Reports

This report is from a designated mini-conference event by the 2005 White House Conference on Aging (WHCoA). Its purpose was to provide the full WHCoA Policy Committee with recommendations specific to long-term care that could be considered for incorporation into its final policy recommendations to the President and Congress. The report contains final recommendations in three areas: Economic Security & Long-Term Care Financing, Health and Independence and Supportive Services.

Long term care reform is happening across the nation and some states are using systems change as an opportunity to better coordinate across aging and disability networks. Using the HHS framework as a guide, this paper examines promising practices in LTC reform in four states: Oregon, South Carolina, Vermont, and Wisconsin. As part of our examination of systems change in these states, we will consider how their LTC reform efforts have impacted collaboration across aging and disability networks.

This paper from NGA includes a number of potential short-run policy changes as well as long-run structural changes to improve the US health care system. The policies outlined do not represent comprehensive reform but instead 5 linking objectives: Reforming Medicaid; Enhancing Quality & Reducing Costs in the Overall Health Care System; Strengthening Employer-Based & Other Forms of Private Health Care Coverage; Slowing the Growth of Medicaid LTC; State Contribution to the Medicare Drug Benefit.

Informal family assistance is often a key factor in determining whether a person with a disability can live in a community setting. However, the practice of paying relatives as caregivers remains controversial. This article reports findings from the Cash and Counseling Demonstration and Evaluation (CCDE) in Arkansas, in which consumers receive a cash allowance to purchase personal assistance services. The article appeared in Marriage and Family Review, Vol. 1, No. 1/2

The Council on Quality and Leadership (CQL) proudly offers the cross-walk between CQL’s new Quality Measures 2005 and The Centers for Medicare and Medicaid Services Quality Framework for Home and Community Based Services (HCBS). This cross-walk is intended to help align the Quality Framework with valid and reliable strategies for gathering and reporting data and evidence. The Cross-Walk clearly demonstrates how CQL’s Quality Measures 2005 provide an integrated approach to quality management.

To assist states in developing and implementing home and community-based waiver programs, CMS has developed a Quality Framework. The purpose of this background memo is to help Cash and Counseling states apply the framework and incorporate the necessary waiver assurances as they develop their quality management plans for consumer directed programs. This paper offers examples that operationalize the quality framework and tables about participants: Access, Safeguards, Outcomes and Satisfaction.

This memorandum presents state-by-state data on Medicaid long term care expenditures in Federal Fiscal Year 2004 (October 2003 through September 2004). The accompanying tables present data on Medicaid Expenditures for Long-Term Care services from 1992 to 2004. A new table this year shows the effect of supplemental nursing facility payments in some states on expenditure data. A separate file ranks states based on the proportion of LTC spending for community services.

This entry presents data on Medicaid 1915(c) Home and Community-Based Services (HCBS) waiver expenditures from Federal Fiscal Years 1999-2004. As in previous years, information is classified for each individual HCBS waiver by the target population served in order to present information on the distribution of HCBS waiver expenditures across long term care populations. Tables include waiver spending by target population; growth in spending; expenditures by state; distribution of expenditures.

This paper synthesizes the ideas and practices of states as they seek to improve the quality of HCBS services. The purpose of this paper is: to promote the exchange of information among states regarding the use of discovery methods for HCBS services; to identify and share the various approaches that states are using to identify gaps, redundancies, strengths and weaknesses in their HCBS quality systems; to discuss ways to prioritize activities and select quality improvement activities.

The State of South Carolina implemented a state-wide automated monitoring system whose real time data allows for monitoring & verification of the providers delivering services under the state's home and community-based services waivers. The toll-free number allows providers to check-in and check-out as they deliver services in a participant's home, while the database inferfaces with claims data to minimize fraudulent billing. The database has empowered waiver service recipients.