Quality

New York has 12 long-term care (LTC) programs: two residential and ten community-based. Data from all are compiled here with the goal of informing policymaking and addressing challenges to the state’s Medicaid LTC programs. An overview of current programs and a snapshot of data such as enrollment and spending are also presented. The first chapter takes a look at the whole system and four other chapters offer data on the largest programs in terms of people served and dollars spent.

The conference took place in May 2009 in North Carolina and focused on the global advancement of the principles of self-determination. Presenters spoke on topics including Medicaid reform, self-directed budgeting, self-employment; quality, education, advocacy; and youth, among others. Included here are slides from talks as well as essays by the organizer on the purpose of public funding for services and challenges facing Medicaid.

Ohio seeks a contractor to coordinate the NCI survey and related interviews involving 400 subjects. The purpose of studying the indicators is to understand service outcomes, compare Ohio to other states, align the state with the CMS HCBS Services Quality Framework, and inform strategic planning. The RFP, a schedule for proposals, blank survey forms, and a “bidder’s library” are given. Proposals are due June 5, 2009.

The Council on Quality and Leadership offers short guides on quality elements such as accountability, service relationships, leadership, record and data keeping, human resources, and many more. Each guide provides a bulleted list of things to keep in mind or actions to complete to ensure that each element is managed well.

CA’s In-Home Supportive Services (IHSS) aims to keep people in their homes by paying for personal care services approved by social workers. SB 1104 was introduced in 2004 to ensure and measure delivery of services and program integrity. The report examines whether the elements of the bill were enacted. It also describes alternative models for in-home service delivery, including the Cash & Counseling model and one wherein private companies provide IHSS. Sample timecards and handbooks are given.

In 2004, a task force reviewed Veterans Affairs’ Vocational Rehabilitation and Employment (VRE) program and recommended focusing on employment through a Five-Track service delivery model and increasing program capacity. Here, the GAO looks at how employment has been impacted, the extent to which steps have been taken to improve capacity, and how program outcomes are reported. The authors recommended adjusting financial incentives and to improve strategic planning and transparency of reporting.

The NQE provides free technical assistance on quality to states operating Medicaid HCBS programs. States can use the site to request technical assistance, pose questions to staff, engage online with other HCBS staff, and learn about upcoming events and NQE publications.

In 2004 the Veterans Affairs' Vocational Rehabilitation and Employment (VR&E) program was reviewed by a VR&E Task Force. It recommended numerous changes, in particular focusing on employment through a new Five-Track service delivery model and increasing program capacity. Since then, VR&E has worked to implement these recommendations. This report includes VR&E's progress in implementing the 2004 recommendations and includes additional recommendations moving forward from the Accountability Office.

In addition to recommendations for reforming long-term care, this report goes over why it should be reformed and suggests the first steps for accomplishing change in the public and legislative arenas. Finance, service delivery, workforce, and quality are all identified as focus areas for improvement, and options are provided for each. Special attention is paid to low-cost options as a place to start with bipartisan cooperation. The report is accompanied by presentation slides.

Minnesota’s Legislative Auditor investigates the state of the personal care workforce and the regulation of these services and presents recommendations for improvement. Information is provided on eligibility and access as well as the demographics of people that are assessed for or receiving personal care services. Program traits examined include regulation, expenditure trends, fiscal integrity, and quality. Family caregivers are looked at in the final section.