The Connecting Point Volume 2 Issue 7
Date September 2, 2004

In This ISSUE:    

1) CMS Encourages States to Give Medicaid Beneficiaries MoreControl Over Long-Term Care Services
2) Study shows placing relative with dementia into long-term care facility does little to ease the emotional burden of caregivers
3) A Statistical Portrait of Well-Being in Early Adulthood
4) Online Customized Employment Seminar
5) SSA Ticket to Work Program:  Ticket Tracker

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1) CMS Encourages States to Give Medicaid Beneficiaries More Control Over Long-Term Care Services - More states than ever are redirecting Medicaid funds to keep more people out of institutions and living in their own communities and homes, and there are many approaches that states can use to accomplish this, the Centers for Medicare & Medicaid Services (CMS) said Tuesday, August 17 in a letter to state Medicaid directors.
"There is growing evidence that states can enable more people to live in the community by giving the elderly and people with disabilities more control over how they get the Medicaid services they need," CMS Administrator Mark B. McClellan, M.D., Ph.D. said. "Because the concept of money following the person's own preferences improves satisfaction and may reduce Medicaid costs too, we intend to keep taking steps to remove barriers, real or perceived."
CMS is advi sing states about what actions they can currently take while Congress reviews the necessary changes in the law. The letter to the Medicaid directors addresses several areas of confusion that may be impeding state efforts to rebalance their long-term care support systems, including: Home and Community-based Services (HCBS) Waiver Capacity and Cost Neutrality, Backfilling of Nursing Home Beds and Self-Directed Models.
A copy of the full letter can be obtained at http://www.cms.hhs.gov/states/letters/smd081704.pdf . More information about the Money Follows the Person initiative is available at http://www.cms.hhs.gov/promisingpractices .
Source: Reference Points

2 ) Study shows placing relative with dementia into long-term care facility does little to ease the emotional burden of caregivers - A new study shows that caregivers of dementia patients who must make the difficult decision to place their relatives into institutionalized care get no relief from depression and anxiety, and in fact suffer additional emotional trauma following their decision . The study, funded by the National Institute of Nursing Research and the National Institute on Aging, part of the National Institutes of Health, appears in the August 25, 2004 issue of the "Journal of the American Medical Association (JAMA)".
The four year investigation, which was coordinated by the University of Pittsburgh School of Medicine and led by Richard Schulz, Ph.D., Director of the Center for Social and Urban Research at Pitt, determined that clinical intervention may greatly benefit caregivers by helping them to prepare for the placement of their relatives and by treating their depression and anxiety during the placement process.
This is the first study to provide a comprehensive analysis of the emotional turmoil caregivers experience during the transition of their loved one from home to a long-term care facility, according to Dr. Schulz. The investigators looked at a number of factors including the conditions that led to placement, the nature of contact between the caregivers and their relatives after institutionalization, and the impact of these factors on health outcomes among caregivers following the placement.
Participants of the study were recruited from six U.S. sites and included 1,222 caregiver-patient pairs. For the 180 caregivers who had to turn over care of their loved one to an institution, symptoms of depression and anxiety stayed as high as when they were in-home caregivers. These findings stand in sharp contrast to earlier findings reported by Schulz and his group showing that death of a loved one after care giving results in improvement in depression.
This NIH News Release is available online at: http://www.nih.gov/news/pr/aug2004/ninr-26.htm

3) A Statistical Portrait of Well-Being in Early Adulthood - This new brief provides a portrait of early adulthood in the U.S. using the latest data in areas such as educational attainment, financial self-sufficiency, family formation, and health behaviors. The brief, which focuses on young adults around age 25, also includes descriptive portraits of the white, black, Hispanic, Native American, and immigrant populations in this age group. To view this and other data briefs and indicators, visit http://www.childtrendsdatabank.org .

4 ) Online Customized Employment Seminar - From NCWD/A New s - Learn to develop negotiated positions with employers - The Training and Technical Assistance for Providers (*T-TAP*) project has a new online seminar on job negotiation and customized employment. The customized employment process is based on a match between the unique strengths, needs, and interests of the job candidate with a disability, and the identified business needs of the employer or self-employment business chosen by the candidate. The result is a job that benefits the job seeker and company alike. You can also purchase a series of eight web casts on customized employment from the website.
T-TAP is a joint project of Virginia Commonwealth University and the Institute for Community Inclusion/ U Mass Boston, funded by the Office of Disability Employment Policy at the U.S. Department of Labor. Online Customized Employment Seminar -- http://www.t-tap.org/training/onlineseminars/pam/pamseminar.htm

5) SSA Ticket to Work Program:  Ticket Tracker - The Ticket Tracker provides the latest statistics on the Ticket to Work program, i.e., data on the number of tickets issued and the assignment level to the employment networks.  There is also a link at the bottom of the table to obtain the same information for the State Vocational Rehabilitation Agency. http://www.ssa.gov/work/Ticket/ticket_info.html#TicketTracker
If you scroll up on this same page, you will find numerous links to resources and information on the Ticket to Work and Work Incentives Improvement Act of 1999 (Public Law 106-170), and the Ticket to Work Program.

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