Policy alerts, briefs, letters & papers

The latest in a series provides background on the landscape of home- and community-based long-term care services funded by Medi-Cal, California's Medicaid program. In-Home Supportive Services (IHSS) is the largest personal care program in the nation.

Review this policy brief which summarizes 15 states' preliminary proposals to better coordinate care for people who are in the Medicare and Medicaid programs. The design contracts are an outgrowth of new efforts under the health reform law to develop service delivery and payment models that integrate care for the nation’s nearly 9 million "dual eligibles," whose medical needs and health care costs typically exceed those of other Medicare and Medicaid beneficiaries.

This policy brief examines the program created to provide financial support for home care, adult day care or a nursing home stay, and highlights how policy-makers could make the program sustainable. Options range from changing the premium structure and lengthening the vesting period, to incentivizing employers and more. The Obama administration acknowledges the program’s shortcomings and will ensure the program remains solvent and self-financing for at least 75 years, as the law requires.

Adults with disabilities have diverse, complex, and expensive needs for health care services, costing the health care system $398 billion in 2006. This group, which represented 14 percent of the adult population in 2008, will grow larger in the future. This report discusses study designs and outcome measures that can be used to address different comparative research questions. Policymakers, practitioners, and the public need a better understanding of what works for study designs.

This issue brief is the first in a series of four papers designed to highlight pressing issues facing dual eligibles and provide recommendations to the Medicare-Medicaid Coordination Office, state Medicaid agencies and other interested policymakers and stakeholders on how to address them. This first paper provides recommendations for consumer protections in delivery system models that integrate Medicare and Medicaid.

One in six seniors living alone faces physical, cultural or geographical barriers that prevent them from receiving benefits & services that can improve their economic security, and ability to live healthy, independent lives. This brief describes the ways in which social and geographical isolation pose barriers to benefits access among older adults. By examining the main characteristics of the isolated, this paper identifies new opportunities to improve and expand outreach and enrollment efforts.

Mathematica released the sixth report in a series that use the latest data available on MFP grants and state efforts to transition Medicaid enrollees to community living and rebalance LTC systems. The report presents survey results showing change in quality of life, quality of care and community integration reported by 803 MFP participants after one year of community living. The authors explore policy implications for MFP and other transition programs.

On September 1 & 2 2010, over 50 stakeholders representing service providers, families, advocates and individuals with intellectual and developmental disabilities came together at Oregon's Silver Falls Conference Center for the Employment First Summit, the kick-off event for the Employment First Outreach Project. Employment First's goal is full employment for working age adults with intellectual and developmental disabilities in Oregon. To learn more, explore this paper with recommendations.

How does the state of Massachusetts disseminate important disability related information? Attached are four examples of issue briefs put out by Work Without Limits, a Massachusetts Disability Employment Initiative, that aims to educate consumers with disabilities as well as policy makers on relevant news and statistics. Some topics covered are disability prevalence, employment, income and poverty statistics, and more.

A growing number of individuals with disabilities are leaving the workforce and obtaining SSDI. Statistics show that the household incomes of these workers are falling behind those of workers without disabilities. This brief lays out a two-pronged approach for bending these curves—increasing the employment rate for people with disabilities, reducing their reliance on federal support, and increasing their household incomes—while preserving benefits for those who are unable to work.