Reports

This report outlines an integrated strategy to update the country’s long-term care services infrastructure in preparation for the aging of the population over the next thirty years. Recommendations are focused on the areas of quality, workforce, technology, and financing.

This is the third in a series of reports examining various state systems and processes directed to older adults to realize the goals of the Real Choice Systems Change grants. This report analyzes the results of twenty-four focus groups consisting of 240 participants representing older adults, caregivers to older adults, and HCBS providers. In general, the results indicate Illinois has a plethora of programs and services targeting older adults, but there are disparities between communities.

For states that receive federal funding, the Olmstead decision confirmed the obligation to serve individuals with disabilities in more integrated settings rather than provide supports and services in institutional settings. As states move forward with strategies to support community living for individuals with disabilities and promote the principles of person-centered planning, these tools and strategies provide complimentary opportunities to accelerate the achievement of inclusive outcomes.

In late 2007, the Center for State Health Policy surveyed 23 states that operate Medicaid waivers targeted to individuals with brain injuries. Data was obtained about the cost and number of individuals served by these waivers for the waiver years 2002 through 2006. Three states began waivers for those with brain injuries in 2002 or later, and 3 other states discontinued waivers in 2006. Every state except Arizona has multiple Medicaid 1915(c) home and community-based services (HCBS) waivers.

In February 2006, a Round Table Discussion Meeting was held in Oregon to identify and analyze policies and strategies that maintain or increase the availability of supported employment services to persons with developmental disabilities. The meeting focused on how such services may be preserved and expanded in Oregon, but in addition, national perspectives on supported employment were discussed. The discussion report, evaluation and graphic facilitation of the Round Table are included.

This study is intended to describe the nursing facility level of care determination processes in use by the states and to draw general conclusions from the data collected. When read in conjunction with the previous work in this area, this study will aid state staffs, CMS, and other parties interested in understanding how to improve post acute care assessment. The Appendix provide a brief description of data the state collects, the name of the assessment form, plus contact information.

This paper is an expansion of the NCD’s livable community framework (LCF): a set of public policy recommendations for ensuring that people with disabilities have all the opportunities and choices available to people without disabilities. It links key elements of the LCF to specific needs of people with psychiatric disabilities, and discusses stigma and discrimination.

Compare best practices from affordable assisted living projects in Florida, Vermont, Washington and Arkansas. Each study details proven project structures, such as a review of service fees, staffing patterns and project financing; lessons learned from project sponsors; and key distinguishing features such as new construction in rural communities or use of low income housing tax credits and conversion of public housing facilities.

This study evaluates the efficacy of applying standard market study methodologies and benchmarks for assisted living to rural markets and identifies factors that may contribute to the success of assisted living residences in rural markets. Written as part of the Coming Home Program, this publication offers ideas about how states with comparable policy environments should make allowances for more acute resident profiles, a more Medicaid-based payment mix, and higher market capture rates.

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.