Wisconsin

When assessing the needs of persons with dementia and caregivers in the community, it is important to understand the number of persons affected and their unique needs for services and programs. This toolkit complements the issue brief titled Making the Long-Term Services and Supports System Work for People With Dementia and Their Caregivers by identifying resources that states and communities can use to design initiatives to ensure that programs are dementia-capable.

In the context of “rebalancing” efforts, the authors describe flexible accounting as budgeting practices and contractual language that incentivize the use of less expensive noninstitutional programs and use savings to expand lower-cost services to further reduce the state’s use of institutional care. The authors offer recommendations for California and pay special attention to flexible accounting in Medicaid managed LTSS and identify examples of flexible accounting practices.

Each year, AoA compiles a summary of the latest statistics on individuals 65 years or older across 15 topical areas including income, poverty, employment, health, disability, and caregiving. This report has now been updated to reflect the most recent year for which data is available, 2010.

This brief reviews Medicaid’s importance and limitations when it comes to long-term care and makes the case for strengthening Medicaid’s safety net in one of two ways—assumption of full federal responsibility for Medicare beneficiaries who also rely on Medicaid (so-called “dual eligibles”) or an enhanced federal match for Medicaid long-term care services.

Many states are undergoing long-term services & supports (LTSS) transformations. The lagging economy & increased demand for publicly funded LTSS are placing pressure on state policymakers to find solutions. As a result, many states either have or plan to implement Medicaid Managed LTSS, with 12 states having existing programs & another 11 with plans for implementation. Many states used the economic downturn as an opportunity to balance services from institutional to non-institutional settings.

Despite continued fiscal pressures on states, eligibility policies remained stable in nearly all state Medicaid and Children's Health Insurance Programs during 2011. Moreover, many states used technology to increase program efficiency and streamline enrollment. The "maintenance of eligibility" requirement in the Affordable Care Act (ACA) played a key role in preserving coverage levels. Without it, more states likely would have limited eligibility or tightened enrollment procedures.

State aging & disability agencies are operating in an era of state agency reorganization, re-conceptualization of state government, & restructuring of long-term services & supports delivery systems & financing. Key elements driving continued change include the economic environment, ACA implementation, uncertainty in the federal budget particularly with the failure of the Congressional Super Committee, changes in state level leadership, & the 2012 elections.

The latest HCBS data from The Kaiser Commission on Medicaid and the Uninsured and the University of California at San Francisco analysis of The Centers for Medicare & Medicaid Services (CMS) Form 372 have been added and are available for all states and the nation for 2008. This website allows you to do an interactive search. Review the updated topics including total HCBS waivers, participants by waiver type, home health expenditures, and personal care participants.

In an effort to improve care & reduce costs, states & the federal government are seeking new ways to provide services to people eligible for both Medicare & Medicaid. Missing from the discourse are the voices of these dual eligibles. Changes to the way their care is organized & delivered could have profound effects on their health, quality of life, & satisfaction. This project aims to complement state & federal efforts by offering perspectives on what duals want from their models of care.

Using six states as examples, this report illustrates how the DD Network partners, working with each other and in collaboration with state developmental disability agencies and others, have positively affected the lives of hundreds of thousands of individuals with intellectual and developmental disabilities - assuring their rightful place as full community members through advocacy, research, training, and programs that directly support individuals and families.