Data

This report is the latest in a series on expenditures for Medicaid waivers authorized under Section 1915(c) of the Social Security Act, also known as home and community-based services waivers. For the first time, the tables include state-reported data for 1915(c) waiver services provided through managed care programs that are not identifiable in the state CMS 64 reports. Thomson Reuters collected these data for FY 2008 and FY 2009.

Despite more than $428 billion in spending in FY2008 to assist working-age people with disabilities, services provided are often fragmented, confusing, & less effective than they could be. This brief explains how the government serves a caretaker role. Authors point out that this model runs contrary to the goal of maximizing self-sufficiency embraced by the Americans with Disabilities Act & fails to direct funds to help those with disabilities join, remain in, or return to the workforce.

After a systematic review and development process, the U.S. Department of Health and Human Services (HHS) has adopted new data standards for race, ethnicity, sex, primary language and disability status. Identifying disparities and effectively targeting and monitoring efforts to reduce them has been limited by a lack of specificity, uniformity and quality in data collection and reporting procedures. Review the Final Collection Standards required by Section 4302 of the Affordable Care Act.

This Chart Book reports on nursing facility services provided to Maryland Medicaid beneficiaries aged 19 years and older. It summarizes demographic, service utilization, acuity, expenditure, and length of stay data for fiscal years 2006 through 2009. This Chart Book was prepared for the Maryland Department of Health and Mental Hygiene and is intended to monitor trends. Hilltop updates the chart book annually.

This presentation, delivered by Charles Milligan to the Medicaid and CHIP Payment and Access Commission (MACPAC) in Washington, D.C., addressed the issue of coordinating long-term care for persons eligible for both Medicare and Medicaid (dual eligibles). Milligan discussed Hilltop's research on Medicare/Medicaid cross-payer effects that found that Medicare and Medicaid financing do not align to promote home and community-based services.

With the growing role of home and community-based services in Medicaid long-term services & supports, an understanding of the different characteristics of the population transitioning from institutional care to HCBS, the trends occurring in LTSS & the effect of the different programs is needed. Hilltop developed a series of metrics to present to the Maryland Money Follows the Person Stakeholder Advisory Group now in the form of chart books. These metrics can be tailored for any state.

This fourth and final report for the national evaluation of the FY05, 06, and 07 Real Choice Systems Change (RCSC) Grants presents findings for both FY05 and FY06 Systems Transformation (ST) grantees. The findings address how grant efforts progressed between initial and final implementation periods and whether those efforts resulted in the achievement of grant outcomes and ultimately transformation of state systems.

Certain states significantly outperform others in the delivery of long-term services and supports (LTSS) to older adults and people with disabilities. The report examines four key dimensions of state LTSS system performance: affordability and access; choice of setting and provider; quality of life and quality of care; support for family caregivers. It assesses each state's performance overall as well as on 25 indicators, some of which measured for the first time. Compare data on the website.

The state-by-state charts can be downloaded, and feature information on workforce size and projected employment growth, trends in wages for each direct-care occupation, and information on health insurance coverage rates and reliance on public assistance. The PHI Data Center also features short write-ups and links to legislation and regulatory developments pertaining to workforce, notable state-based initiatives, employer best practices, and resources.

A review of 36 studies of outcomes for nearly 5,000 people with intellectual & developmental disabilities moving from large institutions to community living arrangements found high consistency in positive change in daily living skills. Studies specifically addressing social skill development, language & communication skills development, self-care & domestic skill development & community living skill development also showed positive outcomes associated with leaving large institutions.