Reports

In light of this major change and assuming that states may want to learn more about Cash & Counseling, this publication offers an in-depth description of the option, a discussion of key findings from the three-state demonstration, and preliminary information about the program’s expansion into 12 more states. At the end is a list of resources—both Web sites and published materials—for further information. Stories about consumers who have first-hand experience appear throughout this publication.

The cost effectiveness calculation spreadsheet allows users to compare four separate locations and multiple scenarios of using state general revenues for rental assistance. In many instances, the net state cost to serve individuals with disabilities in the community is considerably less than the net state cost in an institution.

Interviews were conducted to identify current perceptions, patterns, themes, and suggestions for improving the choice and self-direction, quality and access to long term care supports. This research also identified ways to develop a mechanism to balance state resources for services, and to identify elements for the design and structure of a single point of entry mechanism. Groups included: consumers of HCBS, elderly and younger nursing home residents, family members of consumers, and providers.

Completed over an 18 month period in 2004-2005, this project was conceived of as an activity that met the objectives of the Maine Real Choice Systems Change grant and the mission of the Maine Personal Assistance Services Association to build recognition and opportunity for the direct care, direct support, and personal assistance workforce through education, public awareness and professional development. Each story evolves out of a series of in-depth interviews and is told in the worker’s voice.

This paper reports the outcome of focus groups, interviews and written surveys conducted in 2003 by a consultant working for the Northern Area Agency on Aging in Wisconsin under a contract with the Department of Health and Family Services. Groups of elders, family members and long-term care professionals were asked to address the question of how, when and why older people make the decisions they do about long-term care.

Massachusetts was among the first states to receive a Real Choice grant and like many states, took a while to start the grant activities. The work of this collaboration did not always progress smoothly. Many setbacks were experienced by all parties. However, as the end of the grant drew near, key stakeholders looked back and realized that significant progress had been made. This report and a companion video documents lessons learned for policy makers and other stakeholders.

People Talking to People Building Quality and Making Change Happen accomplishes not just a system change, but also a paradigm shift. Their goal is to create a system of quality assurance and quality improvement that has consumers providing feedback. The feedback gathered during the three year period allows for system wide quality improvement by giving consumers and their family members a voice, thus able to control important choices and decisions in their own lives.

To help States build the infrastructure needed to remove barriers and create more consumer responsive LTC systems, CMS awarded $70 million in Real Choice Systems Change Grants. Fifty-two Grants were awarded in Sept. 2001 (25 Real Choice, 10 Community-Integrated Personal Assistance Services & Supports, 17 Nursing Facility Transition). This report describes the progress FY01 Grantees have made on their activities during the first year of the three-year Grant period (Oct 1, 2001-Sept 30, 2002.)

This paper explores and analyzes selected state approaches to engage nursing facility operators to be part of systems change activities that offer individuals additional, less restrictive choices to live more independently with appropriate supports. The strategies described offer other states lessons learned that may be replicated as part of a broader approach to meet changing and growing demand for home and community-based services. Efforts in IN, IA, MI, MN, NE, ND, NY, and WI are described.

This report provides a comprehensive framework for Wisconsin’s Functional Screen Quality Assurance. Wisconsin’s Functional Screen system (a web-based application that collects information about an individual’s functional status, health and need for assistance for various programs) is comprised of three separate screens: Adult Long Term Care Functional Screen (LTC FS), Children’s Long Term Support Functional Screen (CLTS FS), and Mental Health/AODA Functional Screen (MH/AODA FS).