Reports

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.

This report is focused on the status of Family Care implementation in WI. It contains background information on the Family Care program, as well as evaluative information on the development of each pilot project. The report also contains a glossary of terms and a research methodology section that demonstrates the contacts made by The Lewin Group in the five pilot counties—Fond du Lac, La Crosse, Milwaukee, Portage and Richland—in order to assess the current status of the Family Care program.

State legislatures continue to face the challenges presented by the Supreme Court's 1999 ruling in L.C. & E.W. v. Olmstead. These briefings report on the measures undertaken in each of the 50 states and the District of Columbia in dealing with this critical issue. Provided here are the complete 2001, 2002, and 2003 reports as well as individual state excerpts from the 2003 report.

This report provides a thumbnail sketch of long-term care budgets, legislation and planning in the 50 states and the District of Columbia. The goal of the project is to obtain insights into recent state long-term care public policy reforms,as evidenced by their proposed or recently enacted legislation, task forces and budgets.

In these reports, the National Conference of State Legislatures (NCSL) traces the budget issues that states confronted in 2002 & 2003 and examines how they addressed those issues. The report also describes long-term care legislation enacted in 2002 & 2003 and long-term care planning work that is under way in many states.