Resource Library by Topic
Care Coordination:
- J. Gillespie, R. Mollica, R, Care Coordination for People with Chronic Conditions, Partnership for Solutions, Johns Hopkins University, January 2003.
- A. Chen, R. Brown, N. Archibald, S. Aliotta, P. Fox, Best Practices in Coordinated Care, Mathematica Policy Research, Inc under contract for Health Care Financing Administration, March 22, 2000.
- M. Booth, E. Griffin, Addressing Potential Conflicts of Interest
Arising from the Multiple Roles of Colorado's
Community Centered Boards, USM Muskie School, December 2007.
- Support broker job description (Quality Standards for Support Brokers, The Dane County Department of Human Services and the Dane County Support Broker Coalition, page 5-6, February 2006.)
Consumer Direction:
- Understanding Medicaid Home and Community Services: A Primer 2010 Edition.
- Developing and Implementing Self-Direction Programs and Policies: A Handbook, National Resource Center for Participant-Directed Services.
Covered Services:
- CMS Medicaid State Waiver Program Demonstration Projects - General Information
Defining MLTSS:
Enrollment:
- J Barth, Enrollment Options for Medicaid Managed Care for People with Disabilities, Center for Health Care Strategies, July 2007.
Federal Laws and Regulations
- Social Security Act, Title XI (General Provisions): http://www.ssa.gov/OP_Home/ssact/title11/1100.htm
This link takes you to the Table of Contents for Title XI. Use it to find any reference to an “1100” section of the law, including Sections 1115 and 1115A.
- Social Security Act, Title XVIII (Medicare): http://www.ssa.gov/OP_Home/ssact/title18/1800.htm
This link takes you to the Table of Contents for Title XIX. Use it to find any reference to a “1800” section, including Sections 1859 and 1894.
Note that the so-called 402/222 Medicare waiver authority does not appear in the Social Security Act itself. It is codified at 42 U.S.C. § 1395b-1: http://frwebgate.access.gpo.gov/
- Social Security Act, Title XIX (Medicaid): http://www.ssa.gov/OP_Home/ssact/title19/1900.htm
This link takes you to the Table of Contents for Title XIX. Use it to find any reference to a “1900” section, including Sections 1902; 1903; 1915(a), (b), (c), (i), or (k); 1932; and 1934.
- Federal Medicare Advantage Regulations (42 CFR 422):
http://www.access.gpo.gov/nara/cfr/waisidx_10/42cfr422_10.html
This link takes you to the Table of Contents for Part 422, the Medicare Advantage regulations. Use it to find any section within Part 422.
- Federal Medicaid Managed Care Regulations (42 CFR 438):
http://www.access.gpo.gov/nara/cfr/waisidx_10/42cfr438_10.html
This link takes you to the Table of Contents for Part 438, the Medicaid Managed Care regulations. Use it to find any section within Part 438.
- Federal Medicaid Services Regulations (42 CFR 441):
http://www.access.gpo.gov/nara/cfr/waisidx_10/42cfr441_10.html
This link takes you to the Table of Contents for Part 441, the Medicaid Services regulations. Note that Home and Community Based Services Waiver requirements begin at 441.300.
Financial Incentives
- Integrating Care Program Design: Checklist for States, Center for Health Care Strategies, June 2006.
- CMS, Money Follows the Person.
Including Medicare:
- Dual Eligibles: Medicaid’s Role for Low-Income Medicare Beneficiaries, Kaiser Commission on Medicaid and the Uninsured, 2009.
- Saucier, P., Kasten, J., and Burwell, B. (2009). Federal Authority for Medicare Special Needs Plans and Their Relationship to State Medicaid Programs.Prepared by Thomson Reuters for the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Office of Disability, Aging and Long-Term Care Policy.
- CMS Medicare-Medicaid Coordination Office
- Center for Health Care Strategies, Inc., From the Beneficiary Perspective: Core Elements to Guide Integrated Care for Dual Eligibles
- Profiles of State Innovation: Roadmap for Improving Systems of Care for Dual Eligibles
- Options for Integrating Care for Dual Eligible Beneficiaries
- Supporting Alternative Integrated Models for Dual Eligibles: A Legal Analysis of Current and Future Options
National Status of MLTSS:
- CMS PACE site
- Planning Contracts
- PACE Information
- Information on Dual Eligibles, CMS
- "Implementing the Affordable Care Act: New Options for Medicaid Home and Community Based Services" by Diane Justice. NASHP, October 2010.
- State Medicaid Directors letter dated August 6, 2010, "Improving Access to Home and Community-Based Services"
Person-Centered Approach:
- Wunderlick and Kohler, eds. Improving the Quality of Long-Term Care. Institute on Medicine Committee on Improving Quality in Long-Term Care. Washington, D.C.: National Academy Press, 2001.
- M.J. Koren. "Person-Centered Care For Nursing Home Residents: the Culture-Change Movement," Health Affairs 29 (2), February 2010.
- The Pioneer Network
Quality Management Systems:
- AHRQ, National Advisory Council Subcommittee: Identifying Quality Measures for Medicaid-Eligible Adults.
- AHRQ, Quality Measures for Children, CHIPRA Core Set Technical Sepcifications Manual, 2011.
- Evidence-Based Policy Initiative
- Medicaid Managed Care
Quality Benchmarking
Project: Final Report, National Committee for Quality Assurance, 2010.
- National Core Indicators
- National Council on Aging
- SAMHSA Evidence-Based Practices resources
- What Really Matters: A Guide to Person-Centered Excellence. Towson, MD: Council on Quality and Leadership, 2010.
Stakeholder Engagement:
- J. Barth. The Consumer Voice in Medicaid Managed Care: State Strategies. Center for Health Care Strategies, March 2007.
- A. Lind, S. Gore, L. Barnette, S. Somers. Profiles of State Innovation: Roadmap for Managing Long Term Supports and Services. Center for Health Care Strategies, November 2010.
- A. Lind, S. Gore. Engaging Consumer Stakeholders to Improve System of Care for Dual Eligibles. Center for Health Care Strategies, December 2010.
- Consumer Involvement Toolkit: A Resource for State Agencies, prepared under the Systems Transformation Grant, June 2010.
- C. O'Shaughnessy. The Aging Services Networks: Accomplishments and
Challenges in Serving a
Growing Elderly Population, 2008.
- Plain Language Resources:
- Plain Language: A Promising Strategy for Clearly Communicating Health Information and Improving Health Literacy. Centers for Disease Control, 2005.
- People First Language: Language Follows the Model. Alliance of Disability Advocates.
- Tips and Tricks from plainlanguage.gov
- Writing About Disability, Easter Seals Disability Services.
- Plain Language: A Promising Strategy for Clearly Communicating Health Information and Improving Health Literacy. Centers for Disease Control, 2005.