Reports

Most Medicaid beneficiaries are enrolled in some form of managed care. States are expected to increase their reliance on managed care to deliver services in their Medicaid programs. This 50-state survey provides a comprehensive look at state Medicaid managed care programs, documenting their diversity, examining how states monitor access and quality, and exploring emerging efforts to improve care, including managed long-term care and initiatives targeted toward dual eligibles.

Certain states significantly outperform others in the delivery of long-term services and supports (LTSS) to older adults and people with disabilities. The report examines four key dimensions of state LTSS system performance: affordability and access; choice of setting and provider; quality of life and quality of care; support for family caregivers. It assesses each state's performance overall as well as on 25 indicators, some of which measured for the first time. Compare data on the website.

A review of the federal financing mechanisms used by state agencies to implement the evidence-based employment models ( IPS and CE) come with the recognition that the federal financing of employment services for people with serious mental illness is a shared responsibility across multiple federal agencies. Improvements in this shared responsibility can lead to more effective support for these evidence-based employment models at the state and local levels.

Summary presents key findings from a collection of nine studies conducted in 2009–2010, focusing on the employment efforts of working-age (age 18 to full retirement). Three of these reports concern TTW participants and program issues, while the other 6 are studies on more general topics related to beneficiary employment and SSA work supports. These nine studies constitute the fifth report of the Ticket to Work program evaluation.

Report illustrates the need for careful planning on how to address the health disparities experienced by persons with disabilities into the next decade. Because the perception that disability is solely an aging phenomenon, current analysis to people of working age (18-64) is limited. Also, little research compares the health disabilities to that of other racial and ethnic minority groups. The report suggests the time is now for a national plan to address disparities.

The Affordable Care Act of 2010 offers a number of options and financial incentives for states seeking to expand their systems of long-term services and supports. Many of these opportunities can be leveraged to work together and to build on existing initiatives. Key provisions of the ACA are summarized, followed by considerations for states seeking to take advantage of these new opportunities.

Person-centered outcomes underpin all aspects of desired assisted living practices and care. Service planning and operational process focused on person-centeredness is able to deliver core promises of assisted living that maximize privacy, autonomy, and choice; fostering meaningful life, engagement, quality of care, and meaningful access to the surrounding community.

Adult day services (ADS) centers are a key provider of long-term care services. As well as providing direct service, they benefit family caregivers by enabling them to remain in the workforce or receive needed respite. Data was collected and analyzed from a representative sample of centers, focusing on the characteristics of services, profile of participants, and the range of services offered. The study provides a picture of current adult day services and offers a look to the future.

This report provides data on Medicaid's role in financing long-term care, including serving as the primary payer for an estimated 63.6% of all nursing home residents. Congress recently offered an array of proposals that would significantly cut the Medicaid program. These proposals include converting the program into a block grant with straightforward cuts and global caps on spending. The latest proposal enables the states to significantly reduce Medicaid eligibility and enrollment.

This report explains the Jobs to Careers program, a model of training and education designed to advance the skills of direct-care workers. It describes how the program has been implemented in Hartford, Connecticut, and Portland, Oregon. The report also presents a list of next steps and recommended goals to improve state and federal policies relating to direct-care worker training. Jobs to Careers is managed by the national nonprofit Jobs for the Future.