.

This memorandum presents data on Medicaid long-term care expenditures in Federal Fiscal Year 2006 (Oct 2005-Sept 2006). Table 1 presents national data on Medicaid expenditures for Long-Term Care from 1994-2006. Other tables present state-by-state data for Nursing Homes, ICF/MR, Personal Care, HCBS Waivers, Home Health, Home Care, Inpatient Hospital Care, Inpatient DSH, Inpatient Mental Health, Mental Health DSH, Medicaid Managed-Care, Prescribed Drugs, Targeted Case Management and PACE.

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.

Hawaii’s MIG, entitled “Hire Abilities”, produced a draft report presenting an analysis on how Hawaii will offer the MIG program to working people with disabilities. The draft report was posted online and made available for reader feedback. The report also addresses how six other States have implemented their MIG programs.

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.

In light of this major change and assuming that states may want to learn more about Cash & Counseling, this publication offers an in-depth description of the option, a discussion of key findings from the three-state demonstration, and preliminary information about the program’s expansion into 12 more states. At the end is a list of resources—both Web sites and published materials—for further information. Stories about consumers who have first-hand experience appear throughout this publication.

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.)