Social and Behavioral Sciences Commons^™

Racial Disparities In Snap Receipt For Eligible Asian Americans In Massachusetts, Sokha Eng, Weichun Yan, Brian Beauregard, Susan R. Crandall

Center for Social Policy Publications

Despite qualifying as income eligible, many Massachusetts families do not access SNAP (Supplemental Nutrition Assistance Program) benefits. Due to the sharp increase in the cost of living, especially the cost of housing and food expenses, more families are facing food insecurity. Thus, it is critical to ensure that families in need receive SNAP benefits. While previous studies have examined racial disparities, there is a limited focus on Asian American families. Even fewer studies disaggregate data to explore disparities among Asian American ethnic subgroups. Further, few studies have addressed disparities in SNAP receipt specifically for income eligible families.

The purpose of …

Exploring Financial Situations And The Cliff Effect For Single-Mother Families In Allegheny County, Pennsylvania (Working Paper), Susan Crandall, Brian Beauregard, Sokha Eng, Emek Karakilic

Center for Social Policy Publications

The mitigation of the cliff effect is essential to effectively foster economic mobility and to address systemic racism facing low-income mothers in Allegheny County. The Pittsburgh Foundation’s report A Qualitative Study of Single Mothers in Allegheny County: A 100 Percent Pittsburgh Project revealed that 41% of single mother households earn below the poverty line. The report found that the cliff effect – the reduction of public benefits resulting from wage increases – presented a significant barrier to escaping poverty.

This report explores cliff effects in Allegheny County, Pennsylvania. First, simulations were conducted to better understand the nature and types of …

Financial Security Scorecard: A State-By-State Analysis Of Economic Pressures Facing Future Retirees, Christian Weller, Nari Rhee, Carolyn Arcand

Public Policy and Public Affairs Faculty Publication Series

As Americans increasingly worry about their retirement prospects, states play an important and growing role in retirement security policy. States already manage long-term care programs for the elderly through Medicaid. Concerned about the impact of future elder poverty on state and local budgets and their local economies, a number of states are exploring the creation of low-cost and low-risk retirement savings plans for private sector workers who lack access to pensions or 401(k)s on the job. Some states have developed programs to help older workers find work.

This report presents the Financial Security Scorecard, designed to inform state-level stakeholders and …

Implications Of Rhode Island’S Global Consumer Choice Compact Medicaid Waiver For Block Granting Medicaid And Other Retrenchment, Edward Alan Miller, Divya Samuel, Susan Allen, Amal Trivedi, Vincent Mor

Gerontology Institute Publications

On January 16, 2009, the Federal government approved Rhode Island’s application for a Global Consumer Choice Compact Medicaid Waiver whereby the state became the first granted permission to operate its entire Medicaid program under the state plan and a single 1115 “research and demonstration” waiver. The Global Waiver has been implemented in the context of Republican proposals to turn Medicaid into a block grant which would give states substantially more flexibility administering the program in exchange for receiving an upfront allotment from the Federal government. Proponents have held up the Global Waiver as a successful example of what might be …

Implications Of Rhode Island’S Global Consumer Choice Compact Medicaid Waiver For Rebalancing Long-Term Care Under The Affordable Care Act, Edward Alan Miller, Divya Samuel, Susan Allen, Amal Trivedi, Vincent Mor

Gerontology Institute Publications

Federal approval of Rhode Island’s Global Consumer Choice Compact Global Waiver in 2009 provided Rhode Island with greater flexibility to modify its Medicaid program. Because 96% of long-term care expenditures in Rhode Island were directed toward institutional settings, a primary goal was to facilitate the state’s efforts to shift the locus of long-term care to non-institutional settings. This study draws lessons from Rhode Island’s experience with the Global Waiver for the long-term care rebalancing provisions of the Patient Protection and Affordable Care Act of 2010. Data derive from 325 archival sources and 26 semi-structured interviews. Results suggest that prospectively documenting …

Implications Of Rhode Island’S Global Consumer Choice Compact Medicaid Waiver For Designing And Implementing State Health Reform, Edward Alan Miller, Divya Samuel, Susan Allen, Amal Trivedi, Vincent Mor

Gerontology Institute Publications

Provisions in the Medicaid statute permit states to apply for waivers from traditional program requirements. On January 16, 2009, the federal government approved Rhode Island's Global Consumer Choice Compact Waiver. In exchange for a cap on combined federal and state spending of $12.075 billion through 2013, Rhode Island received greater flexibility to adopt certain Medicaid program changes. This study analyzes the design and implementation of the Global Waiver to draw general lessons for health reform at the state-level, a key concern given ongoing state discretion to improve their health care systems under the Patient Protection and Affordable Care Act. Data …

Funding Health-Related Vr Services: The Potential Impact Of The Affordable Care Act On The Use Of Private Health Insurance And Medicaid To Pay For Health-Related Vr Services, Robert Silverstein

All Institute for Community Inclusion Publications

One of the myriad of issues affecting the administration of the vocational rehabilitation (VR) program by State VR agencies under Title I of the Rehabilitation Act is how to maximize access to and use of all available funding sources to pay for VR services and supports for VR applicants and clients. In March 2010, Congress passed and the President signed into law the "Affordable Care Act" (ACA). 1 On June 28, 2012, the United States Supreme Court upheld all of the provisions of the ACA, with the exception of provisions mandating Medicaid expansion. The Supreme Court held that if a …

Increasing Consumer Involvement In Medicaid Nursing Facility Reimbursement: Lessons From New York And Minnesota, Edward Alan Miller, Cynthia Rudder

Gerontology Institute Publications

Medicaid is the major purchaser of nursing home care in the United States. States design their methods of reimbursing nursing homes to achieve desired policy objectives related to facility cost and quality, access to care, payment equity, service capacity, and budgetary control. The incorporation of multiple, sometimes conflicting incentives into state reimbursement systems has resulted in enormously complex and demanding methodologies that inhibit consumer participation in state rating setting decisions. In turn, the lack of consumer involvement has the potential to result in the adoption of reimbursement systems that favor industry and government interests at the expense of issues important …

Consumer Involvement In Medicaid Nursing Facility Reimbursement: Lessons From New York And Minnesota For State Policymakers, Edward Alan Miller, Cynthia Rudder

Gerontology Institute Publications

Medicaid is the major purchaser of nursing home care in the United States. State governments design their methods of reimbursing nursing homes to achieve desired policy objectives related to facility cost and quality, access to care, payment equity, service capacity, and budgetary control.

Often, participation in the process of developing Medicaid payment policy is limited to state agency officials and providers of care and, occasionally, union representatives and state legislative staff. Invited less frequently to reimbursement policy discussions are consumer representatives. Lack of consumer involvement in the development of state rate setting systems has the potential to result in the …

A Primer For Consumer Involvement In Medicaid Nursing Facility Reimbursement: Lessons From New York And Minnesota, Edward Alan Miller, Cynthia Rudder

Gerontology Institute Publications

Medicaid is the major purchaser of nursing home care in the United States. To ensure that providers behave appropriately, the federal and state governments have established an extensive set of regulations that nursing homes must comply with if they are to be reimbursed for patients insured by Medicaid. Consumers exert considerable influence here by focusing on regulations and enforcement of non-compliance.

States also seek to align providers’ interests with those of other interested parties through controls and incentives built into state reimbursement systems, including with respect to facility cost and quality, access to care, payment equity, service capacity, and budgetary …

Massachusetts’ Home Care Programs And Reasons For Discharge Into Nursing Homes, Cathy M. Wong, Nina M. Silverstein

Gerontology Institute Publications

Home and community-based services (HCBS) are a range of long-term care services intended to enable older adults and persons with disabilities to “age in place” in their own homes and communities. Previous studies well document that older adults prefer receiving HCBS rather than institutional care at a nursing home. One study concluded that 84 percent of older Americans, aged 50 years and older, want to remain in their homes for as long as possible. Medicaid is a major source of funding for long term care. Currently, a large proportion of Medicaid funds in most states has been spent on institutional, …

Institute Brief: Minimum Wage Increase: A Guide For Disability Service Providers (Updated 2009), David Hoff

The Institute Brief Series, Institute for Community Inclusion

This publication provides guidance to service providers regarding the increase in minimum wage, with a particular focus on assisting consumers with questions and concerns they may have regarding the impact on their public benefits.

A Trade-Off Proposal For Funding Long-Term Care, Yung-Ping Chen

Gerontology Institute Publications

Long-term care can be a depressing subject. Most of us tend not to think about it. However, we cannot long avoid it as the 76 million baby boomers begin reaching older ages in a few short years. According to projections, in 40 years, those aged 65 to 84 (numbering 31.6 million in 2005) will more than double, and those 85 plus (about 5.1 million in 2005), who are more at risk of dependency, will more than triple (U.S. Census Bureau, 2004 and 2006). Heavy reliance on Medicaid, already the second largest budget item in most states, would not appear viable. …

Data Note: Ssi Recipients With Disabilities Who Work And Participation In 1619b, Brooke Dennee-Sommers, Frank A. Smith

Data Note Series, Institute for Community Inclusion

Supplemental Security Income (SSI) is a federally funded program that provides cash assistance for basic needs. Individuals with a low-income who are over the age of 65, blind, or have a disability are eligible for assistance. SSI beneficiaries typically also receive health insurance coverage through Medicaid. Losing Medicaid benefits can be of concern for SSI recipients with disabilities who desire to work, or are currently working. Section 1619b of the Social Security Act allows individuals to work and continue to receive Medicaid assistance when their earnings are too high to qualify for SSI cash payments as long as they meet …

Research To Practice: Medicaid Involvement In Employment-Related Programs- Findings From The National Survey Of State Systems And Employment For People With Disabilities, Jennifer Sullivan Sulewski, Dana Scott Gilmore, Susan Foley

Research to Practice Series, Institute for Community Inclusion

This brief analyzes data from ICI's National Survey of State Systems and Employment for People with Disabilities regarding the priority Medicaid agencies place on employment and their involvement in recent policy initiatives.

Research To Practice: Collaboration Between Medicaid And Other State Agencies- Findings From The National Survey Of State Systems And Employment For People With Disabilities, Jennifer Sullivan Sulewski, Dana Scott Gilmore, Susan Foley

Research to Practice Series, Institute for Community Inclusion

Many state Medicaid agencies are playing a greater role in multi-agency efforts to promote employment for people with disabilities. This brief uses data from the National Survey of State Systems and Employment for People with Disabilities to explore the varieties of collaboration Medicaid agencies are using and the agencies they are collaborating with.

Policy Brief: The Ticket To Work And Self-Sufficiency Program And Established Under The Ticket To Work And Work Incentives Improvement Act Of 1999, Robert Silverstein

Policy Briefs Series, Institute for Community Inclusion

A description of the major provisions in Title I of the Act, which created the Ticket to Work and Self-Sufficiency Program.

Tools For Inclusion: Understanding The Ssi Work Incentives, John Butterworth

Tools for Inclusion Series, Institute for Community Inclusion

Information about Social Security Administration programs that can help people who receive Supplemental Security Income (SSI) to retain benefits that can support and ensure long-term employment.

Medicaid And Medicaid Cost Containment In Massachusetts, Fredric A. Waldstein

New England Journal of Public Policy

The purpose of this article is to describe Medicaid's financial structure and examine cost containment efforts to limit future growth of the program, particularly pertaining to Massachusetts. The principal focus is the Massachusetts Department of Public Welfare and the Massachusetts Medicaid Fraud Control Unit, the two agencies most responsible for Medicaid cost containment in the commonwealth. Because elected officials are unwilling to face directly the troublesome issues surrounding Medicaid and its growth, the government agencies responsible for cost containment have been left to define the scope of the problem, design remedial strategies, and evaluate their success. This process is found …

Serving The Elderly: Need Versus Policy, Wornie L. Reed

William Monroe Trotter Institute Publications

Medicare was established in 1965 under Title XVIII of the Social Security Act. It was originally meant to eliminate the financial barriers to medical care for the aged. It has been called a form of national health insurance for persons age 65 and over. But it was deliberately designed in a manner to avoid modification of the fee-for-services system that is the basis of American Medical Care (Estes, 1979). As a result, inflation in the cost of care has seriously reduced financial benefits to the beneficiaries and in turn limited the access to medical care by the elderly.