Policy alerts, briefs, letters & papers

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.

This book and corresponding materials present a strategy for improving the health care workforce serving older adults via expanded education and training, models of care, and public/private programs. The committee proposes a three-prong approach: 1)Enhance the geriatric competence of the entire workforce; 2)Increase the recruitment and retention of geriatric specialists and caregivers; 3)Improve the way care is delivered. The book is available free online or for sale in PDF or hard copy format.

This report is about older youth that are involved in the foster care system and have disabilities and the challenges and outcomes they experience in the areas of education, employment, and other indicators of well-being. The goal is to inform and advise state and federal policymakers in improving these outcomes through better services coordination, systems accountability, leadership development, and capacity building, focusing especially on the transition to adulthood.