Reports

Texas QA/QI grantees have shared their Business Case for a Critical Incident System. This document outlines system recommendations, objectives and potential constraints and is a helpful resource for any state trying to present a business case to its budget office. This document provides the background to support an executive management decision to commit resources to conduct an in-depth study to determine scope and cost for the development of a comprehensive critical incident management system.

This comprehensive manual from the State of South Carolina Department of Disabilities and Special Needs outlines the four basic components of the Quality Management Review and includes the protocols and quality measures that are used as part of this process. The PowerPoint tool and new manual are used together to train providers on indicators and changes made from previous years.

The Topeka Independent Living Center developed this list of Quality Indicators to be applied to all their consumer-directed programs.

This recent Health Affairs article presents the latest program trends in the three Medicaid home and community-based services programs (waivers, home health, & state-plan personal care) and reports a national survey of cost control policies used on waiver programs in 2002. The findings show slowing annual rates of participation growth on individual programs, widespread use of cost controls on waivers including waiting lists, and the persistence of large interstate variations.

This report outlines the annual Medicare Advantage capitation rate for each Medicare Advantage payment area for 2006, and the risk and other factors to be used in adjusting such rates. Attached is a spreadsheet containing the capitation rate tables for CY 2006, a spreadsheet which shows the statutory component of the regional benchmarks and the National Per Capita Medicare Advantage Growth Percentage. The 2006 national per capita Medicare Advantage growth rate is 4.8 percent.

The information in this paper supports the President's New Freedom Initiative initiative by describing how a state might use the Health Insurance Flexibility and Accountability (HIFA) waiver option under Section 1115 authority to improve access to community-based services for persons with mental illness. These services can include basic health care coverage, enhanced community-based supports, and provisions to encourage the use of employer-sponsored insurance (ESI).

This topic paper summarizes how states can use Medicaid to pay for most institutional transition program costs on a permanent basis as a result of policy change since 2000. It also describes how states are currently using Medicaid HCBS Waivers to pay for community transition services-temporary supports people need when trying to move such as housing deposits, utility set-up fees, and furniture.

This brief focuses on one consumer-direction model within the Family Care program-the Agency with Choice model-in which a \"co-employment agency\" serves as the Employer of Records and the consumer acts as the Managing Employer. In the other consumer-directed model, the consumer takes on all employer responsibilities. Slightly more than one in five Family Care members choose the co employment option, demonstrating how a managed care program can incorporate consumer direction.

Kansas operates four Medicaid waivers that allow program participants to self-direct their care. These programs permit participants to hire a worker or their choice and choose an organization to act as the Employer of Records for their worker. The programs are noteworthy because of the large number and wide variety of organizations that fulfill this function and the many different ways in which they serve their clients, providing a high level of choice to participants and their representatives.

In 2001, the State of New Jersey was awarded an Administration on Aging grant as part of the National Family Caregiver Support Program (NFCSP). New Jersey’s project involved integrating a focus on caregiving into the existing long-term care system. The project included activities aimed to better identify caregivers and their unique needs and increase awareness among senior service staff of diverse caregiving situations.