Medicaid Waivers

Learn from 10 years of experience in administering the consumer-directed Cash & Counseling program in Arkansas. The report provides a candid history of the development, implementation, and lessons learned from the program. The author gives details on partnership development and use, changes in agency culture and operations, and data on outcomes, cost neutrality, and participant demographics. Also included are the 2003 and 2008 program budgets.

March 2-4, 2009 state program staff, CMS staff, and technical assistance providers met in Baltimore to discuss Money Follows the Person and other strategies for helping people move out of nursing homes. Speakers presented on topics ranging from service integration, housing finance strategies, mentoring, quality, and many others.

Program administrators, advocates, and researchers advise the Senate on ways to improve wellbeing and cost outcomes of long-term care by increasing access to HCBS. They speak on national demographics, successful HCBS programs of the past and present, state programs in Wisconsin and Florida, integrating acute and long-term care for dual eligibles, and program finance models. See “Video Contents Index” for time stamps and information on each testimony.

Models, innovations, and best practices in case management and support coordination for persons with disabilities are described here. Policy issues, the CMS Quality Framework, and types of case management and differences in service by waiver group are given. The brief also links to innovative programs in 7 states and England.

This quality services review consists of direct feedback from individuals who receive services, record reviews, observations, and discussions with agency staff. Agencies are reviewed against clear benchmarks and receive feedback from review staff throughout the process. Quality Action Plans address areas for improvement and are completed by each agency with technical assistance provided by the Quality Management Unit.

An interactive map displays how many 1915(c) waivers each state has. Clicking on a state’s name displays number of participant and expenditures by waiver type as compared to nationwide numbers. Participant and expenditure data are also available for personal care, home health, and individualized budget services. Clicking “Compare” in any data area displays a table illustrating selected data for all states. Information is taken from CMS form 372 and is downloadable.

The purpose of this study was to provide the New Mexico Human Services Department with information about variations (if any) in provider payment rates for home and community-based services within the state and across states.

Medicaid expenditures are often presented as a percentage of state or Federal spending. Here, they are illustrated in terms of market shares for 30 markets defined by provider category of service. In 21 markets, Medicaid plays a small role, but in the other 9, such as long-term care and mental health, Medicaid is the dominant payer. Some of the other markets researched include adult day, waiver, case management and home health services.

PAS Center offers state-by-state participant and expenditure data for all of Medicaid and the three main HCBS programs: 1915(c) waivers, home health, and state plan personal care. The December 2008 update provides 2005 data complemented by survey results related to program policies and provider reimbursement rates.

One way Indiana communicates with HCBS waivers consumers is via this document. Updated periodically, it describes available waivers and what services they cover, eligibility requirements, quality assurance mechanisms and the rights of the consumer. It also provides instructions for applying, contact information for other HCBS resources, and tips on choosing good providers. The guide comes with a feedback and evaluation survey.