Community-Based Services

A Compendium of HHS Technical Assistance Activities Related to the Administration's Community-Integration Initiative

U.S. Department of Health and Human Services A Compendium of HHS Technical Assistance Activities Related to the Administrations Community- Integration Initiative The New Freedom Initiative Workgroup March 21, 2002 (Revised May 6, 2002) PDF Version: http://aspe.hhs.gov/daltcp/reports/2002/Citarpt.pdf (90 PDF pages)

Citarpt.pdf
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Assessing the Need for a National Disability Survey: Final Report. C. Limitations of Existing Data on Disability

Although extensive information pertaining to disability is collected through national surveys and program administrative data, the existing sources of data on disability have a number of shortcomings that limit their usefulness. Gaps and limitations of available disability-related data were identified by the staff of the state and federal agencies

Assessing the Need for a National Disability Survey: Final Report

This is the final report of a project that assesses the need for developing and fielding another national disability survey data collection effort. It presents the findings from three principal project activities designed to assess whether existing data are sufficient to answer key disability-related research questions identified by the staffs of

NatlDS.pdf
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3.3. Some Supportive Housing Models Serve All

Health, Housing, and Service Supports for Three Groups of People Experiencing Chronic Homelessness. 3.3. Some Supportive Housing Models Serve All Three Groups of People

In many communities, some PSH serves all three groups of chronically homeless people--whether or not people are eligible for or enrolled in Medicaid, and whether or not people have a SMI that makes them eligible to receive specialized mental health services. Before we describe the types of housing and services most often available to members of ea

Health, Housing, and Service Supports for Three Groups of People Experiencing Chronic Homelessness

This Issue Paper describes three subgroups of the people experiencing chronic homelessness, and the services and housing configurations currently supporting them.

ChrHomls1.pdf
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Medicaid Financing for Services in Supportive Housing for Chronically Homeless People: Current Practices and Opportunities. Notes

The Kaiser Commission on Medicaid and the Uninsured has published Medicaid: a Primer which explains key information about the Medicaid program. This publication, available at http://www.kff.org/medicaid/upload/7334-04.pdf provides clear explanations about Medicaid for readers who want more information about mandatory and optional benefits,

7.1. How Does Managed Care Deliver Services

Medicaid Financing for Services in Supportive Housing for Chronically Homeless People: Current Practices and Opportunities. 7.1. How Does Managed Care Deliver Services Linked to Permanent Supportive Housing

Capitated financing and the quality or performance standards included in many managed care contracts change the financial incentives for health care providers. If reimbursement is no longer provided on a FFS basis for hospitalizations and emergency room visits, this creates incentives for the MCO or the network of health care providers under contr

6.6. Looking Ahead to 2014: How is Home and

Medicaid Financing for Services in Supportive Housing for Chronically Homeless People: Current Practices and Opportunities. 6.6. Looking Ahead to 2014: How is Home and Community-Based Services Likely to Change?

A number of provisions in the ACA provide new or expanded opportunities for states to use Medicaid to finance HCBS for people with disabilities, including enhanced Medicaid matching payments, demonstrations, and new state plan options. 38 States may be able to develop more unified or consistent approaches to creating and financing services in p

6.5. Challenges, Obstacles, and Limitations of

Medicaid Financing for Services in Supportive Housing for Chronically Homeless People: Current Practices and Opportunities. 6.5. Challenges, Obstacles, and Limitations of Home and Community-Based Services

While it would appear that state efforts to enable people with disabilities to live in non-institutional, community-based settings should align with efforts to use PSH to end homelessness for people with poor health and high levels of disability, often that is not the case. 6.5.1. Separate Service-Providers, Advocates, and Government Organiza

6.4. How Can Home and Community-Based Services be

Medicaid Financing for Services in Supportive Housing for Chronically Homeless People: Current Practices and Opportunities. 6.4. How Can Home and Community-Based Services be Provided to Permanent Supportive Housing Residents?

For the most part, people living in institutional settings are not homeless, although a growing number of older and vulnerable homeless adults are entering nursing homes or other long-term care facilities, often after a period of inpatient hospitalization for an acute medical and/or psychiatric crisis.

6.3. Who is Eligible for Home and Community-Based

Medicaid Financing for Services in Supportive Housing for Chronically Homeless People: Current Practices and Opportunities. 6.3. Who is Eligible for Home and Community-Based Services

In PSH for chronically homeless people it is likely that some tenants meet clinical needs-based eligibility criteria for HCBS, while other tenants who are less disabled may not be eligible to receive these services.

6.2. Home and Community-Based Services Option/

Medicaid Financing for Services in Supportive Housing for Chronically Homeless People: Current Practices and Opportunities. 6.2. Home and Community-Based Services Option/State Plan (1915i) Services

Recent changes in federal law 30 allow states to provide HCBS services, without a waiver, as optional benefits by making a Medicaid SPA. The purpose of 1915i is to expand access to HCBS to persons with disabilities who are not at an institutional level of care. Therefore, states that want to add this optional benefit must establish needs-based

6.1. Home and Community-Based Services (1915c)

Medicaid Financing for Services in Supportive Housing for Chronically Homeless People: Current Practices and Opportunities. 6.1. Home and Community-Based Services (1915c) Waiver Services

States may operate several different HCBS 1915c waiver programs, each designed to target different groups of people based on age, diagnosis, or condition. States may also receive a waiver of Medicaids statewideness requirements and offer some HCBS waiver services in a particular jurisdiction or region of the state or operate statewide but se

Medicaid Financing for Services in Supportive Housing for Chronically Homeless People: Current Practices and Opportunities. 6. Home and Community-based Services

Medicaid-covered HCBS may be available under an HCBS waiver (1915c) or they may be optional HCBS services covered without a waiver under a Medicaid SPA (1915i). HCBS are intended to offer alternatives to institutional care for people with disabling health conditions.

Medicaid Financing for Services in Supportive Housing for Chronically Homeless People: Current Practices and Opportunities. 1.6. The Rest of This Paper

Based on the results of site visits and telephone interviews conducted in early 2011, 12 this paper describes several different service approaches and financing mechanisms that have already been implemented or are in development to provide Medicaid reimbursement for services for chronically homeless people and residents of PSH. The remaining

Medicaid Financing for Services in Supportive Housing for Chronically Homeless People: Current Practices and Opportunities. 1.2. Who is Eligible for Medicaid?

Until the ACA is fully implemented in 2014, Medicaid eligibility is based on income and also is categorical. Only some income-eligible people are in eligible categories defined by age, disability, or eligibility for another program. Among chronically homeless people, Medicaid eligibility is usually dependent on having a disability that makes t

Medicaid Financing for Services in Supportive Housing for Chronically Homeless People: Current Practices and Opportunities. Highlights

This paper describes the specific ways in which Medicaid reimbursement is being used for some of the services provided to chronically homeless people, including services that address their health and behavioral health needs and help vulnerable people get and keep stable housing. States have used different types of Medicaid benefits and payment mec

Medicaid Financing for Services in Supportive Housing for Chronically Homeless People: Current Practices and Opportunities

This Issue Paper describes the ways that Medicaid is being used now and might be used in the future under provisions of the Affordable Care Act of 2010 to serve chronically homeless people. [67 PDF pages]

ChrHomls2.pdf
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Design of a Demonstration of Coordinated Housing, Health and Long-Term Care Services and Supports for Low-Income Older Adults. I. Overview

In 2011, as the baby boomers begin to reach age of 65, their preference to remain as independent for as long as possible and to age in their communities underpins the conceptual framework for housing with services for older adults presented here. Consistent with the U.S.

Design of a Demonstration of Coordinated Housing, Health and Long-Term Care Services and Supports for Low-Income Older Adults

This conceptual framework examines the possible ways that housing sites can link health and long-term services and supports, and potential ways that HUD and HHS could design a demonstration of such a model. [31 PDF pages]

lioaDemo.pdf
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