Reports

On November 13th and 14th in Washington, D.C. teams from Kentucky, Florida, New Jersey, Massachusetts, Maryland, and Delaware and the District of Columbia participated in a Regional Housing Forum to increase understanding and shape the design and implementation of strategies that promote affordable and accessible housing choices for persons with disabilities. Forum participants generated recommendations for CMS and HUD to help support their systems change activities and improve housing choices.

If your job includes recruiting, training, or supervising direct care staff, then you have one of the most challenging jobs in long-term care. This Guide: •gives immediate, concrete suggestions for how to find and keep direct care staff •offers resources both within and beyond your local health care and human service systems •suggests long-term strategies—direct care staff shortages will not disappear easily or soon •offers a view of the nationwide forces causing the staffing crisis.

Reports from the CMS Centers for Medicare and Medicaid Services (formally known as HCFA) Medicaid HCBS Study of the impact of Medicaid home and community based services programs on quality of life, quality of care, utilization and cost. The research project will study the financing and delivery of services to older and younger people with disabilities and the Medicaid financing and delivery of services for individuals with mental retardation and developmental disabilities (MR/DD) in six states.

This paper provides states (both the legislative and executive branches) with background about how to involve stakeholders in planning, program development, and quality improvement related to home and community-based services and supports.

This paper report son the author's forays into Systems Chnage.The system change efforts include the closure of a state operated institution for people with mental retardation in Maine (Pineland Center), the closure of a state operated institution in Arizona (theArizona Training Center in Tucson) and the introduction of consumer selfdirected model also in Arizona.

The Personal Care Assistant pilot project offers individuals enrolled in the Connecticut Home Care Program for Elders (CHCPE) the opportunity to hire and manage their own personal care assistant (PCA) to provide necessary home care services. This Issue Paper provides an evaluation of this program.

This report details a CMS-funded study conducted in Alabama, Indiana, Michigan, Washington, Wisconsin, Maryland, Michigan and Kentucky to assess the major features if the home and community-based services systems for older people and younger adults with physical disabilities in each State. The role that Medicaid plays in home and community-based services is a major focus of the study.

This article evaluates the potential for using negotiated risk contracts in consumer-directed home and community based long-term care.

This is a companion paper to Balancing Safety and Freedom in Consumer-Directed Systems of Support, written to provide concrete strategies for the design and implementation of a process for evaluating and improving both the freedom and the safety of those receiving support. Recommendations are offered to address key issues that are present in consumer-directed systems of support.

This paper identifies and reviews key issues involved in states’ efforts to balance the need to ensure health and safety with the competing necessity to respect the right of the individual to freely determine the events of his or her life.