Policy alerts, briefs, letters & papers

The Adult Protective Services Technical Assistance Resource Center (APS TARC) has released a brief to explain person-centered principles in theory, in the ACL Final Rule, and in current application in APS programs. The brief includes definitions of person-centered principles as established in federal law, an overview of the application of the person-centered principles in the Final Rule requirements, and policy and practice related to person-centered principles based on data from the National APS Process Evaluation. Read the brief to learn more.

The Shirley Ryan Ability Lab released an article about how to address the direct support professional (DSP) workforce crisis. This will include increasing the wages to attract and retain workers. The article reviews the impact of the Access Rule and ways to improve wages for DSPs. In Minnesota legislators and policy makers are working together to link direct support professional certification to increased pay.

In a recent blog post by AARP, the importance of updating state emergency plans to better protect vulnerable populations during disasters is emphasized. The post highlights FEMA's updated State Mitigation Planning Policy Guide, which places greater expectations on states to account for the increased risk hazards pose to socially vulnerable populations like older adults and people with disabilities. Additionally, the AARP LTSS State Scorecard introduces a State Emergency Management Plan indicator, recognizing nine states for their proactive measures in mitigating harm to older adults and people with disabilities from disasters...

The Center for Medicare and Medicaid published a paper examining how the integration of a new Quality Pathway will positively impact overall patient experience in CMS Innovation Center models. The Quality Pathway aims to align quality goals within CMS alternative payment models, elevate outcomes and experience measures, and ensure that evaluations are better designed to assess the impact of models on patient-centered goals. These determinations will help the CMS Innovation Center make critical decisions about which models to expand in the pursuit of improving the quality of care for people with Medicare and Medicaid.

The Center for Medicare and Medicaid published a blog highlighting the progress of the CMS Innovation Center’s Specialty Care Strategy. It addresses the entirety of a person’s care journey and the incentives required to reach and connect primary care and specialty providers at each step of the way. This includes delivering data for more transparency in specialist performance, refocusing specialty care on the person’s experience and outcomes, and facilitating specialty care partnerships with primary care-based Accountable Care Organizations as part of a move to more value-based care. CMS is committed to supporting both primary and specialty care practices in delivering coordinated and state-of-the-art care.

This practice brief explores how Subminimum Wage to Competitive Integrate Employment (SWTCIE) projects engage people with disabilities and lived experience through communities of practice, stakeholder groups, and mentoring programs. The brief summarizes interviews with three SWTCIE projects and shares promising practices including (1) leveraging relationships, (2) providing accommodations, (3) recognizing participation, and (4) including diverse perspectives. The lessons learned could help vocational rehabilitation agencies and other organizations interested in engaging people with disabilities and lived experience to do so meaningfully through creating partnerships for design, implementation, and evaluation of organizational activities.

Mathematica recently released a practice brief that explores the staffing model designs of select Subminimum Wage to Competitive Integrated Employment (SWTCIE) projects. This brief summarizes results from interviews with staff from four projects and shares promising practices including (1) aligning staffing with project goals, (2) remaining flexible, (3) tailoring training, and (4) considering sustainable staffing solutions. The lessons learned could assist vocational rehabilitation agencies and other organizations in designing staffing models to promote competitive integrated employment.

On February 28, Justice in Aging released an issue brief titled “Dual Eligible Special Needs Plans (D-SNPs): What Advocates Need to Know.” This issue brief provides advocates with basic information about D-SNPs, whom they serve, and their structure. It also identifies specific areas where advocates can engage with their states to ensure that D-SNPs work effectively to coordinate care and benefits for dually eligible individuals, including strategies in centering equity from the outset in the design of D-SNPs...

Justice in Aging has launched the first of a four-part series of issue briefs as part of their Equitable Guardianship Reform Series. This brief, “Addressing Bias in the Guardianship Process,” explores diverse aspects of the guardianship system and proposes recommendations for reform to enhance equity in aging. This brief delves into the potential areas where implicit bias may enter the guardianship process, emphasizing systemic concerns. Additionally, the brief offers recommendations for reform, advocating for efforts to eliminate bias at both systemic and individual levels within the guardianship process...

This KFF policy watch examines three key questions to monitor as states navigate the unwinding of the Medicaid continuous enrollment provision initiated during the COVID-19 public health emergency. Examining changes in Medicaid enrollment, the report notes a nearly 10% decline in Medicaid enrollment nationally, with significant state-level variations. As states progress through renewals, the article emphasizes the unpredictable trajectory of Medicaid enrollment at the process's conclusion, acknowledging the potential return to pre-pandemic levels. Confronting challenges posed by procedural disenrollments and new enrollments, the report explores the implications for Medicaid participation and broader trends in healthcare coverage...