Reports

In FY09, 27 states expect budget shortfalls at the same time that HCBS and other services administered by State Units on Aging nationwide experience increased demand. NASUA surveyed 44 states and the District of Columbia about their strategies for coping with this situation. These include creating or increasing waiting lists, cutting budgets, reduced staffing and travel, and adjusting program elements such as eligibility.

The Committee compiled a brief inventory of all research and demonstration projects supported by federal agencies. Program details are not provided, but the report does describe the diverse strategies used by 27 agencies to research and support HCBS. Fields covered include biomedical sciences, housing, environmental protection, preventive care, and hospice care, among others.

Tables listing the formal strategies adopted by each state to achieve compliance with the Olmstead decision and community integration lawsuits related to the case are maintained here. In 1999, the Supreme Court found that people have the right to receive care in the most integrated, least restrictive setting appropriate. This report gives more details on that decision and summarizes the impact it has had on community integration in general.

PAS Center offers state-by-state participant and expenditure data for all of Medicaid and the three main HCBS programs: 1915(c) waivers, home health, and state plan personal care. The December 2008 update provides 2005 data complemented by survey results related to program policies and provider reimbursement rates.

This evaluation assesses the impact of the "Home Health Aide (HHA) Partnering Collaborative" -- a quality improvement initiative implemented at the Visiting Nurse Service of New York -- in three main areas: patient outcomes, patient service use and aide job perceptions and retention.

This paper was used as a handout at a workshop, held as a catalyst for DALTCP's major new initiative to study ways to expand consumer choice and empowerment in obtaining personal assistance services.

SAMHSA offers a series of reports entitled Building Bridges. This series details dialogues among stakeholders, including consumers, mental health-related providers, and policy-makers, to identify strategies to promote recovery and wellness for people with mental health problems. Topics include the faith community, addiction, criminal justice, primary health care, disaster response, students and college administrators.

This paper reports the findings of a study to document and analyze selected best practices related to state administered home and community based services (HCBS) programs. Examination of the programs provided the context for examining two interrelated areas of policy interest: how states organize and deliver a range of HCBS within fixed budgets; and how eligibility determination, needs assessment, care planning and service authorization functions are structured and linked to one another.

This report estimates that public financial and personal clinical outcomes can be improved by moving dual eligibles to capitated managed care. The authors view the clinical and eligibility characteristics of dual eligibles as well-matched to the strengths of integrated care programs. The document lays out the reasoning and data behind the estimate, recommends policy changes needed to make the transition, identifies potential barriers to implementation and offers examples from KY and MN.

This study provides a detailed profile of Hispanic family caregivers to determine how they differ from non-Hispanic caregivers and to explore their information and service needs. Key findings regarding incidence of family caregiving situations, demographics, care intensity, reported stress levels, and cultural beliefs, and others are presented. The authors also discuss policy implications of the findings.