Policy alerts, briefs, letters & papers

In January 2008, a small group of experts met to discuss challenges and recent changes to the early and periodic screening, diagnosis, and treatment (EPSDT) Medicaid benefit. Their discussion focused on helping states maximize children’s access to EPSDT care. They also covered ways to engage with primary care providers and to improve care coordination and quality measurement.

The first in a series on housing issues, this brief provides an overview of various federal and state housing financing programs that can be used to support low income workers with disabilities. The brief also summarizes the related nature of housing and employment services and the impacts of the current housing market on employees with disabilities. The series is meant to provide information to MIG grantees and help them create linkages with agencies providing direct housing services.

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.