Content by Keyword: Community-Based Services

State long-term care (LTC) financing and delivery systems and, in particular, Medicaid funded LTC have long been criticized for being “institutionally biased.” Shifting the balance in publicly-funded long-term care provision away from institutional care (nursing homes, long-term hospitals, intermediate care facilities for the intellectually di

This report describes how frequently various quality requirement elements appear in managed care organization contracts, as well as some similarities and differences in the quality requirements. [139 PDF pages]

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 approache

As of the beginning of 2013, 16 states had Medicaid managed long-term services and supports (MLTSS) plans available, with enrollment being either mandatory or voluntary for target populations that varied by state (e.g., elderly, younger adults with adult-onset disabilities, persons with intellectual or other developmental disabilities). In 13 of t

ASPE is releasing a 2010 update of "Understanding Medicaid Home and Community Services, A Primer". This is an update of the well-received document ASPE released in 2000 to address conflicting understanding and interpretation of Medicaid home and community-based services options. The 2000 "Primer," as it has come to be called, has served as a def

This report analyzes the impact of current federal policies and programs on the growth of community living arrangements and supportive services for people with mental retardation and other developmental disabilities (MR/DD).

The long-term care component of the Health Security Act encompasses six key elements: (1) a new home and community-based services program; (2) improvements in long-term care coverage under Medicaid; (3) private long-term care insurance standards and tax incentives; (4) tax incentives that help individuals with disabilities to work; (5) a demonstra

This report assesses the appeal of the Cash and Counseling demonstration by: (1) estimating the proportions of eligible beneficiaries that participated and comparing the characteristics of participants and nonparticipants; (2) describing beneficiaries' most common reasons for agreeing or declining to participate; and (3) examining whether the demo

This report describes the effects of Cash and Counseling on the caregivers who were providing the most unpaid assistance to adult beneficiaries when those beneficiaries volunteered to participate in the demonstration and completed a baseline telephone interveiw. The caregivers in this analysis — identified by beneficiaries as their primary infor

Although adult day care and adult day health care are increasingly promoted as key community-based services for older persons, little is known about their provision, utilization, or outcomes; this is largely due to a paucity of data. This review examines state approaches to regulating these services, also referred to generically as adult day servi

This report describes the effects of Florida's Cash and Counseling demonstration program, Consumer Directed Care (CDC), on the caregivers who were providing the most unpaid assistance to children when their parents voluntarily enrolled those children in the demonstration. This report follows another one containing earlier findings, which showed t

This report reviews and summarizes the research literature on cost-effectiveness of home and community-based services. [32 PDF pages]

This paper reports the findings of an exploratory study to document and analyze selected best practices related to state-administered home and community-based services (HCBS) programs.

This report examines the issues involved in seeking to address the long-term care service needs of persons with severe mental illness (SMI) in a generic long-term care financing and service delivery system, as was proposed in the home and community-based services provisions of the Health Security Act. SMI, as defined by the Center for Mental Healt

This paper was used as a handout at a workshop, held as a catalyst for DALTCP's major new initiative to study ways to expand consumer choice and empowerment in obtaining personal assistance services. [15 PDF pages]

This publication summarizes the results of a study, conducted by Mathematica Policy Research, Inc., for the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, to examine the availability of and funding for home- and community-based services for people with AIDS. The study, which also helped

Elderly and younger persons with disabilities who require help from others to perform many of the most ordinary activities of daily living are said to require "long-term care." These services, when provided in the home or other non-institutional settings, may be termed personal assistance services, home and community-based services, or in-home sup

This study analyzes how federal policies and programs influenced state policy choices with respect to expanding family and community care. The study presents an in-depth review of six state mental retardation/developmentally disabled service systems (Colorado, Illinois, Michigan, Nebraska, Texas and Virginia). Data collection and analysis emphasiz

The project examined how states have used Medicaid's Personal Care Services Optional Benefit (also called the PC Option), assessed whether coverage regulations for these services be revised, and discussed the ways in which the program might affect public debate about the expansion of public funding for long-term care. The project entailed reviewin

In 1985 there were about 5.5 million functionally disabled elderly persons (65+) in the United States (U.S.) living in the community and an additional 1.3 million in nursing homes. By 2020, these figures are expected to almost double to 10.1 million and 2.5 million respectively. The long-term care (LTC) system in the U.S. is large and complex.