Diversity is a hallmark of the state-federal Medicaid program. The saying goes: "If you've seen one Medicaid program, you've seen one Medicaid program." In terms of MLTSS quality, the same holds true to a large extent. CMS has always accorded states discretion in the design and operation of their Medicaid programs, including quality monitoring, as
This report explores how several states have designed their quality monitoring and improvement programs for managed long-term services and supports (MLTSS). The authors focus on the early adopters of MLTSS as well as those programs that are presented considered "established". The findings demonstrate how states take somewhat different approaches
Cook JA, Terrell S, JonikasJA. 2004. Promoting Self-Determination for Individuals with Psychiatric Disabilities through Self-Directed Services: A Look at Federal, State and Public Systems as Sources of Cash-Outs and Other Fiscal Expansion Opportunities . Rockville, MD: Substance Abuse and Mental Health Services Administration.
This report describes the different strategies that four states--Louisiana, North Carolina, Tennessee and Vermont--are utilizing to improve the integration and coordination of care for individuals with mental health and substance use disorders. These strategies include introducing new managed care arrangements and care coordination mechanisms, enh
Adler, D., T. McLaughlin, W. Rogers, H. Chang, L. Lapitsky, & D. Lerner. "Job Deficits Due to Depression." American Journal of Psychiatry , 2006, pp.1569-1576.
Altarum Institute. "Analysis of Affordable Care Act in Relation to the Employment of Persons with Disabilities."Ann Arbor, MI: Altarum Institute, 2010a.
Issue: Should kin foster parents receive the same level of financial support for the care of foster children as is provided to non-kin foster parents? Should such support be available only while the child remains in State custody, or should it continue if the child is discharged to the relative’s legal custody?
The quantitative data sources used in this memorandum include the Medicare Enrollment Data Base (EDB) and claims data, HUD tenant and property-level data, and SASH program participant files. Medicare claims are quarterly observations of payments and health care utilization from January 2006 through June 2013. Medicare claims data are also used to
PSH is a phenomenon of the 1990s and 2000s, when homelessness assistance systems evolved and their goals shifted and changed. PSH beds available to end people's homelessness went from about zero in the late 1980s to estimates of 114,000 beds in fall 1996 (Burt et al. 1999), about 188,000 beds in January 2007, and 284,298 beds in January 2013 (H
In states that have expanded Medicaid eligibility under the provisions of the Affordable Care Act, a significant number of adults who are eligible because their incomes are low enough to qualify (up to 133 percent of the federal poverty level) are likely to have substance use disorders. The Affordable Care Act includes services for substance use d
In Minnesota, a 2010 state law authorized the Department of Human Services to develop a Medicaid demonstration project to test alternative and innovative health care delivery systems, including Accountable Care Organizations. That year a state law also authorized Hennepin County to establish a pilot program to provide a health delivery network for
Louisiana has undertaken a multiyear, comprehensive redesign of its public behavioral health system for children and adults. The redesign has required numerous waivers and state plan amendments, some of which are still to come. Completion of the redesign's components is not expected until 2015 or 2016. Known as the Louisiana Behavioral Health Part
The District of Columbia Department of Mental Health (DMH) has made a considerable investment in service expansion, including adding many housing units and other services for its clients who are homeless. Earlier parts of this chapter described the agency's investments in housing and expansion of Assertive Community Treatment services.
Many issues related to payment surfaced during the case studies. These related mainly to what aspects of the supports needed by people experiencing chronic homelessness and PSH tenants the Medicaid arrangements available during the study period (2010-2012) would and would not pay for. However, providers also described issues with respect to the me