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Beyond Cash & Counseling: An Inventory of Individual Budget-based Community Long-Term Care Programs

This brief describes the evolution of beneficiary-managed home and community-based services since the original demonstration and provides an overview of state activity as of January 2006. The Deficit Reduction Act of 2005 gives states the option to use this model for an expanded range of home and community based services in their state Medicaid plans without having to obtain a waiver.

Short URL: http://www.advancingstates.org/node/52138

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Medicaid HCBS Waiver Expenditures FY 2003 through FY 2008

This report and tables present Medicaid 1915(c) Home and Community-Based Services (HCBS) Waiver expenditures data from Federal Fiscal Years 2003 through 2008. Each HCBS waiver is classified by population served in order to show the distribution of expenditures across long-term care populations. This report includes new target population categories to identify waivers that target particular developmental disabilities such as intellectual disabilities and autism spectrum disorders.

Short URL: http://www.advancingstates.org/node/52133

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Medicaid Home and Community-Based Service Programs: Data Update

Developing HCBS alternatives to institutional care has been a priority for many state Medicaid programs over the last three decades. While the majority of long-term care dollars still go toward institutional care, the national percentage of spending on HCBS has more than doubled from 19 percent in 1995 to 41 percent in 2007. This article presents a summary of the main trends to emerge from the latest (2006) expenditures and participant data for the three main Medicaid HCBS programs.

Short URL: http://www.advancingstates.org/node/52110

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Consumer Satisfaction with Self-Direction West Virginia Personal Options

Interested in how self-directed options in the 1915(c) Medicaid Aged and Disabled Waiver program are succeeding? In June of 2008 PPL, a nationwide company that provides financial management and supports for self-directed programs, conducted a survey of all 241 participants enrolled in Personal Options for the West Virginia Bureau for Medical Services. The attached report, includes results and summary.

Short URL: http://www.advancingstates.org/node/52105

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Rebalancing Long-Term Care Systems: State Case Studies-Final Case Studies

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.

Short URL: http://www.advancingstates.org/node/52097

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CMS State Medicaid Directors Letter: Implementation of section 6087 of DRA - Section 1915(j)

Guidance is offered on the implementation of section 6087 of the Deficit Reduction Act of 2005 (DRA) Public Law Number 109-171. Section 6087, the “Optional Choice of Self-Directed Personal Assistance Services (PAS) (Cash and Counseling)” amended section 1915 of the Social Security Act by adding subsection (j). Guidance also applies to section 1915(c) HCBS waiver programs when states offer the self-direction opportunity and permit participants to purchase “individual directed goods and services.”

Short URL: http://www.advancingstates.org/node/52092

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HCBSselfdirection.org Technical Assistance Website

Unsure about how to best design and implement HCBS programs? This site provides technical assistance to states that may need assistance in determining which Home & Community Service authority best meet their needs, as well as assisting them in developing, evaluating and maintaing HCBS waiver programs. HCBSselfdirection.org is intended to assist state HCBS program administrators, their staff and contractors, and other state agencies involved with developing HCBS programs.

Short URL: http://www.advancingstates.org/node/52088

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Advancing Access to Medicaid Home and Community-Based Services: Key Issues Based on a Working Group Discussion with Medicaid Experts

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.

Short URL: http://www.advancingstates.org/node/52050

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Reassessing the Impact of Managed Care in the Developmental Disabilities Sector

Are we on the brink of a revival of interest in managed long-term care for people with intellectual and developmental disabilities? Four states’ experiences in experimenting with managed care are examined here, along with stakeholders’ views on these efforts. The report looks at goals, methodologies, and similarities and differences between programs. It concludes by looking at implications for other states.

Short URL: http://www.advancingstates.org/node/51960


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