Consumer/Participant Direction

The Medicaid program is a major payer for long-term services and supports (LTSS) in the United States, accounting for 40 percent of total spending for long-term services and supports. This brief highlights two important aspects of operations in states that affect access to LTSS in the community: efforts to provide accurate and timely information to consumers, and procedures to make Medicaid eligibility determinations quickly and efficiently.

Explore this brief for information on the main trends to emerge from the latest Medicaid expenditures and participant data for the three main Medicaid HCBS programs: (1) optional 1915(c) HCBS waivers, (2) the mandatory home health benefit, and (3) the optional state plan personal care services benefit. It also presents 2009 findings on the policies used in these three programs, including eligibility criteria, provider, service and waiting list data.

A NORC, the widely used term short for Naturally Occurring Retirement Community is a community that was not originally built for seniors, but that now is home to a significant proportion of older residents. The American population is aging, and these communities will increase over the next 20 years. NORC programs are innovative models that coordinate a broad range of social and health care services to support the senior. The website provides FAQs, a toolbox and assistance with sustainability.

This needs assessment is one example of how the state of Wisconsin is working to achieve the goals of the Medicaid Infrastructure Grant and to strengthen its employment infrastructure for residents with disabilities. Within this report find input from consumers, employment service providers, advocacy groups, and other stakeholders as well as recommendations for for emerging training needs in order to best serve those involved in the community rehabilitation process.

Persons who are dually eligible for Medicare and Medicaid account for a disproportionate share of expenditures under both programs and receive services that are fragmented and inefficient. Learn about how state contracts with Medicare Special Needs Plans can be used to achieve Medicaid policy goals and advance care integration for dually eligible beneficiaries.

View the Federal Tax Changes for Fiscal/Employer Agents in 2011, compiled by the National Resource Center for Participant-Directed Services, noting that the Advanced Earned Income Credit must no longer be paid by employers, and Federal tax deposits must be made by electronic funds transfer. Read about these changes and more.

Are you looking to develop an Options Counseling training program? Explore Nevada's training materials including a presentation with information on what options and benefits counseling are, efficient ways to establish dialogue with a consumer, tips on conducting the Nevada Options Assessment, a listing of public resources and funding options. Also included are a role playing activity and a pre-test to obtain a baseline measure of knowledge.

In June 2008, Tennessee passed legislation restructuring LTC service delivery, including the expansion of HCBS services by integrating LTC within a managed care environment and providing consumer direction options. In March 2010, the state implemented the CHOICES program, wherein persons enrolled in TennCare that needed LTC services would receive them through a managed care organization. Review a presentation given at the 2010 HCBS conference and the CHOICES website.

Are you developing a participant handbook for your Veteran-Directed Home and Community Based Services program? Review state examples from Maine, Massachusetts, Texas, and Washington. These participant handbooks provide an overview of the VDHCBS program, the assessment process, developing a person-centered plan and individual budget, legal responsibilities as an employer, working with a Financial Management Services vendor, and more.

Self-directed programs that allow individuals with intellectual and developmental disabilities to exercise greater control over their finances have become increasingly common, however challenges in the recruitment, retention and training of direct support workers have grown more acute. In this article, the authors investigate the status of the Direct Support workforce for people using self-directed supports in one Midwestern state, based on the results of a statewide survey of service users.