Wisconsin

Discusses options for combining Medicaid long-term care funding and expanding the scope of long-term care services. The call was organized in response to a need identified by a grantee and included states that were available and had relevant experience with the questions being raised.

Case study reports on programs in 9 states that received federal Nursing Home Transition Grants from 1998 - 2000 are now available. New reports describe programs, implementation, and lessons learned from transition programs in Arkansas, Florida, New Jersey, Pennsylvania, Texas, Vermont, Michigan, Wisconsin and from a hospital to nursing home diversion program in Colorado.

A wage pass-through is an additional allocation of funds provided through Medicaid reimbursement for the express purpose of increasing compensation for direct-care workers. Twenty-one states have implemented these programs in expectation that doing so will help address the worker shortage. The purpose of this issue brief is to: describe the structure in selected states; summarize what is known about the impact of these programs on recruitment and retention; and identify key design elements.

This issue brief will present several approaches that attempt to tackle the underlying challenge of reducing nursing facility utilization and expenditures. These range from modifying the nursing facility reimbursement methodology; to converting nursing facilities to assisted living centers, paying nursing facilities to take beds off-line, and using capitated managed long-term care; to approaches with theoretical promise that have yet to be adopted in any state.

The sixth biennial edition of the AARP Public Policy Institute's databook, presents an overview of long-term care in each state plus the District of Columbia by using numbers, graphs, charts, and maps. Data includes each state's demographics, need for LTC and HCBS services, the number of LTC workers per thousand people aged 65 and over, urban average for private-pay home health aide wages, and CNA hours per resident day. Each state is compared with others through rankings and national averages.

The survey results highlight inconsistencies and gaps in training, testing, and other pre-employment requirements for nursing assistants. The results from the nurse aide registries are presented in a series of charts. The survey notes who pays for pre-certification training in each state, whether candidates are allowed to become certified by passing the test without undergoing training, whether nurse aides pay a fee to be licensed or certified, who does criminal background checks, and more.

The Compendium contains basic information about each of the Real Choice Systems Change Grantees. The Compendium will help you learn more about how these grants will be used to allow more people of all ages with a disability or long term illness to live and participate in their communities. Real Choice Systems Change Grantees will also find the Compendium useful to identify other Grantees with similar goals and activities. The fourth edition of the Compendium replaces all previous editions.

The MOU is developed among the ADRC in Richland County, the Economic Support Services Unit (ESS), the enrollment consultant for WI Family Care program, and the Care Management Organization (CMO). The MOU is intended to help clarify the specific roles and responsibilities, ensure that the participating units understand the key elements of coordination and communication, and to facilitate their working in partnership to achieve quality outcomes for program consumers and the general public.

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.

This is the first in a series of papers synthesizing the ideas and practices of states as they improve the quality of home and community based services (HCBS) and supports for older persons and persons with disabilities. Building on the experiences and challenges of the QA/QI Systems Change grantees, the paper addresses four fundamental questions about quality management. The intent is to provide an account of current practice, and a structure for how states view their options.