Aging and Disabilities

All but two states maintained or improved eligibility rules for their Medicaid and Children’s Health Insurance Program, commonly known as CHIP, in 2010.These programs continued to be critical to providing insurance coverage for children and families that otherwise would be uninsured. The median state income limit for children’s coverage is now above 200 percent of the FPL, and pregnant women are eligible up to a median of 185% FPL. However, the median income limit for adult coverage is significantly below the higher eligibility level of 133% FPL that will be implemented under health reform in 2014.

This Act enables doctors to report to the state department of motor vehicles patients who have physical or mental conditions which impair the patients‘ driving skills.

Changes in state policy are helping Ohio rebalance its long-term-care system in a way that expands choices for consumers and results in cost savings.

The majority of state Medicaid programs are testing models of coordinated medical care to improve quality and reduce costs, particularly for patients with multiple chronic illnesses.  Patient-centered medical homes are similar to managed care approaches and health maintenance organizations, but ask providers to focus on improving care rather than managing costs. Such medical homes focus on improving the relationship between doctors and patients, aim to put the patient at the center of the care system, and provide coordinated and integrated care over time and across care settings. Descriptions of eleven states’ pilot programs or authorizing legislation are included.

One New Hampshire woman had been caring for her husband with Alzheimer's disease for two years. Devoted to his needs, she couldn’t leave the house. That meant she couldn’t go to her book club two nights a week.  What seemed like such a small thing was actually a key step in keeping her emotionally and mentally healthy, and avoiding burnout—a high risk for family members who become caregivers of sickly or elderly patients.

As President Obama welcomed activists from across the country to the White House to celebrate the 20th anniversary of the Americans with Disabilities Act (ADA), similar scenes played out in state capitols across the country with governors and state legislative leaders marking this important anniversary. However, for the 54 million Americans living with a disability, the future of the programs and services they depend on to live, learn, and earn is deeply tied to a host of tough budget choices and Byzantine program requirements faced by policymakers in the state house as well as the White House.

On the 20th anniversary of the Americans with Disabilities, CSG released a comprehensive survey of state policy related to disabilities, featuring nearly 149 different entries from 31 states, in an effort to help spread awareness of these programs from across the nation.  Challenges and issues facing disability are numerous.  State and federal governments continue to struggle developing policies surrounding housing, employment, and independent living.  This document seeks to provide policymakers with information on policies that they can pursue in their own states.

Millions of Americans have Alzheimer's disease and the number is growing as the population ages.  Large numbers of  persons with Alzheimer's disease in nursing homes present care-giving challenges, as well as state financing issues.

Suggested State Legislation: According to the Alzheimer’s Association, Physician Orders For Life-Sustaining Treatment (POLST) are forms people complete with their doctor for the purpose of clearly defining which medical treatments are to be given to them at the end of their lives. At least eight states currently recognize POLST forms, including California, Idaho, New York, North Carolina, Oregon, Tennessee, Washington and West Virginia. Although the names may differ slightly by state (such as Idaho’s POST program), the forms are essentially the same.

Suggested State Legislation: This Act establishes procedures for determining where jurisdiction lies in guardianship and conservatorship proceedings when the parties are not all in the same state.

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