Reports

This report is a collective summary of the impact and outcomes of Medicaid services to over half a million unique individuals with intellectual and developmental disabilities. Using data and statistics, from 2007, State rankings are given with the intention of providing guidance as to how each State performs overall in serving these individuals, acknowledging areas for each State that need improvement, and identifying top performance areas for each State, making resources easily identifiable.

Studies show that 70% of the uninsured children in the United States, approximately 5 million children, are eligible for Medicaid or the Children’s Health Insurance Program (CHIP) yet remain uninsured, despite varying State outreach efforts. Beginning in 2008, Maryland introduced Maryland Kids First Act, a new and innovative way to identify and enroll eligible children; through income tax filings. Preliminary efforts, results, and challenges are outlined here.

The purpose of this report is fourfold: 1) to present a brief overview of the results of the Systems Change grants awarded from FY 2001 through FY 2004, 2) to describe the remaining challenges to community living that Grantees identified, 3) to provide Grantees’ recommendations for actions needed at the state and federal level to further improve their long-term care systems, and 4) to discuss the key lessons learned regarding factors that are needed to improve states’ long-term care systems.

CMS awarded the fourth round of 3-year grants for RCSC in Sept 2004. Three categories of grants were awarded: Research and Demonstration grants (40), Technical Assistance grants (10), and Feasibility Study and Development grants (2). This report focuses on the outcomes and Enduring Systems Improvements in Housing, Comprehensive Systems Reform, Mental Health Systems Transformation, Quality, Rebalancing, and Family to Family Grantees.

One goal of long-term care policy is to increase the use of HCBS and to reduce reliance on institutional care. The use of nursing homes as measured by the number of residents in facilities on a single day has declined over the past two decades. Despite the centrality of this issue for balancing efforts, there has been no systematic effort to examine the reasons. This report begins to fill the gap by conducting descriptive analyses of factors. In most cases, analyses were to extend to 2007.

Annual survey of all 50 States finds that during this time of recession the number of people on Medicaid is greatly increasing, as is the amount of money being spent on the program by individual States. Despite federal assistance from the American Recovery and Reinvestment Act (ARRA), this leads to further strain on already tight State budgets. This trend is expected to continue & States should be expecting a predicted increase of 6.3% on Medicaid spending in the 2010 fiscal year.

States increasingly require criminal background checks for home care workers to protect vulnerable adults from harm. While 46 states mandate some type of background check for Medicaid-funded workers, there is no uniform protocol for screening and disqualifying candidates. Developing sound policies and practices is challenging due to costs, database problems & time constraints. The paper offers an up-to-date assessment of practices, policy considerations & research and guidance on moving forward.

The second in a series, this report explores the cross-payer effects of providing Medicaid long-term supports and services on Medicare acute care resource use. Patterns of Medicaid eligibility, as well as resource use under both Medicare and Medicaid, are examined primarily within the context of service use-based groups that can be used to set rates for Medicaid capitation payments for managed long-term care.

This updated resource provides a state-by-state look at wages and wage trends for PHCAs, the second fastest growing occupation in the country, and a key job title within the direct-care workforce. Review wages over a 9-year period. Prepared as a resource guide on wages for advocates and policymakers concerned with the direct-care workforce, the data underscore the problem of low and declining real wages for PHCAs, factors which contribute to workforce.

The Bazelon Center for Mental Health Law issues this call to action to inform advocates, policymakers and the public about the vital role the Supreme Court’s landmark decision plays in enabling people with mental illnesses to benefit from community life. The Olmstead decision is now 10 years old. According to the report, many people with mental illnesses remain segregated in board-and-care homes, nursing facilities and other institutions even though supportive community living is cost-effective.