Reports

This study examines dynamics affecting the direct-care workforce in Vermont. It found that only one third of those workers have employer-sponsored health insurance, one half of those surveyed expected to receive a raise, and 42% received formal job training. The report includes nine recommendations to strengthen the state’s direct-care workforce. In addition, the appendices include original surveys given to employers and direct-care workers.

This MIG project is focused on assisting individuals with disabilities to become gainfully employed. Included are work products from CES including: a resource mapping project on the availability of employment related services and supports, summaries of findings from focus groups regarding the rehabilitation needs of un-served and under-served populations, and a summary of input gathered from employer focus groups.

Find an abundance of information on Health Coverage for Workers with Disabilities (HCWD), a Medicaid expansion in North Carolina created under the authority of the Ticket to Work and Work Incentives Improvement Act. Included are: reports on cost and participation projections; a powerpoint presentation on information gathered from workgroups; brochures on the program; and a fact sheet about the shift from personal care services (PCS) to HCWD.

This report details the state-by-state impacts of seven regulations issued by the CMS that would make major wide-ranging changes. Areas affected include cost limits for public providers, graduate medical education, outpatient hospital services, provider taxes, rehabilitative services, school administration and transportation services, and case management services. The website offers an interactive map showing how proposed regulations would impact each state.

Over the last eight years, federal, state, and local governments have re-envisioned how to deliver and pay for an ever-growing caseload of elderly individuals and persons with disabilities who need services at home, in the workplace, or in more costly nursing facilities. This discussion provides a vision and a context for HCBS reform consistent with CMS’ vision for reforming post-acute care that focuses on addressing system barriers and informing and empowering health care consumers.

This paper explores the various participant-direction models, existing quality management strategies, and the potential for change that allows participant-directed quality management systems to remain true to the core values they were founded upon. Participant-directed programs face unique challenges in meeting federal requirements while remaining faithful to the principles of participant-direction. Well-defined roles and responsibilities are essential and will directly influence the design.

The Kaiser Commission on Medicaid and the Uninsured supported this focus group project of adults with disabilities in 4 states, who are enrolled in Medicaid Consumer Directed Personal Assistance Services programs. This research was undertaken to learn about Medicaid enrollees’ experiences in the program and their opinions about key features of the program including recruitment issues and degree of responsibility over services. Ways to improve upon the programs were also identified.

Maryland's vocational rehabilitation and mental health agencies jointly promote supported employment evidence-based practices (EBP) for people with mental illness. The state provides a payment for EBP services and monitors fidelity to EBP. Training, technical assistance, and small, time-limited grants have assisted providers transitioning to EBP. More than two-thirds of Maryland’s supported employment providers either have adopted EBP or are implementing these practices.

Consumer direction of personal assistance services (CD-PAS) is one model of service delivery that gives Medicaid beneficiaries varying degrees of control over hiring, scheduling, training, and paying personal care attendants. Program administrators, experienced with the programmatic features of CD-PAS in their state, were interviewed. Eligibility criteria, participant support services, and method of financial management used by Medicaid beneficiaries to pay direct care workers are discussed.

a