Policy alerts, briefs, letters & papers

These Guiding Principles were developed to help to preserve the rights of individuals under participant direction, no matter what form or model, if and when workers choose to form a union. The NRCPDS cover letter, Guiding Principles, and NRCPDS Director Kevin Mahoney's signing ceremony remarks are available here.

This paper provides recommendations on changes to improve delivery of the Qualified Medicare Beneficiary (QMB) program so that it can more fully serve the purposes for which the program was established. It is the last in a series of four papers that highlight pressing issues facing dual eligibles and provide recommendations to the federal Medicare-Medicaid Coordination Office (MMCO), state Medicaid agencies and other interested policymakers and stakeholders on how to address them.

The Centers for Medicare & Medicaid Services, along with Mission Analytics Group & Human Services Research Institute, created an implementation manual for the Balancing Incentive Program. The Program encourages states to increase the percentage of long-term care dollars going to home & community-based services through making additional Federal Medical Assistance Percentages available to States that are currently lower performing. This manual aims to help States make the most of this Program.

Medicaid officials in every state are enacting a variety of cost cutting measures as states’ spending is projected to increase 28.7% in FY2012 to make up for the loss of federal stimulus money. The survey finds cost containment actions ranging from restrictions on payments to providers & benefits, to new copayments for beneficiaries & additional efforts to contain the costs of prescription drugs. States are also trying to make their programs more efficient through a number of procedures.

Implementing an MFP program and looking for ideas on policy? The State of Texas was one of the originators of the "money follows the person" (MFP) concept. Review the website which offers definitions and policies.

This Primer has been updated to include all relevant statutory, regulatory and other policy changes that have occurred in the last 10 years in Medicaid home and community services. Given the significance of recent changes, this Primer will be an even more useful tool for all those working to ensure that people with disabilities can live in the most integrated settings appropriate to their needs.

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.

The Affordable Care Act of 2010 offers options & financial incentives for states seeking to expand systems of long-term services and supports. Many of these opportunities work together & build on existing initiatives, resulting in a strengthened infrastructure for service provision & an LTSS system that meets the needs of Medicaid beneficiaries. Key provisions of the ACA are summarized in this issue brief, followed by considerations for states seeking to take advantage of new opportunities.

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.

The latest brief describes Medicaid expenditures in 2009, showing that 45% of its total long-term care dollars nationally were spent on home- and community-based services. The findings in this analysis are based on the CMS Form 64 data published by Thomson Reuters, detailing each state’s Medicaid expenditures.