Quality

New York spends more than most states on Medicaid and long-term care. To understand why this is, the following traits are evaluated: demographics of residents over 65; poverty level; long-term care spending, budgets, and services; and quality of nursing home care. The findings identify a number of demographic and program factors likely contributing to the high rate of spending.

Quality surveys were developed to be administered by consumers to other consumers and their families. They measure in-home attendant care, habilitation, and respite services delivered. In addition to surveys are materials used to train the interviewers, survey response thresholds, and a presentation outlining survey findings.

This paper provides an overview of the health coverage interventions tested by CMS DSW demonstration grantees and examines four approaches in more detail through the following four case studies:(1)Subsidizing Employer Based Insurance(North Carolina),(2)Prescription Discounts, Basic Health Insurance and Tax-Free Accounts(New Mexico),(3)DirigoChoice and Outreach to Home Care Agencies(Maine)and (4)Outreach to Consumer-Directed Home Care Workers (Washington).

The trends in state Medicaid HCBS programs, target groups, participants, and expenditures are summarized and policy recommendations are made. The paper shows the progress in providing Medicaid HCBS but also identifies many current problems and policies. Inequities in access to services and limited funds result in unmet needs. Cost issues have been a primary focus of policy makers and quality problems are largely not addressed.

The Handbook was developed to provide state staff, policymakers, service providers, program participants, and other stakeholders with a comprehensive source of information about participant direction programs and policies. Its primary purpose is to explain how States can increase program participants’ choice of and control over their services and supports. In addition to providing detailed information, the Handbook also provides links to additional web resources on the selected topics.

This White Paper recommends minimum data sets that states should collect to help assess the magnitude of workforce issues they face and to design and evaluate policy responses. The three basic data elements include: numbers of workers (full time and part time); stability of workforce (turnover and vacancies); and average compensation (wages and benefits). The authors also offer guidance on how to implement data collection.

This curriculum, "Choices for Long-Term Care" was developed by the New York State Office for the Aging in partnership with Albany area institutions. These materials serve as a tool for NY Connects professionals to better understand the philosophy and definition of information and assistance, enhance their communication skills, and become familiar with the call map to better assist callers.

Florida created tools to gather information essential to measuring quality from consumers in programs serving people with developmental disabilities and their families. The “Road Map” summarizes the quality assurance process and informs people of their rights. “My Personal Compass” assists in evaluating services received. The last link connects to other resources from the Florida Statewide Quality Assurance Program.

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.