Reports

How are federal agencies hiring, managing, and retaining employees with disabilities? This report draws from an online survey of government employees involved in the hiring or management process. Findings indicate that a number of barriers exist including lack of education around key mandates, lack of manager training and accountability. Though stereotypes were also a barrier, they were significantly less common in agencies with proper tools and knowledge.

Long-term services and supports (LTSS) for the elderly and younger populations with disabilities are a significant component of national health care spending. In 2008, spending for these services was almost $191.1 billion (almost 10 percent of all U.S. personal health care spending), most of it paid by the federal-state Medicaid program. This publication presents data on LTSS spending by major public and private sources.

Integral to the coverage framework laid out in the reform law is a dramatic expansion of the Medicaid program. This primer provides key information about the program today, including a definition of what it is, who and what services are covered, Medicaid expenditures and how they are financed, and information of how health reform reshapes the program for the future.

An update to the Robert Wood Johnson 2002 chartbook examines the impact of chronic conditions on individuals and their caregivers, and the inadequacies of the U.S. health care system to meet their needs. According to the author, care for people with chronic conditions is not coordinated, leading to unnecessary service use. Included among his recommendations is the encouragement and support of patient self-management and family caregiving. Also attached is a presentation with supporting data.

Find national and state by state estimates of the increases in coverage and the associated costs compared to a baseline scenario without the Medicaid expansions in health reform. Findings show there will be large increases in coverage and federal funding in exchange for a small increase in state spending. Since it is impossible to predict the behavior of each state, the analysis examines two participation rate scenarios differing in the strength of outreach and enrollment efforts.

New job descriptions and titles are being developed to focus on the needs of individuals for activities such as support coordination, brokerage and personal resource management. This report helps to define the concept of “support brokerage” as it relates to persons with developmental disabilities. It addresses issues such as conflicting interests, self determination and structural requirements.

The US Department of Labor sponsored three national demonstration projects to research effective policies and practices that improve self-employment outcomes for people with disabilities. These projects represented a diversity of locations, economic environments and stakeholder groups, and resulted in new knowledge as well as local policy and program improvements that will help individuals achieve their entrepreneurship career goals. The projects are described in the attached report.

Explore Medicaid expansion under health care reform and savings for states through Medicaid “modernization.” This report examines three broad categories of savings opportunities including the greater use of coordinated care techniques, the greater use of managed care for LTC, and the upgrading of Medicaid’s administrative processes. Find national and state-specific projections of increases in Medicaid enrollees as a result of health reform legislation and of the associated Medicaid costs.

Find an estimate for the US of the costs over the next 20 years of providing public transportation to the advancing wave of older adults looking to maintain their independence. Investments recommended to address needs included more bus operator training and consideration of older adults’ needs in route planning and placement of transit stops. Capital enhancements include more low-floor and kneeling buses, improved interior circulation, additional grab bars and other accessibility features.

Review an early assessment of the balance of state LTC systems before the implementation of the MFP demonstration. The authors’ goal was to develop a baseline against which the impacts could be measured as the program matures and evolves. This baseline information is used to identify key differences in the makeup of states’ LTC systems, and the observations suggest that the impacts of the program are likely to differ across states.