Policy alerts, briefs, letters & papers

AAHSA provides information and resources on legislative, operational, and legal issues and opportunities affecting HCBS providers. The site is geared toward provider agencies and provides breaking news, email listservs, and articles and advice organized by topic.

Families and government spend $200 billion annually on long-term care (LTC), yet many elderly and disabled people still do not receive needed care. This brief illustrates the flaws of the current LTC finance system and presents three potential solutions and some challenges and advantages of each option. The proposed solutions are: enhance private insurance; base public financing on social insurance rather than welfare; or meld private and public insurance.

The author of this policy brief presents his perspective on the future challenges of long-term care (LTC) in the U.S., with a focus on family caregivers, public policy, and funding. Noting the strain placed on caregivers and the market dynamics that discourage the purchase of LTC insurance, he encourages a broader role for the public sector. These include more funding for the National Family Caregiver Support Program and expanding Medicare to cover comprehensive LTC services.

This report and the accompanying tables summarize ways in which states have implemented optional Medicaid programs authorized by the Deficit Reduction Act of 2005 (DRA). Each section of the report explains a program states have the option of implementing, which states did so, and how these changes affect people with mental disorders. The tables illustrate key characteristics of the programs in each participating state.

These are the final rules on the Ticket to Work and Self-Sufficiency Program published May, 2008 by the Social Security Administration. The changes were authorized by the Ticket to Work and Work Incentives Improvement Act of 1999. The rules affect the areas of eligibility, funding for employment networks, and reimbursement allocation and sharing between employment networks and state vocational rehabilitation agencies, among others.

This resource presents ten key facts showing the economic and health insecurity of the direct care workforce. It can be used to advocate for improved public policies and increase public awareness of the needs and importance of caregivers. The figures presented also illustrate the linkage between quality of care available to the growing population of older Americans, recruitment and retention of workers, and wage and benefits levels.

This issue brief reviews how new rules issued by CMS governing Medicaid coverage of targeted case management (TCM) services would affect people with complex health needs receiving home and community-based services. The author finds that the availability of several important services and strategies used in TCM would be significantly reduced. New record keeping requirements would also increase administrative burdens and costs.

This budget analysis compares the degree to which the aging of the population and rising health care costs, as well as the interaction of the two factors, will contribute to an overall increase in the federal spending on Medicare and Medicaid as a portion of the GDP. Using four different scenarios, it finds that a significantly larger portion of this increase will come from rising health care costs rather than aging.

This issue brief and background paper outline the ongoing history, services, and expenditures associated with the Older Americans Act (OAA). The report also summarizes services that are funded through the OAA and other federal and state funds and are provided by the state and local agencies that comprise the Aging Services Network. Finally, key challenges to meeting the needs of the changing population are identified, especially with regards to service improvement and funding.

This analysis examines how U.S. federal laws may be affected if the U.N. Convention on the Rights of Persons with Disabilities (CRPD) is ratified by the country. The authors summarize each CRPD article along with with U.S. laws that either guarantee the same rights or contradict the convention. The authors conclude that better implementation of existing laws or congressional action would bring federal law in line with CRPD.