Cathy Cope Melissa Hulbert Centers for Medicare & Medicaid Services
Download 2.18 Mb.
|
ConclusionBringing about enduring change in any state’s long-term services and supports system is a difficult and complex undertaking that requires the involvement of many public and private entities. As Congress and CMS intended, most states used the grants as catalysts for new initiatives or to expand existing initiatives; many used them to leverage funding for existing state efforts to develop and improve home and community-based services. Despite their many accomplishments and enduring systems improvements, most Grantees described continuing barriers to community living for people of all ages with disabilities. These barriers include insufficient funding for home and community-based services and for infrastructure changes; lack of affordable, accessible housing and transportation; continuing difficulty in recruiting and retaining direct care workers because of low wages and lack of benefits; and outdated or inflexible administrative, statutory, and regulatory provisions. This report provides an overview of 73 Grantees’ initiatives to improve their long-term services and supports systems and the enduring systems improvements they achieved. It includes lessons learned and recommendations that can guide states that are undertaking similar initiatives. As the population ages, increasing the demands on the service system, these Grantees’ efforts will prove invaluable, helping states to provide a greater choice of high-quality participant-directed home and community-based services. These services will enable people of all ages with disabilities or chronic illnesses to live in the most integrated setting consistent with their needs and preferences. Part 1 Community-Integrated Personal Assistance
Report Overview vii Methods viii Organization of This Report viii Enduring Systems Improvements ix Personal Assistance Services and Supports (PASS) ix Money Follows the Person Policies (MFP) ix Self-Directed Services ix Quality Assurance and Improvement ix
Involving Participants and Stakeholders x Specific Recommendations xi Approaches to Bringing about Systems Change xiii Recommendations for Changes in State and Federal Policy xiii
Community-Integrated Personal Assistance Services and Supports Grantees 1 1Section One. Overview 1 Enduring Systems Improvements 1 New Policies to Enable and Support PASS and Self-Directed PASS 2 Increased Options for Self-Directed PASS 2 Increased Access to PASS 3 Improved PASS Quality for Persons with Serious Mental Illness 3 New Methods to Help Participants Recruit and Retain Workers 4 Systems Improvements Beyond the Grant Period 5
Funding Issues 5 Policy Challenges 5 Workforce Issues 6 Lessons Learned and Recommendations 6 Lessons Learned 6 Recommendations 7
Money Follows the Person Grantees 1 2Section One. Overview 1 Enduring Systems Improvements 2 New Assessment and Budgeting Process for Individualized Portable Budgets 2 New MFP Funding Mechanism 2 New Infrastructure/Funding to Support Transition Services and MFP Policy 3 Increased Access to and Funding for HCBS 4 Increased Access to and Funding for Supported Housing 4 New Process to Involve Consumers in Policy Development 4
Lack of Funding for HCBS 5 Lack of Affordable and Accessible Housing 5 Medicaid and State Policies and Practices 6 Lessons Learned and Recommendations 6 Lessons Learned 7 Recommendations 7
Independence Plus Grantees 1 3Section One. Overview 1 Enduring Systems Improvements 2 New Infrastructure for Self-Direction Programs 2 New IP Option in Waiver or State Plan Program(s) 6
Lessons Learned 9 Recommendations 9
Quality Assurance and Quality Improvement in Home and Community-Based Services Grantees 1 4Section One. Overview 1 Enduring Systems Improvements 1 New/Improved Methods to Measure Participant Satisfaction and Other Outcomes 3 New/Improved Provider Standards or Monitoring Tools 5 New/Improved System to Collect, Analyze, and Report Quality Data 5 New/Improved Process or System to Help Ensure Continuous Quality Improvement in Services 6 New/Improved Critical Incident Reporting and/or Remediation Process or System 8 New Methods to Involve Participants in QA/QI Processes and Policy Development 9
Lack of Funding 10 Organizational and Administrative Issues 10 Information Technology and Data Collection Issues 11 Policy and Practice Issues 11 Stakeholder Involvement 11 Lessons Learned and Recommendations 12 Lessons Learned 12 Recommendations 13
Family to Family Health Care Information and Education Center Grantees 1 5Section One. Overview 1 Results 2 Providing Information and Referral Services 3 Developing Informational Materials 3 Providing Education and Training 3 Improving Programs and Informing Policies 4
Policy Issues 5 Services and Supports 6
Feasibility Study and Development Grants 1 6Overview of Respite for Adults and Children Grants 1 Individual Respite for Adults Grant Summaries 3 California 5 New York 7 Ohio 9 Rhode Island 11 Individual Respite for Children Grant Summaries 13 Alabama 15 Arkansas 17 Maryland 19 Michigan 21 Oregon 23 Rhode Island 25 Overview of Community-Based Treatment Alternatives for Children Grants 27 Individual CTAC Grant Summaries 29 Illinois 31 Maryland 33 Massachusetts 35 Mississippi 37 Missouri 39 Texas 40 Exhibits Exhibit 1-1. FY 2003 CPASS Grantees 1 Exhibit 1-2. Enduring Improvements of the CPASS Grantees 1 Exhibit 2-1. FY 2003 MFP Grantees 1 Exhibit 2-2. Enduring Systems Improvements of the MFP Grantees 2 Exhibit 3-1. FY 2003 Independence Plus Grantees 1 Exhibit 3-2. Enduring Systems Improvements of the IP Grantees 2 Exhibit 4-1. FY 2003 QA/QI Grantees 1 Exhibit 4-2. Enduring Systems Improvements of the QA/QI Grantees 2 Exhibit 5-1. FY 2003 Family to Family Grantees 1 Exhibit 6-1. FY 2003 RFA Grantees 1 Exhibit 6-2. FY 2003 RFC Grantees 1 Exhibit 6-3. FY 2003 CTAC Grantees 27 Directory: sites -> nasuad -> files -> hcbs -> files sites -> 587 Return function, r i(X) r i(0) r i(1) r i(2) r i(3) 1 0 2 4 6 Thermal Station, I 2 0 1 5 6 3 0 3 5 6 10 sites -> Glossary for Chapter 1 Algorithm sites -> North Carolina Inclusion Initiative Mapping Where Children with ieps are Being Served Purpose sites -> Northern England’s set-jetting locations sites -> Physical custody of 1033 program property accountibility form statement of Physical Custody: By signing for the below 1033 property I am a Law Enforcement Officer of the aforementioned Law Enforcement Agency sites -> Nstructions for Acquiring Excess Equipment online, through the 1033 Program sites -> Memorandum of agreement files -> Acronyms introduction: The most important fact about acronyms and professional jargon is that it is not necessary for any of this work. In fact Download 2.18 Mb. Share with your friends:
|