State Medicaid health maintenance organization policies and special-needs children.

Little research has been done to ascertain what enrollment in a health maintenance organization (HMO) may mean for the care of Medicaid recipients who regularly require specialty health services. This article presents the results of a survey of all State Medicaid agencies regarding their policies for enrolling and serving special-needs children in HMOs. The survey revealed that many States have implemented one or more strategies to protect special-needs Medicaid recipients enrolled in HMOs. The survey results suggest, however, that such strategies are too limited in scope to ensure appropriate access to specialty services for all children with special health needs

Trends and issues in the Medicaid 1915(c) waiver program.

Over the past 15 years, Medicaid 1915(c) home and community-based waivers have made a substantial contribution to States' efforts to transform their long-term care (LTC) systems from largely institutional to community-based systems. By 1997, every State had implemented a waiver program for at least some subgroups of individuals with disabilities, and expenditures increased from $3.8 million in 1982 to more than$8.1 billion in 1997. Emerging, as well as long-standing, policy issues related to the waiver program include concerns with access, variation in availability by disability group, State decisions related to the provision of community-based LTC, and evidence on effectiveness

The Chelsea Foyer at the Christopher at Five Years: Lessons in Developing Stable Housing and Self-Sufficiency For Homeless Youth and Youth Exiting Foster Care

The Chelsea Foyer at the Christopher is a transitional housing program for youth aging out of foster care and youth who are homeless or at risk of becoming homeless. Launched in 2004 as partnership between Common Ground Community and Good Shepherd Services, the Chelsea Foyer at the Christopher has served 165 young people between the ages of 18-25, providing up to two years of transitional housing in conjunction with a rigorous, developmentally-appropriate program designed to prepare young people for self-sufficiency upon discharge.When the Chelsea Foyer at the Christopher was launched in 2004 the needs of this population were beginning to be recognized. Now, the 18-to-25-year range is increasingly understood as an important developmental stage in which young people who have experienced great challenges can be positioned for lifetime employment and self-sufficiency instead of reliance of public assistance and chronic risk of homelessness. Programs across the country are exploring new housing models and best practices to address the problem of youth homelessness. However, this national conversation requires Federal participation and a national policy on youth is needed to elevate public understanding of this issue and underscore the benefits and cost savings of addressing the needs of these young people so they can lead productive, independent lives.This report aims to provide perspectives to facilitate this conversation. A general overview of lessons learned is offered in the final section -- Section V. The history of the development of the Chelsea Foyer at the Christopher, financing of the building and lessons on use of space and partnership development can be found in Section I. The program and practice lessons on working with this population are described in Section II. Funding and costs for the program are outlined in Section III. A review of current data is presented in section IV

Medicaid 1915(c) home and community-based services waivers across the states.

This article provides State-level data on the Medicaid 1915(c) home and community-based services (HCBS) waivers program. Medicaid 1915(c) waiver participants were 32 percent of the Medicaid participants in institutional care in 1997. These data document wide interstate variation in organizational oversight and program policies for the waivers. Many structural barriers to HCBS waiver growth existed. Case management services, in some form, were normative for most HCBS waiver participants, but formal mechanisms to assess client satisfaction and service quality were less common. Substantial new growth in this program may require fundamental changes in HCBS waiver policies

Two Alternative Yet Complementary Conceptual Frameworks for Financing American Education

Outlines strategies to integrate systemic performance-based reform, which assumes that improving the school system will help all students meet standards, and out-of-school interventions, which attempts to mitigate the effects of poverty and other factors

The Therapist Can\u27t See You Now: How Paid Sick Leave Policy Can Accommodate Mental Illness in the Workplace

Restaurants have become the “poster child” for why employers should adopt paid sick leave. Advocates suggest that employees without access to paid sick leave often show up to work ill due to their inability to sacrifice pay. Clever protest signs read, “No Boogers in my Burger” and “No Coughing in my Coffee.” Any rational customer would not appreciate the thought of a flu-ridden chef assembling their main course. However, the benefits of paid leave legislation and policies go beyond protecting cheeseburgers from flu germs. Just as employees with the flu require time off for medical attention, employees with mental illness require time to attend appointments and engage in preventative care. A staggering one in five adults in the United States have a mental health condition, and the depression rates among young adults is worsening

The Health Care Financing Maze for Working-Age People with Disabilities

Much of the research on health care financing for people with disabilities has focused on the Medicaid and Medicare programs. The findings of this research often highlight the inadequacies of those programs in providing appropriate services to address the special needs of people with disabilities. A focus on these large programs, however, obscures the role of other public and private insurers, as well as the role of programs that provide many additional services to this population – all of which add complexity to the system. The purpose of this paper is to describe the health care financing system as a whole, including the large public programs, other public and private insurers, and the many other programs that provide additional services. The description of the system highlights structural problems that need to be addressed in order to substantially improve the delivery of health and related services to people with disabilities. In the next section, we describe each source of health care financing for working-age people with disabilities and highlight its implications for service delivery and quality of life. In the concluding section, we describe the key structural shortcomings of the current financing system, assess the extent to which current reform efforts are addressing these shortcomings, and discuss the implications for broader efforts to reform health care financing system

Snapshot of Permanent Supportive Housing in Illinois

This snapshot report paints the picture of supportive housing in this state, including how much there is, where it is located, whom it serves, how it helps chronically homeless and other at-risk populations become stably housed, and how close it comes to answering the need for supportive housing in Illinois

Driving Value in Medicaid Primary Care: The Role of Shared Support Networks for Physician Practices

Examines the challenges of transforming small primary care practices under healthcare reform and options for Medicaid to drive changes through practice supports to help implement and sustain new models of care or catalyze investments in new systems

Headed for a Crunch: An Update on Medicaid Spending, Coverage and Policy Heading Into an Economic Downturn

Presents findings from a survey of state Medicaid officials on trends in spending, enrollment, policy actions, and budgets for fiscal years 2008-2009. Discusses the possibility of increased enrollment and budget shortfalls due to the economic slowdown