Reports

This groundbreaking two-part report calls for significant improvement in health care and long-term care that relies too much on families without recognizing and assessing family caregivers' own support and health needs. Volume II provides four background papers and two personal accounts. Chronic illness and disability, as these accounts reveal, affects not only the lives of the individual, but also of family members who provide the care and support.

This two-part report calls for significant improvement in health care and long-term care that relies too much on families without recognizing and assessing family caregivers' own support and health needs. Volume I reflects the professional consensus achieved among experts and stakeholders on fundamental principles and practice guidelines that apply to a range of practitioners in a variety of settings. The strategies focus on stimulating caregiver assessment as a basic component of practice.

This paper discusses the activities of 11 grantees and the program and policy issues they have encountered. The paper’s primary purpose is to provide information that states and stakeholders will find useful when planning or implementing consumer-directed initiatives, whether through solely state-funded programs or the Medicaid program. In particular, the report highlights program and state and federal policy challenges and how Grantees are addressing them.

One of the greatest challenges facing every state Medicaid program is devising an appropriate and effective delivery system for its most resource-intensive beneficiaries. Several pilot programs called Disability Care Coordination Organizations are taking the best attributes of managed care and reconfiguring them to improve the lives of Medicaid beneficiaries with disabilities. This paper synthesizes the programs’ key components and describes the challenges they face.

Support brokerage is a potentially important development that can assist in enabling people to make informed decisions and promoting independence. This discussion paper from England raises a number of pertinent debate questions about the practicalities and potential difficulties of support brokerage. As we here in the US implement system transformation that includes self-determination, we can learn from the examples illustrated in these UK brokerage pilots.

United Cerebral Palsy conducted a holistic analysis to chart each state’s ranking and progress in creating a quality, meaningful and community-inclusive life for those Americans with mental retardation and developmental disabilities served by that state’s Medicaid program. This is part of a three-phase process that also will study top-performing states and then create state-specific action plans on how their state can improve.

This issue brief explores the continuing evolution of the Medicaid program on several fronts. It discusses the benefits and cost-sharing flexibility that is included in the Deficit Reduction Act and examines the implications for states, beneficiaries, and providers. The paper also explores recent trends in section 1115 waiver development and considers the use of waivers as a vehicle for restructuring Medicaid financing systems and for testing completely new approaches to health care delivery.

Coordinated care organizations (CCO) are an emerging person-centered health delivery system for community-based Medicaid adults with disabilities or complex chronic disease. This report develops recommendations on how states can support CCOs. The recommendations are drawn from visits to seven pilot programs in NC, MN, MA, NY, VT, WI. This report reviews the challenges the CCOs encounter in measuring quality and offers a comprehensive approach for developing an actionable measurement set.

The Hennepin County Human Services and Public Health Department outlines the accomplishments made to date after their one-year initiative. They also offer their future plans for implementation.

This brief provides background information on characteristics of the MR/DD population and describes the major information and service needs of the MR/DD population and the existing supports and services system. The brief also addresses implications for grantees serving this population and provides additional resources to facilitate ADRC planning and operations.