Reports

Many states are undergoing long-term services & supports (LTSS) transformations. The lagging economy & increased demand for publicly funded LTSS are placing pressure on state policymakers to find solutions. As a result, many states either have or plan to implement Medicaid Managed LTSS, with 12 states having existing programs & another 11 with plans for implementation. Many states used the economic downturn as an opportunity to balance services from institutional to non-institutional settings.

Despite continued fiscal pressures on states, eligibility policies remained stable in nearly all state Medicaid and Children's Health Insurance Programs during 2011. Moreover, many states used technology to increase program efficiency and streamline enrollment. The "maintenance of eligibility" requirement in the Affordable Care Act (ACA) played a key role in preserving coverage levels. Without it, more states likely would have limited eligibility or tightened enrollment procedures.

Enrollment in MFP continued to grow steadily with 15,818 cumulative transitions to the community as of June 30, 2011, a 33 percent increase from the end of 2010. The states reported 3,722 new transitions during the six-month period from January to June 2011, 9 percent more than in the previous six-month period. The report provides an overview of state MFP grantee progress on key performance indicators and challenges states reported when implementing their transition programs.

State aging & disability agencies are operating in an era of state agency reorganization, re-conceptualization of state government, & restructuring of long-term services & supports delivery systems & financing. Key elements driving continued change include the economic environment, ACA implementation, uncertainty in the federal budget particularly with the failure of the Congressional Super Committee, changes in state level leadership, & the 2012 elections.

Existing national disability-related survey & administrative data are limited in their ability to meet needs of federal programs & policy makers. One potential response to these shortcomings is the fielding of a national disability survey. This report was prepared to assess the need for developing & fielding another national disability survey data collection effort. It presents findings from one of the project’s major activities designed to review the disability-related information.

As state and federal agencies strive to meet the growing needs of people with disabilities while using fewer resources, better disability data are needed for monitoring and improving the health, economic status, and overall well-being of this population. The report identifies limitations in national survey data on disability and outlines a wide range of potential short- and long-term options for addressing them, including developing and fielding a national disability survey.

This brief describes key features of Georgia’s MFP program & highlights recent experiences. Through MFP, Georgia has achieved a 2 percent growth in annual spending on home & community-based services. With the extension of MFP under the ACA, the state plans to continue the program through 2016 with hopes to transition more than 2,000 individuals with the help of over $93 million in enhanced federal matching funds. Also, review brief profiles on several Georgia residents enrolled in the program.

This report examines state policies that are needed to help older adults age in place. These policies include integrating land use, housing and transportation; efficiently delivering services in the home; providing more transportation choices, particularly for older adults who no longer drive; and improving affordable, accessible housing to prevent social isolation.

In an effort to improve care & reduce costs, states & the federal government are seeking new ways to provide services to people eligible for both Medicare & Medicaid. Missing from the discourse are the voices of these dual eligibles. Changes to the way their care is organized & delivered could have profound effects on their health, quality of life, & satisfaction. This project aims to complement state & federal efforts by offering perspectives on what duals want from their models of care.

The MO HealthNet Division administers the MFP program called My Life, My Way, My Community. This site is an example of how this state presents material to the community about the program. See samples of the Initial Application, Operational Protocol, Brochure and Participation Agreement.