Reports

This brief summarizes lessons in offering more home and community-based services from states at the forefront of the effort. It describes current options for state Medicaid programs and draws on interviews with state officials to provide details about specific policies and procedures in states.

This brief highlights key strategies to address financing, program administration and community workforce challenges that key experts, federal and state officials and advocates believe must be overcome to expand access to home and community-based services (HCBS). Among the key ideas drawn from a working group discussion at the Foundation are the benefits of providing additional federal financing to states to provide Medicaid HCBS and to administer these benefits.

Developed with aging and transportation professionals in mind, this paper provides an overview of the challenges and opportunities involved in senior transportation. Addressing the need to increase public knowledge about options for older people, promising practices in coordination, cooperation, integration, volunteer programs, financing, and using technology to improve services are addressed. The paper also provides an extensive list of annotated references.

The Medicaid Buy-In program is a key component of the federal effort to make it easier for people with disabilities to work without losing health benefits. This issue brief, the ninth in a series on workers with disabilities, examines the prevalence and characteristics of Medicaid Buy-In participants who leave the program as well as their participation status in other public programs and their employment outcomes after disenrollment.

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.