Physical Disabilities

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Medicaid Home and Community-Based Services: Selected States' Program Structures and Challenges Providing Services

State Medicaid programs are increasingly opting to cover home and community-based services. This report looks at the efforts of various state Medicaid programs, examines their structure, and highlights the challenges encountered. From this review, GAO highlights three main challenges: 1) difficulty recruiting and retaining home care workers, 2) difficulty serving those with complex needs and, 3) limited funding for HCBS services.

Short URL: http://www.advancingstates.org/node/70785

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States Expand Employment and Training Opportunities for People with Disabilities

This recently released white paper explains the barriers to employment faced by people with disabilities and highlights areas where governors can help people with disabilities overcome the challenges they may face in seeking employment. The strategies in this paper were developed following a learning lab meeting with states to discuss ways to take advantage of pools of untapped talent and ensure that workforce development and hiring policies are inclusive of people with disabilities.

Short URL: http://www.advancingstates.org/node/70777

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Achieving Value in Medicaid Home- and Community-Based Care: Considerations for Managed Long-Term Services and Supports Programs

Medicaid value-based payment (VBP) models tie payment to outcomes including quality of care, health status, and costs. This guide outlines considerations for adopting value-based payment (VBP) to promote high-quality MLTSS programs. It combines insights from five states - Minnesota, New York, Tennessee, Texas, and Virginia - with input from national health policy experts.

Short URL: http://www.advancingstates.org/node/70745

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Prevalence of Disabilities and Health Care Access by Disability Status and Type Among Adults — United States, 2016

The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing state-based, random-digit-dialed telephone survey of noninstitutionalized U.S. adults. The 2016 BRFSS survey included questions about six disability types; hearing, vision, cognition, mobility, self-care, and independent living. One in four (61 million) U.S. adults reported a disability. Disability-specific disparities in health care access were prevalent, particularly among young and middle-aged adults.

Short URL: http://www.advancingstates.org/node/70683

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Exploring the Growth of Medicaid Managed Care

This report presents information on managed care’s enrollment and spending. It explores the growth of enrollment in Medicaid Managed Care in the United States and the contributing factors. It also analyzes the fact that funding does not directly parallel enrollment, as the share of total Medicaid spending that went to managed care only grew from 15 percent to 37 percent between 1999 and 2012, despite enrollment growing from 63 percent to 89 percent during that same time period.

Short URL: http://www.advancingstates.org/node/70681

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Employing People with Disabilities: Lessons from Kessler Foundation’s Signature Employment Grants

This paper examines the success of grants given to initiatives that address the employment gap between people with and without disabilities. Independent evaluations identified five elements which were common to successful projects, namely, 1) A focus on changing attitudes about people with disabilities and their ability to work, 2) A person-centered approach to employment, 3) Technological platforms or model documentation, 4) Strong community partnerships, and 5) Wraparound services.

Short URL: http://www.advancingstates.org/node/70602

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Managed Long-Term Services and Supports: Status of State Adoption and Areas of Program Evolution

This chapter is part of MACPAC's June 2018 Report to Congress on Medicaid and CHIP. It reports on the trend of states using managed long-term services and supports (MLTSS). The chapter discusses program outcomes, the added complexity of long-term services and supports in Medicaid managed care, and different directions being explored in MLTSS. It also identifies issues for further examination.

Short URL: http://www.advancingstates.org/node/70555

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State Vocational Rehabilitation Agencies’ Early Implementation Experiences with Pre-Employment Transition Services

This report is one of three reports released around the same time from Mathematica Policy Research focusing on how transition services are being used for youth with disabilities. This report examines states' experiences with a new mandate requiring them to provide pre-employment transition services available to all students with disabilities.

Short URL: http://www.advancingstates.org/node/70540

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