Reports & Publications

February 2018
H. Stephen Kaye
A pie chart with five colored slices of pie, divided vertically approximately in the middle.  The left half of the pie is labeled "In labor force (with or without disability)"; it has two slices, one labeled "Employed 41.2%" and the other "Looking for work 11.2%."   The right half is labeled "Not in labor force"; three slices of pie are labeled "Exempted due to disability 27.7%," "Caring for family, attending school, already in work program 14.1%," and "No identified community engagement 5.9%"

In January 2018, the Centers for Medicare and Medicaid Services (CMS) issued guidance that would allow states to use 1115 Waivers to add “work and community engagement” requirements for working-age Medicaid beneficiaries.  This report examines the extent to which disability affects working-age Medicaid beneficiaries, and identifies the subset of beneficiaries with disabilities and work-limiting health conditions who would likely be exempt from proposed Medicaid work requirements or would benefit from modified requirements.

January 2018
Brooke Hollister, Winston Tseng, Marian Pi-Ju Liu, Mel Neri, Bethany Lee, Charlene Harrington, Carrie L. Graham
The Cal MediConnect logo

In 2014, California became one of 13 states to implement a financial and administrative alignment demonstration called the Coordinated Care Initiative (CCI). In California, existing Medicare and Medi-Cal (California’s Medicaid program) managed care health plans in seven counties created new products called “Cal MediConnect” (CMC). Researchers from the University of California conducted an evaluation of the impact of the CMC program on beneficiaries and health systems.

November 2017
Ari Ne'eman
A map of the U.S. showing states with managed LTSS programs in blue and the other states in gray.

Over the course of the last decade, the United States has seen a significant increase in the use of Managed Long Term Services and Supports (MLTSS) within the Medicaid program. In order to ensure that MLTSS systems deliver high-quality services to people with disabilities and do not involve inadequate or overly medicalized service provision, states adopt certain requirements within their procurement for and contracting with MCOs.

March 2018
Mary Lou Breslin

Many people with disabilities who get paid help with daily activities also need help with health maintenance tasks, such as ostomy care, ventilator management, bowel and bladder care, tube feeding, insulin injections, and management of other medications.  In many states, laws prohibit paid workers without nursing or other medical licenses from performing such tasks.  In others, nurses are permitted to delegate such tasks to these workers.  In some instances, such workers can perform health maintenance tasks under the direction of the consumer, without nurse delegation or supervision.

November 2017
Carrie Graham, Mel Neri, Brooke Hollister, Marian Liu, Stephen Kaye, Edward Bozwell Bueno, Winston Tseng, and Charlene Harrington
The Cal MediConnect logo

Researchers from the University of California have conducted an evaluation of the impact of the Cal MediConnect (CMC) program on beneficiaries and health systems. One goal of CMC was to decrease expenditures through incentives to redirect care away from institutional settings and toward more home- and community-based services (HCBS). This research brief includes results from an in-depth examination of the efforts of CMC health plans to administer HCBS through their new managed long-term services and supports programs.