Reports

This brief describes the evolution of beneficiary-managed home and community-based services since the original demonstration and provides an overview of state activity as of January 2006. The Deficit Reduction Act of 2005 gives states the option to use this model for an expanded range of home and community based services in their state Medicaid plans without having to obtain a waiver.

A template used by Arkansas' IndependentChoices program and a sample report cover page.

This article reviews the development of empowerment-based practice in social work. The article discusses the effect that the Cash & Counseling program has on empowerment, specifically for the elderly.

This report’s results suggest that surrogates can adequately represent consumer's views about satisfaction with personal assistance, and therefore provide encouragement to continue investigation of the utility of surrogate representatives. The study results also replicate previous findings that persons with cognitive impairments and persons with severe disabilities are able to express their preferences for everyday matters.

Liability issues pertaining to consumer-directed personal assistant services are discussed in this report. Issues are divided into topics including consumer-worker relationships, the risk of fiscal agents, the risk of consultants, and the risk for states and government entities. The report goes onto provide options to address liability risks.

First illustrating the US workers’ compensation system, this article continues to detail worker’s compensation programs and how they function. A historical overview and the basic objective of worker’s compensation laws are also reviewed. The article ends with a discussion of issues, challenges, and promising practices.

This report focuses on creating a more balanced delivery system by expanding home and community-based services and reducing reliance on institutional care where possible is a major goal for virtually all states and the Centers for Medicare & Medicaid Services. The paper concludes by summarizing initiatives and drawing implications for the future financing of home and community-based services.

The proportion of long-term care spending that goes to institutional care has been dropping over time, from 81 percent in 1995 to 63 percent in 2005. However, there remains significant concern that many people who would prefer to receive care in the community are unable to do so because of what has been termed the ‘institutional bias’ of Medicaid. This report discusses the issues surrounding efforts underway to shift the balance toward HCBS in the state of Pennsylvania.

Looking for a way to gauge consumer satisfaction in self-direction programs? The state of Virginia Department of Medical Assistance Services (DMAS) conducts an annual Consumer-Directed Recipient Satisfaction Survey, to monitor the performance of the fiscal agent and to provide DMAS with feedback to assist in the development and implementation of quality improvement strategies. The first and second year statewide survey and findings from 2007 and 2008, are available below.

Looking for profiles of each State’s Home-and Community-Based Service (HCBS) programs? This project report covers the components of HCBS programs under multiple funding streams. It includes an overview of findings from cross-state comparisons with accompanying tables and charts and individual profiles of 48 states and Washington, DC. The findings are intended to provide states with information that can help guide their efforts to expand and improve HCBS programs.