Reports

Are we on the brink of a revival of interest in managed long-term care for people with intellectual and developmental disabilities? Four states’ experiences in experimenting with managed care are examined here, along with stakeholders’ views on these efforts. The report looks at goals, methodologies, and similarities and differences between programs. It concludes by looking at implications for other states.

The largest and fastest growing group of Social Security disability program beneficiaries is people with psychiatric disabilities. The paper finds that combining evidence-based supported employment with mental health services could reduce the rate of disability and enable those already disabled to gain employment, potentially saving personal and government money. Four policy recommendations are given to achieve this goal.

New York has 12 long-term care (LTC) programs: two residential and ten community-based. Data from all are compiled here with the goal of informing policymaking and addressing challenges to the state’s Medicaid LTC programs. An overview of current programs and a snapshot of data such as enrollment and spending are also presented. The first chapter takes a look at the whole system and four other chapters offer data on the largest programs in terms of people served and dollars spent.

Planning documents show how Connecticut will use a Cash & Counseling model to provide flexible service choices to keep people out of institutions. The narrative gives details such as the state’s current rebalancing status, goals and objectives, approach, challenges, service options, training and eligibility. The work plan details “Choices at Home” key tasks, lead person and time frame associated with each major objective.

The conference took place in May 2009 in North Carolina and focused on the global advancement of the principles of self-determination. Presenters spoke on topics including Medicaid reform, self-directed budgeting, self-employment; quality, education, advocacy; and youth, among others. Included here are slides from talks as well as essays by the organizer on the purpose of public funding for services and challenges facing Medicaid.

Meant for individuals with disabilities and entities that have obligations under disabilities law, the handbook provides basic information about disability rights and resources for finding out more. The book is in a Q and A format while the website is organized by topic. Employment, services and programs, public accommodations, housing, education, transportation, and technology and communications are all discussed.

How can state developmental disabilities agencies minimize service interruptions while absorbing budget cuts? At a 2008 forum, directors of these agencies shared their strategies, experiences and thoughts on the topic. Those ideas are synthesized here.

This May 2008 presentation by Mary DeRoo of the Elder Services of Merrimack Valley in Massachusetts describes the risk management system they use that manages risk while maximizing consumer choice and control.

Recognizing caregivers' needs, many federal and state lawmakers have spent the past several years introducing legislation to provide supports to caregiving families. Unfortunately, fiscal crises and other pressing social concerns have meant that few of these proposals have actually passed or been enacted. Trends in caregiver legislation introduced in 2007 and 2008 are summarized and those that have been successful are highlighted.

CA’s In-Home Supportive Services (IHSS) aims to keep people in their homes by paying for personal care services approved by social workers. SB 1104 was introduced in 2004 to ensure and measure delivery of services and program integrity. The report examines whether the elements of the bill were enacted. It also describes alternative models for in-home service delivery, including the Cash & Counseling model and one wherein private companies provide IHSS. Sample timecards and handbooks are given.