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Fiscal Challenges to a Strong Home and Community-Based Long-Term Care System: Oregon’s Fight to Maintain Leadership

In order for Oregon to balance its two-year budget for 2001-03, the Seniors and People with Disabilities Division (SPD) in the Department of Human Services was mandated to reduce LTC spending by nearly 30%. This paper analyzes the 2003 cuts to Oregon’s Medicaid long-term care (LTC) system, the impact of those cuts on a well-developed home and community-based services (HCBS) system, how the state has responded, and lessons that could be learned from its response.

Short URL: http://www.advancingstates.org/node/51601

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Issue Brief: A Survey of Medicaid Brain Injury Programs

In late 2007, the Center for State Health Policy surveyed 23 states that operate Medicaid waivers targeted to individuals with brain injuries. Data was obtained about the cost and number of individuals served by these waivers for the waiver years 2002 through 2006. Three states began waivers for those with brain injuries in 2002 or later, and 3 other states discontinued waivers in 2006. Every state except Arizona has multiple Medicaid 1915(c) home and community-based services (HCBS) waivers.

Short URL: http://www.advancingstates.org/node/51559

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Compendium of Home Modification and Assistive Technology Policy and Practice Across the States

The purpose of this compendium is to establish baseline knowledge of the scope of assistive technology and home modification services that states make available to Medicaid-eligible adults. This study provides federal and state policymakers with basic information to inform planning and policy development. It also provides other stakeholders, including consumers, with valuable information about Medicaid State Plan and HCBS waiver.

Short URL: http://www.advancingstates.org/node/51557

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1915(c) Waiver Application - The web-based application

Launched on November 17, 2006, this website assists states in applying for their waiver. The site offers training materials, a migration protocol, a copy of the application, and a technical guide. Many questions can be answered in the FAQ section. The application can be downloaded as an html file in order to save your work. States can also allow CMS to view a draft before submitting a final copy.

Short URL: http://www.advancingstates.org/node/51510

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Medicaid HCBS Waiver Expenditures FY 2001 through FY 2006

This memorandum and tables present data on Medicaid 1915(c) Home and Community-Based Services (HCBS) waiver expenditures from Federal Fiscal Years 2001 through 2006. Each HCBS waiver is classified by population served in order to show the distribution of HCBS waiver expenditures across long term care populations. This year's memo also identifies which waivers exclusively serve children.

Short URL: http://www.advancingstates.org/node/51377

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Promising Practices in HCBS: South Carolina - Home Modifications Specialist

South Carolina hired an environmental modifications specialist to improve the quality of home modifications funded by its Medicaid HCBS waivers. The specialist trains case managers to develop specifications for ramps, and develops specifications for other home modifications so contractors can quickly make an informed bid. South Carolina also leveraged a state-funded home modification program to expand the types of modifications available in its waivers.

Short URL: http://www.advancingstates.org/node/51300

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2007 CMS New Freedom Initiative Conference: Access to Community Living: Promoting Independence and Choice

The 7th CMS New Freedom Initiative Conference was held March 5-7 in Baltimore. Presentations are available in both PDF and text formats. “Choice and Independence” is a key pillar of CMS’ vision for a person-centered long term services and supports system for the future. The 2007 conference focused on the policies, programs, and tools -including opportunities authorized by the Deficit Reduction Act– available to shape and carry out the vision.

Short URL: http://www.advancingstates.org/node/51199

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Quality Close to Home: A Preliminary Design for an Integrated Quality Management System

The “Quality Close to Home” papers are part of Wisconsin’s process to review the existing quality management system for Home and Community Based Services. The report on local practices was the result of a series of interviews conducted with local informants who conduct quality management activities. The second paper outlines the scope of quality management, challenges of quality management, federal rules and regulations, and provides a design for an improved quality management system.

Short URL: http://www.advancingstates.org/node/51186

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Assessing Utah\'s Long-term Care System

These reports are reviews of Utah’s long–term care system and waiver programs and provide recommendations for change. The Focus Group Findings focused on non-institutionalized and community based settings. The Long-Term Care paper provides more generalized findings about the structure of Utah’s long-term care system and how to transition forward based on input from stakeholders and administrators, comparisons to other states, and review of current documents and policy.

Short URL: http://www.advancingstates.org/node/51146


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