Reports

This is the third report in a series, from Mathematica's five-year evaluation of the Money Follows Person demonstration, aimed at helping Medicaid enrollees transition, from long-term care institutions to the community. It describes states’ early implementation experiences and state transition activity as of December 2008. Also discussed, are the challenges that states have encountered in trying to launch the program, and implications for making fundamental changes in the long-term care system.

Developing HCBS alternatives to institutional care has been a priority for many state Medicaid programs over the last three decades. While the majority of long-term care dollars still go toward institutional care, the national percentage of spending on HCBS has more than doubled from 19 percent in 1995 to 41 percent in 2007. This article presents a summary of the main trends to emerge from the latest (2006) expenditures and participant data for the three main Medicaid HCBS programs.

Review the findings from a survey of eldercare and disability services employers. While most employers in the state offered employer-sponsored insurance, less than one-fifth of Massachusetts direct-care workers were enrolled in 2009. Based primarily on data from the survey, the main reason for the low number and recommendations are outlined in this report that deals with the impact of Massachusetts health reform on the eldercare and disability services sector.

What is the cost of providing job accommodation? Recent amendments to the Americans with Disabilities Act (ADA) refocused attention on workplace accommodations by broadening the definition of disability. This increased attention has some employers concerned about the costs of providing job accommodations. However, a study conducted by the Job Accommodation Network (JAN), shows that workplace accommodations not only are low cost, but also positively impact the workplace in many ways.

Interested in how self-directed options in the 1915(c) Medicaid Aged and Disabled Waiver program are succeeding? In June of 2008 PPL, a nationwide company that provides financial management and supports for self-directed programs, conducted a survey of all 241 participants enrolled in Personal Options for the West Virginia Bureau for Medical Services. The attached report, includes results and summary.

The National Technical Assistance and Research Center to Promote Leadership for Increasing the Employment and Economic Independence of Adults with Disabilities has released Collaborating and Coordinating with Employers, a brief that illustrates key research findings, outlines existing strategies and practices that are advancing the concept of disability and business collaboration, and provides resources that further illuminate effective strategies and examples of these collaborations.

As part of Research on Program Management Techniques by States to Rebalance their Long Term Care Systems, Final Case Studies were conducted in each State for the time period ending December 2007. These Case Studies focus particularly on the reflections of State government officials on rebalancing goals, accomplishments, and next steps as they reflect on all the State’s experiences in moving towards more community-based services.

In FY07 CMS awarded 13 PCP Implementation Grants. The purpose twofold 1) to change the basic model of care planning from one that is directed by the needs of institutions and provider agencies to one that responds to the needs of the individual, and 2) to assist states and territories in developing ways to identify the strengths, capacities, and preferences. This report presents factors that facilitated and/or impeded progress and how stakeholders were included in development and implementation.

This report is the result of a study exploring management techniques and programs States have put in place to rebalance their Medicaid long-term supportive services. It summarizes the methods, products and findings of this project then suggests conclusions and recommendations for State officials, legislators, advocates, and providers and CMS on ways to increase and improve LTSS systems for people with disabilities, enhance participant choice, and reduce reliance on institutions.

In this survey, the MetLife Mature Market Institute found that private room nursing home rates rose 3.3% to $219 per day or $79,935 per year, while assisted living also rose 3.3% on average to $3,131 per month. Home health care aides now cost an average of $21 per hour; adult day services run $67 per day. The report includes average costs for each state, as well as for several individual cities, and includes other long-term care facts about provider training and available services.