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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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Developing Individual Budgets and Reimbursement Levels Using the Supports Intensity Scale

This report describes recent progress in moving state developmental disability systems using HCBS 1915 (c) waivers toward greater efficiency and equity, in the context of pressing issues in the field. It is important to note that these initiatives could be equally well applied to other Medicaid waiver populations.

Short URL: http://www.advancingstates.org/node/51930

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Implementing Self-Direction Programs with Flexible Individual Budgets: Lessons Learned from the Cash & Counseling Replication States

Twelve states received Cash & Counseling Replication grants in October 2004. Here, the Replication States’ experiences in developing and implementing their new programs are documented in three stages: planning; design/development; and implementation/enrollment. The appendix includes summaries of the states' grant initiatives.

Short URL: http://www.advancingstates.org/node/51903

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The Role of Section 1115 Waivers in Medicaid and CHIP: Looking Back and Looking Forward

For many years, Section 1115 waivers have been used in the Medicaid program and the Children’s Health Insurance Program, to provide states an avenue to test and implement coverage approaches that do not meet federal program rules. While these waivers have facilitated important program evolutions over time, some have also raised issues. This brief reviews the experience of Section 1115 Medicaid and CHIP waivers and discusses issues for the Obama administration to consider for the future.

Short URL: http://www.advancingstates.org/node/51898


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