Transition/Diversion from Institutions

Based on a comprehensive review of the relevant literature, this paper examines the impact of asset ownership on meaningful and participatory social inclusion. The paper first, presents an overview of the assets-based perspective of welfare and highlight factors that have shaped this perspective with an overview of rural communities and their relationship to these issues. Next, the paper reviews the potential effects of asset ownership and how this may impact social inclusion in rural areas.

With the recent enactment of the Deficit Reduction Act, states who are interested in increasing their home and community based programs have three new opportunities. The DRA has many components but the three provisions that increase flexibility over benefits and cost sharing include the Home and Community-Based Services (HCBS) option (section 6086-page 118), a Money Follows the Person (MFP) demonstration project (section 6071-page 99)and a Cash and Counseling option (section 6087-page 124).

The Nursing Home Transition Summit, convened by Rutgers Center for State Health Policy, was held September 28 through September 30, 2005. It brought together 39 participants from ten states, in addition to representatives from CMS, to discuss how to sustain nursing home transition programs. The New Jersey Community Choice Counseling program served as the summit centerpiece, with presentations by program staff and visits to several sites in the Central New Jersey area.

The report describes programs in various states whose primary purpose is nursing facility diversion or transition and identifies promising practices that have helped states divert or transition individuals from nursing facilities. Drawing upon those experiences, the report provides a variety of recommendations for states to consider in addressing the barriers and strengthening efforts to divert and transition individuals from nursing facilities.

This State Policy in Practice brief describes Indiana’s efforts to develop a new, comprehensive program that helps people in Indiana (the Hoosiers) avoid nursing home placement if possible and desirable. It also describes pilot programs to transition those who choose to enter a nursing home, but then want to return to their homes. It is intended to help state policy and program leaders, advocates, and providers learn from their peers and colleagues across the states.

This policy in practice brief describes the statutory foundation of the Community Choice Counseling program which is rooted in pre-admission screening for nursing homes, and how state leaders used that 1988 law to reduce resistance from nursing homes and obtain a sustainable funding source for the staff. This brief also summarizes new innovations, evaluation findings, lessons learned, and potential future directions.

In recent years, states have been trying to shift resources from institutional to home and community based long-term care services. This report examines \"transition\" and \"diversion\" policies and practices in eight states. It provides a sense of what state Medicaid programs are doing or could be doing to promote diversion.

Access to affordable, accessible, and integrated housing within a community of choice has been identified as one of the primary barriers faced by persons with disabilities in West Virginia. Lack of housing has become a major barrier to successfully moving individuals from institutions to the community. This manual is intended to be a resource to assist individuals with understanding the complicated maze of systems that must be navigated to successfully own or rent a home or apartment.

This report analyzes survey data to describe the characteristics of two groups of nursing home residents who are 65 years or older: those discharged back to the community over a one year time period and those who remain in nursing homes longer than 90 days. As some states turn their attention to returning nursing home residents to the community, this report offers insights on who to target in transition programs and what level and types of community resources are needed.

This report describes the FY 2002 and FY 2003 Grantees’ challenges and progress using information provided by the Grantees during the reporting period October 1, 2003 to September 30, 2004. The report describes grant activities in four major LTC systems areas: Access to Long-Term Care Services and Supports, Services, Supports, and Housing, Administrative and Monitoring Infrastructure and Long-Term Care Service and Support Workforce