Reports

New strategies are being pioneered that address both the challenges of advancing employment options for individuals with disabilities and moving forward with options to advance their economic security. This report focuses on three cities: Detroit, Jacksonville and Milwaukee, and the tie-in between the workforce development system and advancing self-sufficiency. These three diverse cities, in partnership with their local organizations have partnered to educate and assist people with disabilities.

This public policy issue brief from the Alzheimer’s Association describes functional eligibility issues for people with dementia and discusses how six states determine eligibility for Medicaid-funded long-term care services. Based on an analysis of these states provisions, the paper makes recommendations for appropriately assessing the long-term care needs of people with dementia, and for setting level-of-care criteria that treat people with physical and cognitive impairments equitably.

This innovative disability and health data tool uses data from the Behavioral Risk Factor Surveillance System (BRFSS) to identify disparities in health between adults with and without disabilities. Find data on a range of health indicators for your state and compare the health of adults with and without disabilities and certain health conditions. Maps, data tables and state profiles are available.

This issue brief uses the most recent comprehensive data, from 2009, to examine the characteristics and costs of dual-eligible beneficiaries. The report also examines the different payment systems that Medicare and Medicaid use to fund care for dual-eligible beneficiaries and recent efforts at the federal and state levels to integrate those payment systems and coordinate the care between both programs. Given the high cost of dual-eligibles, legislative solutions are reviewed.

Few employer-sponsored and private insurance plans offer the range of services that workers with disabilities may need. Medicaid Buy-In programs are a viable option that allows these workers to receive needed services without spending down for Medicaid. This report describes findings from a study of characteristics and service utilization of higher-income enrollees compared to regular Medicaid enrollees. Providing these programs may keep higher-income workers with disabilities employed.

This scan was designed to understand facilitators and barriers to self-direction in behavioral health, ascertain interest among stakeholders, adapt the model and outcome measures to better fit the needs of behavioral health consumers, and develop recommendations to inform next steps. The scan was a joint effort conducted over 18 months (Sept 2011-Feb 2013) by researchers from the National Center for Participant-Directed Services, Human Services Research Institute, and University of Maryland.

This report provides background on MLTSS to brief the intellectual and developmental disability community, as well as the President and the Secretary of the Department of Health and Human Services, on managed care and changes in LTSS administration so that they may take action and influence outcomes. The report also contains a number of recommendations related to disability stakeholder engagement, choice and self-determination, consumer protections and rights and quality measurement.

This policy brief provides a comparison of CMS’ finalized memoranda of understanding with California, Illinois, Massachusetts, Ohio, and Virginia to test a capitated model and with Washington to test a managed fee-for-service (FFS) model to integrate care and align financing for dual-eligibles. These 2013 demonstrations will introduce changes in the care delivery systems and will test a new system of payments and financing arrangements among CMS, the states and providers.

The Census Bureau created the supplemental poverty measure, in an effort to differently reflect cost of living and financial status from the "official" measure. Poverty rates among older adults are higher under the supplemental poverty measure (15%) than under the official poverty measure (9%). This analysis does a state-by-state comparison using both poverty measures to describe seniors living in poverty. An understanding of elder financial hardship is important for fiscal policy debate.

CMS created a financial alignment demonstration to better promote coordinated care for dual-eligibles. The fee-for-service managed care model has received less attention than capitated managed care. However, this model could be useful in states or regions where traditional managed care organizations are not well established or do not function well. This brief makes some assessments of the advantages and difficulties of the model and identifies elements necessary for successful implementation.