Aging and Disabilities

The federal government has launched a new initiative designed to change how states deliver services in one of the most costly areas of Medicaid: long-term care.

One in four Medicare dollars goes to care for individuals in the last year of their life. The Dartmouth Atlas Project has just released a new study looking at end-of-life medical care. The study found that there are lessons to be learned by looking at geographical differences.

In 2003, 32.2 percent of patients died in a hospital but by 2007, the rate had dropped to 28.1 percent. The rates vary greatly by geography: In 2007, the highest rates of death in a hospital were in regions in and around New York City, including...

This Act provides a mechanism to enable patients with the ability to acquire lower cost drugs through the Veterans‘ Administration to access those drugs if those patients reside in a different long-term care facility. This means permitting the pharmacy within the long-term care facility or which has a contract with the long-term care facility to receive the lower cost drugs directly from the Veterans‘ Administration Drug Benefit Program in the patient's name and repackage and re-label those drugs so they may be dispensed in unit doses to the patient.

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.

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