Policy alerts, briefs, letters & papers

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.

A reader can use this report to better understand proposed rule changes regarding which TCM services are eligible for federal financial participation. Various perspectives on the changes are presented. Several tables and graphs illustrate past and projected TCM expenditures. Prompted by the Americans with Disabilities Act, CMS issued the interim rule in order to limit the growth of TCM costs. Current proposed legislation would delay rule implementation until April 1, 2009.

A broad coalition of stakeholders created this example of a comprehensive state-level workforce development plan. The document suggests solutions to the following workforce challenges: recruitment and retention; education, training and development; data gathering and monitoring; status and awareness of profession; and mentoring and supervision. An executive summary and 1-page call to action targeted at key stakeholders are included.

This paper outlines the most common barriers to implementing livable communities and outlines cases where these barriers were overcome using planning and zoning tools. Housing, transportation and mobility, land use, cooperation and communication, public involvement in community planning, and leadership are the components of livable communities that are addressed.

This fact sheet summarizes and analyzes direct-care workforce statistics from the U.S. Dept. of Labor’s national occupational projections for 2006-16. The analysis shows that demand for workers will sharply exceed supply. Demand will especially surpass the number of women aged 25-54 entering the workforce, which is the primary demographic group from which direct-care workers are drawn. The analysis also shows that twice as many people will be working in HCBS settings than in facilities.

The Red Book 2008 serves as a general reference source about the employment-related provisions of the Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). In addition to the PDF versions posted here in English and Spanish, the Red Book website has a page highlighting recent changes to the programs and html versions of the resource in both languages.

CMS has proposed rule changes to implement Section 1915(i) of the Social Security Act. 1915(i) enables states to provide a prescribed set of HCBS to individuals that earn less than 150% of the Federal Poverty Level and require less than institutional levels of care. It does so without requiring waivers (as in 1915(c)), consumer eligibility for institutional care, or a cost savings demonstration. Further background information and instructions for comment submission are included.

This policy paper proposes that the unionization of direct care workers can improve recruitment, retention, and service quality without limiting consumers’ rights and choices. The author explores the historical roots of efforts to address direct support workforce issues, reviews the role of unions in the field in the past, examines emerging support models, and comments on current union efforts.

The Deficit Reduction Act (DRA) of 2005 clarified which case management and targeted case management services are covered by Medicaid. The rule addresses concerns about improper billing of non-Medicaid services to the program by some states, while aiming to ensure comprehensive services that meet the needs of beneficiaries. These documents from CMS are meant to assist practitioners in understanding and abiding by these rules.