Washington

States face significant obstacles in diverting individuals from institutional settings. Throughout the long-term care system, there exists an institutional bias for placing people in institutional settings over HCBS settings. Most states have some form of nursing home diversion program however, these programs face several challenges. This paper outlines many of the challenges, details strategies, and offers resources.

Washington developed this protocol for use when the recommended plan of care can not assure the health and welfare of recipients due to participant issues, environment, or resources. Addresses shared responsibility for participant safety. Addresses service denial and service termination. The purpose is to promote statewide consistency in dealing with difficult to serve clients before denying or terminating services.

Washington has developed protocols in some high risk areas, such as skin breakdown. Protocols are automatically triggered when certain characteristics are identified in the assessment (a pressure sore or history of pressure sore, incontinence with cognitive impairment, etc.). The protocols dictates referral and recommendations for caregiver follow up.

Washington’s automated, comprehensive, person centered assessment and planning tool measures the personal care needs of anyone receiving services at home or in a residential setting and develops a care plan. The tool contains 60 different screens, some relate to risk. Participant selects a service setting and then the program computes eligibility, need and a service plan that crosses settings. The package contains: CARES Training Manual, CARES Assessment, Eligibility & Rates for LTC Services.

This report reviews the initiatives of five states and highlights ongoing efforts to create a more balanced financing and delivery system. A table summarizes the home and community-based services system in each of the states. The case studies suggest at least five key issues for other states, Area Agencies on Aging, providers and consumers that are interested in reform. This report is one of 5 in a series called Case Studies from the Aging Network: Health and Social Support Systems Integration.

This report focuses attention on a growing issue facing the nation: how to support & sustain those who are the cornerstone of our LTC system—the dedicated families & informal caregivers. This national study is the first to examine publicly funded caregiver support programs throughout all 50 states. The report identifies key findings, describes state approaches to providing caregiver support services, offers state-by-state profiles, pinpoints challenges, & expands recognition of caregiver needs.

NCHSD held its 4th Annual National Fall Technical Assistance Conference for Medicaid Infrastructure Grantees. This year’s meeting featured pre-conference regional gatherings, a day-long session on building public-private partnerships with employers, updates from our CMS partners, and a series of state expert panel presentations. Attached are the Fall 2004 Conference Edition eNews with highlights and promising practices plus the conference materials and presentations from every session.

To assist states in preparing for the challenges and opportunities they will face as baby-boomers age, the National Governors Association's Center for Best Practice's (NGA Center) published this report designed to identify current trends and future directions, and to assist state policymakers in creating programs and policies that respond to need. This data book provides information on demographic shifts, health care concerns, & long term care workforce shortages.

The Department of Housing and Urban Development (HUD) has published final FY 2005 Fair Market Rents (FMRs) that reflect the estimated 40th and 50th percentile rent levels trended to April 1, 2005. The FMRs determine the Section 8 payment amounts established by HUD for counties. FMRs apply to both renewal rents and initial rents for vouched programs. HUD is legally required to publish FMRs at least annually, adjusted to be effective on the first of October of each year.

A get acquainted teleconference for 2003 and 2004 Family to Family grantees with Kathy Rama of CMS and facilitated by Darrell Jones of ILRU on November 10, 2004.