Policy alerts, briefs, letters & papers

In 2004, a task force reviewed Veterans Affairs’ Vocational Rehabilitation and Employment (VRE) program and recommended focusing on employment through a Five-Track service delivery model and increasing program capacity. Here, the GAO looks at how employment has been impacted, the extent to which steps have been taken to improve capacity, and how program outcomes are reported. The authors recommended adjusting financial incentives and to improve strategic planning and transparency of reporting.

The study compares monthly income for people receiving Supplemental Security Income (SSI) to local median incomes and Fair Market Rent rates for modest units across the U.S. In 2008, there were 219 housing markets in 41 states where recipients of SSI, people with long-term disabilities and virtually no assets, would have to pay 100% of their income for a modest one-bedroom unit. Ten years ago there were 44 such markets in 13 states. Policy recommendations are given to reverse this trend.

The brief make the case that supportive housing should be the primary housing option available though mental disability service systems. The point is based on data showing that stable, independent housing is what people with mental disabilities want and is a necessary condition for the success of other services, such as case management and addiction treatments. Further, the Americans with Disabilities Act mandates that services be provided in the most integrated setting possible.

This report describes recent progress in moving state developmental disability systems using HCBS 1915 (c) waivers toward greater efficiency and equity, in the context of pressing issues in the field. It is important to note that these initiatives could be equally well applied to other Medicaid waiver populations.

This paper summarizes the strategic framework HSRI has developed to achieve needed system improvements; and ten common issues or concerns that states have encountered throughout the process to develop individual or level-based budget allocation models, and examples of how states have addressed each issue.

Use the resources on this site for evaluating and making housing policies and strategies. It contains examples of proven solutions, easily accessible information on state and local policy tools, and guidance on how to put them together to form a comprehensive, effective housing strategy. The site is run by the Center for Housing Policy.

Follow the link for a comprehensive listing of state statutes, regulations, policies, and procedures regarding the use of emergency or planned physical, chemical, mechanical, or other restraints. Additional documents offer information on positive behavior support guidelines, training manuals, and other policy-related materials. Many emphasize the use of positive or non-aversive interventions. Links are provided to access documents on many state DD agency websites.

One-Stop Career Centers serve a diverse range of customers. These include individuals with a variety of educational and work backgrounds, as well as individuals with a wide range of disabilities and support needs. An effective way to serve this broad customer pool is to provide One-Stop services according to the principles of what is known as “universal design,” using common strategies that benefit many groups. This brief discusses the benefits of One-Stop services in detail.

To answer the question posed in the title, the authors studied HCBS spending and the availability of family members. Higher HCBS expenditures are found to be associated with lower risk of nursing home admission, but this association is statistically insignificant for older adults with living children. Doubling state HCBS expenditures would reduce the risk of nursing home admission among childless seniors by 35%.

New York spends more than most states on Medicaid and long-term care. To understand why this is, the following traits are evaluated: demographics of residents over 65; poverty level; long-term care spending, budgets, and services; and quality of nursing home care. The findings identify a number of demographic and program factors likely contributing to the high rate of spending.