Medicaid & CHIP Strengthening Coverage, Improving Health

Medicaid provides vital health insurance coverage to over 70 million people, including more than 32 million low-income children, over 20 million non-elderly adults (including parents), nearly 7 million elderly adults, and more than 10 million Americans with disabilities. Since implementation of the Affordable Care Act (Affordable Care Act)’s Medicaid expansion, the number of people covered by Medicaid has grown by about 17 million, helping drive the nation’s uninsured rate to the lowest level in history, below 9 percent. States, the federal government, and stakeholders have partnered to make Medicaid and the Children’s Health Insurance Program (CHIP) the bedrock of the nation’s system of health coverage by strengthening and expanding coverage, improving the delivery of care, enhancing quality, and fostering innovation. Click here to read the full report.

New Report: Aging, Women, and Poverty in California

In California, approximately one in five older adults is currently living in poverty. Women, and particularly women of color, are disproportionately impacted due to a confluence of factors, including, for example, unequal pay, lower retirement income, caregiving responsibilities, longevity, and higher health care costs.

A new report, Aging, Women and Poverty in California: We Must Do More, written in collaboration by the California Commission on Aging, the California Women’s Law Center, and the California Commission on the Status of Women and Girls, with participation from Justice in Aging, outlines the reasons older women are more likely to live in poverty, describes the impact poverty has on women’s lives, and offers recommendations and action steps to ensure older women can age in dignity.

With a new administration in Washington, the work of Justice in Aging and other advocates to improve the lives of low-income older Californians is going to depend on our ability to defend critical programs from cuts. The new administration and members of Congress need to be educated on senior poverty and the importance of the programs and services poor seniors rely on. It is critical that we tell the stories of poor older adults, and use our expertise to provide strong recommendations for strengthening and expanding programs that reduce and prevent senior poverty.

Medi-Cal Reaches Millions of People Across California, but Faces an Uncertain Future

Enacted in 2010, the federal Affordable Care Act (ACA) has significantly reduced the share of Californians without health care coverage. A central component of California’s implementation of health care reform has been the expansion of Medi-Cal (the state’s Medicaid program) to a broader population of low-income Californians.

A new Budget Center Fact Sheet highlights Medi-Cal’s importance across our state by providing figures on Medi-Cal enrollment for every California county. This analysis shows that Medi-Cal serves more than 13 million people across all 58 counties and that in 49 of these counties over one-quarter of residents are enrolled. However, millions could risk losing Medi-Cal coverage if President-elect Donald Trump and other Republican leaders follow through on their proposals to repeal the ACA and substantially reduce funding for Medicaid. 

Read the Fact Sheet.

Fact Sheets: The Social Security Administration’s Representative Payee Program

Justice In Aging will be publishing a series of informational fact sheets concerning the agency’s representative payee program.

Fact sheet: The Social Security Representative Payee Program – The Basics

Fact sheet (for consumer audiences): What is a Social Security Representative Payee and how are they chosen?

Fact sheet: Ways to Meet the Growing Need for Representative Payees

 

Flexible Accounting for Long-Term Care Services: State Budgeting Practices that Increase Access to Home- and Community-Based Services

This 2012 study conducted by Leslie Hendrickson and Laurel Mildred with support of The SCAN Foundation describes flexible accounting practices used in twelve states that incentivize the use of community-based programs instead of institutional care, and invest the savings to further expand home- and community-based services. It examines how these strategies are being used in states with managed care systems to support rebalancing within managed care models.

 

California’s Fiscal Outlook by LAO

The LAO has released its fiscal outlook for next year.

 

Planning for California’s Growing Senior Population

California’s senior population is entering a period of rapid growth. By 2030, as the Baby Boom generation reaches retirement age, the over-65 population will grow by four million people. The state will need additional resources, including nursing care facilities and health care professionals, especially those who provide home- and community-based services. California’s community college system will be critical in training workers to meet the state’s health care workforce needs for the growing and changing senior population.

Nursing Homes in California

Nursing homes provide room and board, on-site nursing care, supervision, and personal assistance to people who are unable to care for themselves. They are also the most costly residential care option; in 2014 the average annual cost of each bed was approximately $90,000 for a semi-private room and $104,000 for a private room. Research indicates that some senior and disabled Californians can avoid or put off going into nursing homes by participating in programs such as In-Home Support Services (IHSS), which allows Medi-Cal beneficiaries to hire caregivers who help them with daily tasks and activities.

California’s In-Home Support Program

California’s In-Home Supportive Services (IHSS) program serves people who need some support in order to live independently—at a lower cost than the services provided in nursing homes or residential care.. The current budget restores a 7% cut in service hours, which is funded by a tax on Medi-Cal managed-care organizations. This funding restoration will not continue beyond this year unless state lawmakers can find a way to restructure the existing tax so that it complies with federal law or find an alternative revenue source.

Operating TRIP Model Services, September 2015 

The TRIP Program of the Independent Living Partnership has been successfully providing volunteer driver rides for low-income, alone, elderly and disabled residents of Riverside County California since 1993. The success of TRIP for Riverside County has inspired non-profits and other agencies throughout the state and in other places across the country. Funding for five of the programs has primarily been provided through Federal Grants and the programs continue to rely on Federal funds for operation. In addition, the operating programs are using Foundation Grants.

Setting Goals with People Who Have Complex Needs: A Collaborative Approach

Person-centered care requires effective communication and coordination among the individual, health care providers as well as paid and unpaid supports. This report takes a closer look at this collaborative approach and offers success tips.

Policy Approaches to Advancing Person-Centered Outcome Measurement

Quality care for people with complex needs begins with a person-centered assessment and care planning to address what is most important to the individual. This report summarizes findings and policy implications from case studies of leading delivery systems.

Planning for California’s Growing Senior Population

This report from PPIC anticipates significant changes in the numbers, needs, and composition of California’s population of people over 65.

Beds for Boomers: Will California’s Supply of Services Meet Senior Demand?

A report by the California HealthCare Foundation, examines the growth in California’s senior population and potential impacts on acute care hospitals, skilled nursing facilities, home health providers, and residential care facilities.

Study: Calif. Caregivers Provided $57B in Unpaid Care in 2013

In 2013, about 40 million family caregivers in the United States provided an estimated 37 billion hours of care to an adult with limitations in daily activities. The estimated economic value of their unpaid contributions was approximately $470 billion in 2013, up from an estimated $450 billion in 2009.

Building the Business Case: Community Organizations Responding to the Changing Healthcare Environment for Aging Population is a guide for community-based organizations.  This brief is intended to stimulate thinking, to pose questions that catalyze dialogue, and ultimately, to inspire action. Though the primary audience for this brief is community-based organizations, the larger goal is for this content to have crossover impact. Any healthcare organization (provider or payer) exploring partnership, specifically partnership with community providers, would benefit from engaging with the ideas and reflections in this paper. (Feb 2015)

Federal Medicaid Office:  Publications Offering Policy Guidance
As part of the state-federal partnership in administering the Medicaid and CHIP programs, the Centers for Medicare and Medicaid Services (CMS) issues guidance in the form of letters to State Medicaid Directors, letters to State Health Officials (often regarding CHIP policy or financing issues), Informational Bulletins, and Frequently Asked Questions to communicate with states and other stakeholders regarding operational issues related to Medicaid and CHIP.

Thinking Ahead Matters: Supporting and improving healthcare decision-making and end-of-life planning for people with intellectual and developmental disabilities

Coalition for Compassionate Care of California

Overview_of_the_Rate_Setting_Process_for_Cal_MediConnect

California Collaborative for Long Term Services and Supports

Appeals Processes in the Dual Eligible Demonstrations 

Justice In Aging

An Advocate’s Guide for the Coordinated Care Initiative (CCI)
Justice In Aging

Continuity of Care in the Dual Eligible Demonstrations: A Tool for Advocates

Justice in Aging

Stop Segregation of People who have both Mental Health and Developmental Disabilities
Disability Rights California
This 6 page new publication (under subheading “Fact Sheets on the Mental Health System”) addresses several common topics concerning people living with both mental health and developmental disabilities .

Bullying & Disability Harassment of Students with Disabilities

Disability Rights California
This updated 14 page FAQ publication answers common questions about bullying, disability harassment, laws, school districts’ responsibilities, and more.

California Fact Sheets
The SCAN Foundation
This series of California fact sheets produced by The SCAN Foundation provides basic information on the “who, what, where, when, why, and how” of long-term care.

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