Transition/Diversion from Institutions

In 2005, VT became the first state to commit to a federal Medicaid funding cap in exchange for expanded eligibility definitions and access to home and community-based services under a Section 1115 waiver. Case studies and interviews are used to present key findings from the program. Key design features are also presented. Finally, future issues within VT and other states that might emulate the program are discussed.

This report provides a summary of how long-term services and supports (LTSS) are financed and describes factors that contribute to uncertainty of the future costs for LTSS, including changes in how LTSS will be delivered. Three projections of future LTSS spending for senior populations under different scenarios are offered. These scenarios differ based on projecting the number of people with varying functional limitations and the resulting need for varying degrees of LTSS.

Presentations from NASHP’s 21st annual state health policy conference are now available. The conference is planned by state health policymakers for state agencies' staff, legislators, and legislative staff. Review the presentations to learn how others are improving and innovating healthcare through state-level policy.

The 2008 national Aging and Disability Resource Center meeting took place in October in Boston. Find here the presentations and handouts from the workshops and plenary sessions. Topics ranged from nursing home diversion to quality to information flow and technology.

Transitioning out of a care facility can be a challenging time for patients and their caregivers. This checklist will help these people and their support workers plan ahead of the discharge to ensure everyone involved understands the patient’s needs and can avoid any interruption in care. The resource also includes instructions and contact information for finding appropriate support from local, state, and federal agencies.

The Department of Health and Human Services announces $36 million in new grant programs to 28 states to help older Americans, veterans, and people with Alzheimer’s disease to remain in their homes and communities. About $19 million of this involves a collaboration between the Administration on Aging and the Department of Veterans Affairs. The grants are designed to reach people who are not eligible for Medicaid but are at high risk for nursing home placement and to spend-down to Medicaid.

Seven states received a share of over $8 million in federal grants to increase awareness of home-and community-based long-term care options for people leaving hospitals who otherwise may enter a nursing home. Over $7 million of the awards will be used to develop person-centered hospital discharge planning models. An additional $574,613 will supplement grants from FY07 to Wisconsin and Alaska so they can continue their Person-Centered Planning Implementation programs for another two years.

This report and executive summary were completed for Project BRIDGE, an Integrating Long-Term Supports with Affordable Housing grant from CMS. Individuals with disabilities desiring to live independently in Mississippi are hindered by the state’s scarcity of both affordable, accessible housing and the community-based services. The report outlines the issues and offers recommendations for creating community housing arrangements. Review the policy, program and research suggestions.

This guide is a supplement to ABCs of Nursing Home Transition: An Orientation Manual for New Transition Facilitators. The two guides are meant to be used together. This second guide, gives greater detail on one of the most challenging aspects to the transition process—locating and securing housing that meets the individual’s needs and preferences so that the transition can be completed. The Appendix offers tools for housing specialist and consumers including checklists and how-to fact sheets.

This publication provides a summary overview of the accomplishments and enduring changes brought about by all of the Systems Change NFT Grantees Despite bringing about many enduring systems improvements, Grantees reported that many transition barriers remain. Grantees made recommendations to help states address continuing barriers to nursing facility transition and diversion so that no one need live in a nursing home simply because sufficient community services and supports are unavailable.