Medicaid

This report details the state-by-state impacts of seven regulations issued by the CMS that would make major wide-ranging changes. Areas affected include cost limits for public providers, graduate medical education, outpatient hospital services, provider taxes, rehabilitative services, school administration and transportation services, and case management services. The website offers an interactive map showing how proposed regulations would impact each state.

The Kaiser Commission on Medicaid and the Uninsured supported this focus group project of adults with disabilities in 4 states, who are enrolled in Medicaid Consumer Directed Personal Assistance Services programs. This research was undertaken to learn about Medicaid enrollees’ experiences in the program and their opinions about key features of the program including recruitment issues and degree of responsibility over services. Ways to improve upon the programs were also identified.

Consumer direction of personal assistance services (CD-PAS) is one model of service delivery that gives Medicaid beneficiaries varying degrees of control over hiring, scheduling, training, and paying personal care attendants. Program administrators, experienced with the programmatic features of CD-PAS in their state, were interviewed. Eligibility criteria, participant support services, and method of financial management used by Medicaid beneficiaries to pay direct care workers are discussed.

This report by the GAO reviewed the extent to which HHS ensured that Section 1115 Waiver demonstrations will be budget neutral to the federal government and maintain Medicaid’s fiscal integrity. Specifically, the report examined the projected spending associated with two waivers granted to Florida and Vermont. Review the shortcomings in these specific approvals as well as recommendations for further congressional oversight and HHS procedural reform.

Since Medicaid is funded by states as well as the federal government, it has a considerable impact on state budgets. When considering Medicaid’s impact on state budgets and other state spending priorities, it is important to distinguish between total spending on Medicaid and spending with state funds. Often this distinction is not made. This brief examines the different measures and provides data on how much each state spends on Medicaid.

Developed by the Comprehensive Employment Opportunities – Medicaid Infrastructure grant, a strategic plan project was initiated to increase the competitive employment of people with disabilities in Minnesota. The report, based on data obtained through individual interviews and focus groups in 2005, is included. Additionally, the Continuation of Funding Application for 2006 is available.

As part of the Missouri Medicaid Infrastructure Grant, surveys and focus groups were conducted with a wide range of audiences from people with disabilities and their families to state agency staff and providers concerning employment issues. The surveys and focus groups yielded a great deal of information that is helpful in understanding the challenges people with disabilities face when trying to obtain and maintain employment. Included are three reports describing the information gathered.

The Institute for Human Development at the University of Missouri-Kansas City is administering the Medicaid Infrastructure Grant (MIG) to enhance the use of Medicaid resources in Missouri. This report provides a review of research and the activities and findings related to a retreat to assess needs of Missouri employers and people with disabilities. It also provides analysis of a follow-up survey of 153 agency providers and people with disabilities. Suggestions are made for future research.

This final report summarizes the findings from five years of research on how each of the three demonstration states implemented its program, and on how the programs have affected the consumers who participated, the consumers’ paid and unpaid caregivers, and the costs to Medicaid. The analysis is based on an experimental design to ensure that the estimates of program effects are unbiased, and has sample sizes that are adequate to detect program effects of policy-relevant magnitudes.

The purpose of this survey analysis is to provide states with an overview of the implementation of these DRA changes across the country, specifically in terms of Long-Term Care services and the steps the states have taken. Findings address eligibility, Children with Disabilities, Money Follows the Person, HCBS State Plan Amendments, Transition from Institutions, Managed Care, SPA for Personal Care Services, Cash & Counseling, Care Coordination, Disease Management and Long-Term Care Reform.