Medicaid Waivers

This document identifies assessment instruments being used and reviews some of the variation across instruments and in the processes for using them. It includes an overview of the major components of the assessment instruments and of their role in a state’s eligibility determination, assessment, or care planning processes.

The report describes the design & implementation of Arkansas’ model of Cash & Counseling—IndependentChoices—and draws lessons from the state’s experience. The report is based on in-person interviews conducted with Arkansas state officials, IndependentChoices’ program staff, staff providing counseling and fiscal services under IndependentChoices, staff providing traditional PAS in Arkansas, and staff of advocate organizations. The summary also draw lessons for future Cash & Counseling programs.

This report describes the design and implementation of Personal Preference, New Jersey’s model of Cash and Counseling. It also draws lessons from the state’s experience. The report is based primarily on in-person interviews conducted in April 01, about 18 months after the program began enrolling beneficiaries (Nov 99).

This report describes South Carolina’s programs for older people and people with physical disabilities to gain access institutional and community Medicaid supports through a single access point, and have increasing opportunities to direct their own services. The report also describes how the state has been particularly innovative in using information technology to improve the quality of community supports and participants’ access to services.

This document describes New Hampshire’s community based service system for people with developmental disabilities. The document provides a brief overview of the community based system and a discussion on the integration of services and programs, as well as the funding sources.

This report describes the State of Wisconsin’s program to assist people with disabilities find housing. The state employs a supported housing specialist who works with local communities to help people with disabilities and their families to find affordable housing solutions. In addition, the supported housing specialist works with individuals with disabilities, local agencies, developers, housing providers, lenders,and other stakeholders to build relationships and improve housing access.

This report describes Wyoming’s individual budgets for its Medicaid home and community-based services (HCBS) waivers for people with developmental disabilities and the statistical method used to determine individualized budgets. The report also discusses how the budgets were implemented and their impact thus far.

Oregon's Independent Choices Program allows Medicaid-eligible individuals to pay cash directly to providers for personal care and related services. Under this five-year project, participants receive a monthly cash payment and are fully responsible for the mechanics of payroll and budgeting for needed services.

This report describes a Florida cash payment program, Consumer Directed Care, which is testing the effectiveness of increased participant control for people with disabilities, including children and older persons. Florida is part of a demonstration project to measure the impact of substituting a cash allowance for Medicaid services from provider agencies. This document provides information on the program implementation and impact.

This document describes the State of Washington’s many resources specifically designed to facilitate the transition of nursing facility residents to less restrictive, community settings. The state also offers four funding sources for transitional services people may need when leaving a nursing facility. The document notes the specific programs, their implementation and impact.