Reports

In 2004 the Veterans Affairs' Vocational Rehabilitation and Employment (VR&E) program was reviewed by a VR&E Task Force. It recommended numerous changes, in particular focusing on employment through a new Five-Track service delivery model and increasing program capacity. Since then, VR&E has worked to implement these recommendations. This report includes VR&E's progress in implementing the 2004 recommendations and includes additional recommendations moving forward from the Accountability Office.

As part of these demonstrations, six successful interventions that overcome barriers to independent living and employment for young adults are studied in-depth. The first document gives detailed information on the design of the study's evaluation. The second summarizes the core components, services, and strategies of each demonstration project.

Three key issues affecting the understanding of low rates of successful employment outcomes for people with mental illness are explored. These are: lack of a common definition of successful employment; lack of clear, objective, standardized data; and differences among states and programs in measuring client characteristics. Peer critiques to the data and analysis are provided along with tables comparing employment outcomes by state.

Minnesota’s Legislative Auditor investigates the state of the personal care workforce and the regulation of these services and presents recommendations for improvement. Information is provided on eligibility and access as well as the demographics of people that are assessed for or receiving personal care services. Program traits examined include regulation, expenditure trends, fiscal integrity, and quality. Family caregivers are looked at in the final section.

To answer the question posed in the title, the authors studied HCBS spending and the availability of family members. Higher HCBS expenditures are found to be associated with lower risk of nursing home admission, but this association is statistically insignificant for older adults with living children. Doubling state HCBS expenditures would reduce the risk of nursing home admission among childless seniors by 35%.

Do you have questions about the different models of fiscal services in consumer-directed care? The first fact sheet compares the Fiscal/Employer Agent (either government or vendor), Agency with Choice, and Fiscal Conduit models. The second illustrates the factors that influence the costs of these different models.

New York spends more than most states on Medicaid and long-term care. To understand why this is, the following traits are evaluated: demographics of residents over 65; poverty level; long-term care spending, budgets, and services; and quality of nursing home care. The findings identify a number of demographic and program factors likely contributing to the high rate of spending.

The National Council on Disability is required by law to annually submit a report on the status of the nation in achieving policies that guarantee equal opportunity for all individuals with disabilities and empower them to achieve economic self-sufficiency, independent living, and inclusion and integration into all aspects of society. The 2009 report focuses on current quality of life indicators and emerging trends that should be factored into future policies and programs.

Money Follows the Person (MFP) programs only target 0.9% of the people that could be eligible for transitioning out of institutions each year. However, there is a potential to increase rates to 15-40% annually depending on quality of program implementation, who is targeted, and how successful states are in overcoming barriers to transitioning high-needs people. The report looks at grantee states’ potential for accomplishing this rate increase.

Twelve states received Cash & Counseling Replication grants in October 2004. Here, the Replication States’ experiences in developing and implementing their new programs are documented in three stages: planning; design/development; and implementation/enrollment. The appendix includes summaries of the states' grant initiatives.