Policy alerts, briefs, letters & papers

The third paper in the series examines what contemporary social service systems can do to promote consumer-directed services. We identify different features that make a service \"self-directed,\" and we identify characteristics of successful consumer direction and self-determination. In its present form, this paper serves as foundation work for additional dialogue and will also undergo continuing development in discussions with representatives of projects and consumer leaders in states.

The second in the series, this paper identifies the features of high-quality integrated community services and the systems that support them and serves as the foundation work for additional exploration. The paper will undergo continuing development in discussions with representatives of projects and consumer leaders, will augment assessment of existing systems and planning of new or improved systems, and ideally become an even more useful tool for those involved in systems transformation.

First of Three Papers on Unlocking the Code of Effective Systems Change - This paper attempts to create an overall framework for the discussion of systems change and to give a summary of the concepts. Several specific recommendations from other successful programs and the recommendations and guidance of the colloquium participants, can be applied now by any grantee, state, or program to enhance prospects of achieving enduring change in home- and community-based services.

This report draws on interviews with Medicaid care planners for insight into the issues that arise in establishing programs to move individuals with significant long-term care needs from institutional to community settings. The five states that participated in this study—Florida, Louisiana, New Jersey, Ohio and Washington—each received federal grants for nursing home transition activities and had varied experiences.

This report draws on interviews with state Medicaid program officials for insight into the issues that arise in establishing programs to move individuals with significant long-term care needs from institutional to community settings. The five states that participated in this study—Florida, Louisiana, New Jersey, Ohio and Washington—each received federal grants for nursing home transition activities and had varied experiences.

Due to concern that wealthy elderly Americans were transferring assets to gain Medicaid coverage for nursing home care, the Deficit Reduction Act tightened Medicaid eligibility rules. About 43 percent of all nursing home residents eventually become Medicaid eligible. Over the six-year period examined, the authors estimate that, when applying the DRA asset transfer rules, federal savings to Medicaid could amount to $1.87 billion.

Beneficiary-managed individual budget model had its origins in the Cash & Counseling Demonstration. This brief describes the evolution of the model since the original demonstration and provides an overview of state activity. Although Medicaid waivers have been required for individual budget model programs to date, the Deficit Reduction Act gives the option to use this model for an expanded range of home and community based services in the Medicaid plans without having to obtain a waiver.

What are the opportunities and potential pitfalls of this new policy that makes major changes to the Medicaid program? This paper offers explanation and analysis of the changes to the long-term services policies including: Asset Transfers, Long-term care Partnership Programs, Family Opportunity Act, Money Follows the Person Demonstration, State Option to Provide HCBS Services, Cash and Counseling Option.

This AARP Public Policy Institute Issue Paper examines the efforts of South Carolina, Washington and Wisconsin to improve home care quality by using a more person-centered approach. The initiatives described in this report point to the significant ongoing efforts that states are using to ensure quality care and support in the home. The challenge for state officials continues to be the creation of quality assurance systems that place consumer needs and goals for quality of life first.

Long-term care providers are often skeptical of the value of engaging in government workforce development initiatives. This Issue Brief examines the reluctance to invest and highlights five examples of successful partnerships between employers and workforce development networks. Partnerships are seeking to change business as usual to improve the quality of care, increase the supply of direct care workers and promote greater workforce stability through higher retention and lower turnover.