Newsletter, periodic publication

This is the second in a series of newsletters produced at the Exchange to provide assistance to our CMS Real Systems Change grantees. This newsletter is produced biannually. Topics include: Connecting the Dots: Maryland; Money Follows the Person: Grantee Meeting in Nevada; Information Technology (IT) Systems Survey for Single Point of Entry; Housing Work Group Established for Real Choice Grantees; Children’s Mental Health Audio Conference.

This is the third in a series of newsletters produced at the Exchange to provide assistance to our CMS Real Systems Change grantees. This newsletter is produced biannually. Topics include: Physicians’ Role in Determining Level of Care, Nurse Practice Policies for Home and Community Living, ADRC Toolbox, Massachusetts Connecting the Dots, Making Medicaid Work in the 21st Century, Assessment Instruments, HCBS Quality Management Roles & Responsibilities, Family Caregiving, and Housing.

A wage pass-through is an additional allocation of funds provided through Medicaid reimbursement for the express purpose of increasing compensation for direct-care workers. Twenty-one states have implemented these programs in expectation that doing so will help address the worker shortage. The purpose of this issue brief is to: describe the structure in selected states; summarize what is known about the impact of these programs on recruitment and retention; and identify key design elements.

This issue explores the theory that improving pre-employment training and continuing education reduces turnover by giving workers the competence and confidence they need to do the job well. The brief describe federal and state pre-employment and on-the job training requirements; examine the costs involved and how to pay for it; summarizes the research on the impact of training programs on recruitment, retention, care quality; and identifies key questions in developing initiatives.

Informal caregivers, primarily family, but also friends and volunteers, have been and continue to be integral to the system of providing critical assistance to persons age 65 or older who need long-term care. This Data Profile provides an overview of informal caregivers today compared to caregivers a decade ago. This brief also offers excellent data and charts that offer a pictorial overview of the changes.

The Ticket to Work and Self-Sufficiency Program is an employment program for people with disabilities who are interested in going to work. The quarterly newsletter covers marketplace news, opportunities and experiences. This Winter 2005 issues details a new EN Promising Practices Anthology and spotlights a South Florida program. The Newsletter also has an events calendar and a list of Recently Approved Employment Network Providers.

The New England ADA & Accessible IT Center is one of ten regional disability and business technical assistance centers funded by the National Institute on Disability and Rehabilitation Research (NIDRR). The Center is a project of Adaptive Environments, Inc., a nonprofit organization. The website offers Publications & Resources, Technical Assistance & Training, ADA Audio-Conferences and the Access New England Newsletter.

Individuals with certain combinations of needs who enroll in both the state-administered Medicaid program and the federally-administered Medicare program are referred to as dual eligibles. Currently, they receive prescription drugs and most LTC benefits from Medicaid, while they are covered by Medicare for acute benefits. Because dual eligibles receive benefits from both programs, many care coordination challenges arise in delivering high-quality, cost effective, & comprehensive benefits.

Despite preference for community-based long-term care, spending & policy is biased toward institutional services. More flexible policies were passed in 1981, when coverage was extended to non-medical services for people who meet criteria. States still must obtain a waiver for community-based services, and the law requires that Medicaid programs provide institutional care. As a result, policymakers face challenges when creating balanced systems that offer access to quality service choices.

This November 2004 issue brief addresses how states can control costs of the Medicaid program, often the second largest item in state budgets, after education. Every state has taken cost containment actions, & all plan to take additional measures to constrain growth. Enrollment has increased as a result of declining household incomes and declining rates of employer-sponsored insurance. Other factors such as the aging of the population will continue to affect the whole health care system.