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
The Home Health Aide Partnering Collaborative is a quality improvement project developed and implemented at the Visiting Nurse Service of New York. The primary purpose of the Collaborative was to enhance the quality of work life for home health aides while improving outcomes for home health patients. This Implementation Manual emerged out of the l
The purpose of this evaluation was to assess the impact of the "Home Health Aide (HHA) Partnering Collaborative" a quality improvement initiative implemented at the Visiting Nurse Service of New York in three main areas: (1) patient outcomes; (2) patient service use; and (3) aide job perceptions and retention. The Collaborative was des
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 brief describes the key components of the HHA Partnering Collaborative model, implementation challenges and successes, and the results and implications from the evaluation. [9 PDF pages]
This report provides a brief overview of the limited research on adult day services conducted to date. It presents an overview of state approaches to regulating adult day services for elderly persons. Findings from site visits to adult day service providers in five state, and providers' and stakeholders' views on regulatory issues in their states
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
The purpose of this paper is to demonstrate the variability in estimates of disability in the U.S. elderly population as a function of differing definitions of physical disability and cognitive impairment. Differing cut-off points along the disability continuum are employed, in conjunction with the varied definitions of disability, in order to dem
An Examination of Issues Related to How HCBS Programs Operate Within Fixed Budgets and to the Administrative Linkages Between Eligibility Determination, Needs Assessment and Care Planning Functions
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]
In-Home Supportive Services for the Elderly and Disabled: A Comparison of Client-Directed and Professional Management Models of Services Delivery--Non-Technical Summary Report
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
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.
The purpose of the synthesis paper is to review, summarize, and discuss the significance of available research findings on the frontline long-term care (LTC) workforce since 1999, in both home and community-based and nursing home settings. This paper provides an updated review of the status of empirical findings, focusing on what has been learned
"Consumer-direction" is a philosophy and orientation to the delivery of home and community-based long-term care that puts informed consumers and their families in the driver's seat with respect to making choices about how best to meet their disability-related supportive service needs.
This paper examines the current state of nurse practice acts and their implementing regulations to determine the extent to which they permit more consumer direction in home and community based services. This analysis may be helpful to consumers and states that are seeking ways to balance better state policies to support consumer-directed care. [38
Update of ASPE Activities Related to Community-Integration Executive Order for People with Disabilities
President Bush signed Executive Order 13217 on June 18, 2001, "to place qualified individuals with disabilities in community settings whenever appropriate...so as to ensure that all Americans have the opportunity to live close to their families and friends, to live more independently, to engage in productive employment, and to participate in commu
U.S. Department of Health and Human Services HIGHLIGHTS: Inventory of Consumer-Directed Support Programs Pamela DotyU.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation Susan FlanaganEP&P Consulting, Inc. 2002 PDF Version: http://aspe.hhs.gov/daltcp/reports/2002/highlght.pdf
U.S. Department of Health and Human Services Consumer Directed Care and Nurse Practice Acts Susan C. Reinhard, RN, PhD Center for State Health Policy, Rutgers University June 2001 PDF Version: http://aspe.hhs.gov/daltcp/reports/2001/nursprac.pdf (38 PDF pages)