Reports

This technical assistance document is the first in a series of papers that examines issues pertaining to respite services as part of the Medicaid program. By reviewing the prevalent definitions of respite in the published literature and federal documents, we seek a consistent view of respite services that can be used in the development of administrative policies to support respite for Medicaid HCBS beneficiaries and their informal caregivers.

This issue brief will present several approaches that attempt to tackle the underlying challenge of reducing nursing facility utilization and expenditures. These range from modifying the nursing facility reimbursement methodology; to converting nursing facilities to assisted living centers, paying nursing facilities to take beds off-line, and using capitated managed long-term care; to approaches with theoretical promise that have yet to be adopted in any state.

These briefs have been developed to assist the CMS Real Choice grantees who are focusing on strengthening systems of care for children and adolescents with severe emotional disturbances. Five briefs are included in the set. The briefs focus on assessment of children, therapeutic foster care, wraparound services, flexible funding, and multisystemic therapy.

The survey results highlight inconsistencies and gaps in training, testing, and other pre-employment requirements for nursing assistants. The results from the nurse aide registries are presented in a series of charts. The survey notes who pays for pre-certification training in each state, whether candidates are allowed to become certified by passing the test without undergoing training, whether nurse aides pay a fee to be licensed or certified, who does criminal background checks, and more.

A two-year study in Los Angeles County showed that offering health care coverage improves retention rates. This study tracked workers in the city’s In-Home Support Services program, which offers home-based care and services to consumers who direct their own care. The report includes many findings, including an initial study done showing that workers who enrolled in the health benefits program were more likely to be in the workforce at month 12 than workers who did not enroll.

This guide explains the critical role Medicare and Medicaid have come to play in the lives and the futures of roughly 20 million children, adults, and seniors with disabilities - and gives people new information. This guides answers many questions such as: How do people with disabilities apply and can they get help with the process? What is the policy for covering durable medical equipment? How to appeal coverage decisions? Can a person be employed and still keep their coverage?

This report focuses the development of increased access to community transportation services for individuals with disabilities as part of the Access to Services project in Maine. The report includes a summary of grant activity, lessons learned throughout the project, and recommendations for next steps to sustain the work of this grant. The specific project goal was as follows: To make transportation more available and responsive to persons with disabilities.

This report brings together the research, analysis, and conclusions of the work completed under Maine’s Quality Choices grant concerning flexible funding systems for youth with developmental disabilities as they establish themselves in ‘adult’ communities on their road to independent living. The report includes a review of the project history and implementation, research findings Strategies and Recommendations, and a Fiscal Roadmap.

This report is a final list of recommended “dashboard” indicators for use in assessing the quality of HCBS Waiver services. The indicators are organized according to the HCBS Quality Framework to provide a common frame of reference. The report includes recommendations for implementing the “dashboard” indicators, lessons learned throughout the project and a plan for sustaining the work of this grant.

Colorado’s interest in performance measures reflects the recognition that the first step in improving service system performance is to measure it. As part of its implementation of the Systems Change Project, Developmental Disabilities Services has tracked system performance against specified “key” performance indicators. The Accountability Focus Series includes: Key Indicators of Performance; Outcomes Of Services and Supports. The third report is Gauging How Well Colorado Supports Its Citizens.