Reports

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.

In 2005 CMS funded a national evaluation by a consortium led by the RAND Corporation to study the implementation and outcomes of ten funded initiatives. These initiatives were meant to improve the recruitment and retention of the Direct Service Community Workforce. Review the report and listen to a recorded webinar where the author's present their findings.

This outcome evaluation, by The Center for Outcome Analysis, Inc., (their website is included), measures whether microenterprise participants and their direct support workers experienced changes in the qualities and quantities of work life. The results found within this study affirm that microenterprise options do offer a viable alternative to “adult day programs” and “sheltered workshops” for citizens with intellectual and developmental disabilities.

Connect-Ability’s goal of enhancing and supporting employment for people with disabilities is informed in large part by the experiences of people with disabilities themselves. The Pathways to Success project collects information on individual experiences, on an ongoing basis through periodic in-person interviews. With this information, the findings will be used to inform not only state agency policy, but also potential employers, so that they may better assist job seekers with disabilities.

In an effort to understand the services and strategies that sustain employment, the state of Washington conducted an evaluation of Washington’s Healthcare for Workers with Disabilities Program. This program is the state’s version of Medicaid Buy-In, and the results show that enrollees are working more hours, earning more money, paying health insurance premiums, contributing more in taxes relying less on food stamps.

The California Community Choices (Choices) project is designed to increase consumer access to home and community-based long-term care services and to provide additional centralized sources of information and referral. The Choices project includes a study to improve the state’s understanding of the financial and structural barriers to increasing consumer access to these services, and to provide recommendations to the state to more effectively manage funding for long-term care.

A series of PHI issue briefs describes the direct-care workforces in several states. Specifically, the briefs focus on Illinois, Pennsylvania, Michigan, Massachusetts, Iowa, Vermont and New York City. Despite growth in this industry, direct-care workers in all states face numerous challenges. In each of the states reviewed by PHI, direct-care jobs do not offer benefits or pay competitive wages. Review the facts and data for each of these states.