Reports

This report describes examples of more narrowly focused state legislation that is setting the policy and infrastructure for consumer direction, expanding the direct care workforce, and supporting persons who return to the community after living in institutions. The Appendix includes the specific legislative language of selected bills covered in the report.

An advisory committee of consumers, providers, practitioners, advocates and experts worked collaboratively to identify the major challenges preventing people with mental illness from discharging out of nursing facilities and into less restrictive communities. This report is a result of their work and aims to make available a framework for successful transition programs. The best practices described are offered as a guide for service providers, advocates, and mental health clients themselves.

Explore the impact of consumer-directed support on the economic, health, and social outcomes between families enrolled in the program and those on a waiting list. Caregivers reported fewer out-of-pocket disability expenses, greater access to health care, engagement in more social activities, and greater leisure satisfaction. There also appeared to be greater impacts on lower income families; these caregivers reported better mental health and access to health care than did the waiting list group.

The Nurse Delegation Invitational Forum brought together 28 participants from seven states to discuss the involvement of unlicensed assistive personnel (UAP) in the provision of health care tasks to long-term care consumers through nurse delegation and consumer direction. The Oregon long-term care system served as the forum centerpiece, with presentations by staff from state programs, the board of nursing, practicing nurses who delegate and visits to several sites in the Portland area.

Rutgers Center for State Health Policy convened national and state thought leaders in nursing practice and regulation to develop consensus principles to guide the profession's collaboration with people who want to live in their homes and communities. The 2004 draft principles were revised and endorsed by the American Academy of Nursing's Expert Panel on Aging in November 2005. They are offered as a foundation for further dialogue within and across states.

The US is experiencing a severe shortage of qualified direct-care workers to provide personal care services (PCS). Evidence from a number of studies reveals that wages and benefits paid to PCS workers play a fundamental role in determining the quality and quantity of workers. Read this in-depth analysis of state and local practices that reviews the pros and cons of seven strategies for enhancing PCS-worker wages and benefits for direct-care workers delivering Medicaid personal care services.

Popular with journalists, this guide is useful for those interested in health policy issues. Chapters contain key facts, an overview, expert sources with telephone numbers, story ideas and helpful websites. Topics presented for current policy discussion include: the uninsured, private health coverage, children's health coverage, Medicare, Medicare prescription drugs, Medicaid, long-term care, health care costs, quality and health information technology, disparities, mental and public health.

Review two papers that center on the topic of public disability and health benefits and the fundamentals of the Disability Insurance and Supplemental Security Income programs and their relationships with Medicare and Medicaid. Part I looks at definitions, distinctions and overlaps; it reviews the effects on the Ticket to Work and Work Incentives Improvement Act. Part II discusses major initiative and issues in these programs in light of growing administrative, fiscal, and other problems.

This report describes the implementation of consumer directed care by synthesizing information from in-person discussions with program staff, a mail survey of program consultants, telephone interviews with consumers in the treatment group, and program records. It discusses the program’s goals and features, the ways beneficiaries managed their program responsibilities and took advantage of increased flexibility, and the degree to which beneficiaries were satisfied with the program.

This resource guide was developed to help CILs: 1. understand specific needs and problems that are unique to older persons as they age, 2. understand the network of aging organizations including their organizational structure and funding sources, 3. help identify ways to network with these established “aging” agencies and 4. locate and tap into some of the monies that are available for “senior” programs. The guide has 13 sections covering topics from assistive technology to collaboration ideas.