Long-Term Supports and Services
Options to Increase Access to Long-Term Care: Maryland House Bill 594 Final Report, February 4, 2008This study, in response to the mandate of Maryland House Bill 594, analyzed Maryland’s options to increase access to long-term services, including home- and community-based services such as adult medical day care, for individuals at high risk of institutionalization because of cognitive impairments, mental illness, traumatic brain injury, or other conditions, who met financial eligibility criteria in effect as of June 1, 2007. Three approaches to expand access to Medicaid home- and community-based services (HCBS) were considered: Maryland could lower its nursing facility (NF) level of care (LOC) criteria to ease entry into both NFs and community-based programs; Maryland could leave its NF LOC at its current standard, but expand access to HCBS by providing enough funds to move people from the registries for the Older Adult Waiver (OAW) and Living at Home (LAH) waiver into services; or Maryland could adopt the new authority, included in the recently-enacted federal Deficit Reduction Act (DRA), to create a service package of HCBS without the need for a waiver. The Hilltop Institute (as the Center for Health Program Development and Management) reviewed Maryland and seven other states and the District of Columbia, analyzed the estimated costs and effects of three approaches mentioned above, and analyzed the potential for long-term savings for a state, should it elect to lower its NF LOC. To view the full report, click here.
Long-Term Care Planning in Maryland, December 1, 2007The Hilltop Institute (as the Center for Health Program Development and Management) prepared this report on behalf of the Maryland Health Care Commission and in collaboration with the Center for Social Science Research at George Mason University. Required by the Long-Term Care Planning Act of 2006 (House Bill 1342), the report examines the long-term care needs and costs for individuals aged 65 and older and persons with disabilities in 2010, 2020, and 2030. Total costs to the State for long-term services and supports are projected to increase more than threefold from 2005 to 2030, from $1.99 billion to $6.06 billion. The report concludes that planning must begin now or the State’s existing system for the provision of long-term services and supports is likely to be overwhelmed by the aging baby boomers and anticipated trends in the prevalence and intensity of disability.
In this feasibility study, conducted for the Maryland Department of Health and Mental Hygiene, The Hilltop Institute (as the Center for Health Program Development and Management) examined Code of Maryland Regulations pertaining to respite services; surveyed agencies that provide respite services to families of children with disabilities as well as the families themselves; and created a demonstration model for providing respite services in Maryland.
A Survey of Functional Status to Support CommunityChoice Rate Setting and Program Assessments, July 31, 2006
The Hilltop Institute (as the Center for Health Program Development and Management) conducted a telephone survey of 2,100 community-dwelling Maryland Medicaid beneficiaries as the first phase of a broader research agenda to explore how functional status, as measured by activities of daily living (ADLs), is related to resource use over time, as well as how such measures might be used for rate setting and performance assessment for CommunityChoice and other integrated managed long-term care programs.
Community-Based Long-Term Care Services in Rhode Island: A Report Issued Pursuant to Joint Resolution 05-R 384 (2005), April 21, 2006
This report, commissioned by the Rhode Island Department of Human Services pursuant to Joint Resolution 05-R 384 of the Rhode Island General Assembly, examines community-based long-term care services in Rhode Island. The study includes a review of payment rates and rate methodologies, an assessment of workforce capacity, and recommendations for restructuring state funding to promote community-based services.
Maryland Department of Aging: Community-Based Services Needs Assessment for Service Period 2005 - 2012, September 8, 2005
Prepared for the Maryland Department of Aging, this report estimates the number of persons in Maryland who may require some form of publicly-funded long-term support services by the year 2012. The projections take into account income, age, and disability.
A major challenge to expanding home- and community-based services (HCBS) alternatives to institutional long-term care is finding funding sources to pay for HCBS. Unless states can develop policy interventions that actually reduce expenditures in institutional settings, any expansion in HCBS requires new state funds. This issue brief presents several approaches states can use to reduce nursing facility utilization and expenditures in order to make funds available to expand HCBS.
Preferences for Receipt of Care Among Community-Dwelling Adults, June 2004
In planning for long-term care, adults take into consideration both the place of care and the persons to provide care. In this study, 1,500 adults ages 40-70 were surveyed about future long-term care needs and their preferences for care setting and caregivers.
Changing Interagency Service Delivery Systems to Help Older Public Housing Residents Access Services to Assist Them to Age in Place, February 2004
A survey of elderly residents of an urban public housing complex helped area providers design a preliminary model for better coordination of services in order to enable elderly residents to age in place. This project was funded by the Office of the Assistant Secretary for Planning and Evaluation (ASPE) as part of the Service Access for Elders in Public Housing initiative.
Long-Term Care Planning in Maryland Survey Monographs, March 2001
This telephone survey of 1,500 non-institutionalized Maryland residents between the ages of 40 and 70 queried respondents about financial planning for retirement, health-related behaviors, access to sources of information on retirement and long-term care, and knowledge and perceptions of long-term care insurance. Survey findings are presented in four monographs and a technical appendix:
Financial Planning
Health Promotion
Information Acquisition
Long-Term Care Insurance
Technical Appendix
Determining Medicaid Nursing Facility Level of Care Eligibility in Maryland, December 2000
Each state designs and implements its medical eligibility criteria and processes for nursing facility services based on the state's interpretation of federal law and regulation. This report examines Maryland 's system for Medicaid-reimbursed nursing facility services and community-based alternatives and provides recommendations for improvement.