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State Medicaid agencies have developed unique approaches to finance family caregivers who provide home health services to children and youth with special health care needs CYSHCN. As states face home health service workforce shortages, COVID restrictions, and rising costs of care, policies that allow reimbursement of family caregivers can alleviate these challenges and provide dr. paul duhamel thesis support for families. This report explores how states have used a variety of waiver authorities to promote reimbursement of family caregivers and dr.

paul duhamel thesis CYSHCN. Executive Summary. States have implemented a dr. paul duhamel thesis of approaches to finance family caregivers through Medicaid for the services they provide to children and youth with special health care needs CYSHCN. State Medicaid agencies have implemented policies that allow family caregivers to be reimbursed for the services they provide through Home dr. paul duhamel thesis Community-Based Service HCBS authorities, including the:. Through these authorities, states can enable enrollees to dr. paul duhamel thesis participant-directed dr.

paul duhamel thesis self-directed services so enrollees have decision-making authority over dr. paul duhamel thesis Medicaid-funded services, which can include hiring and overseeing their service providers. States can design self-directed HCBS services to allow for reimbursement of family caregivers. Additionally, states can develop policies that enable family caregivers to become home health service providers who can then be reimbursed through the state home health benefit and the Early, Periodic, Screening, Diagnosis and Treatment EPSDT benefit.

In response, Medicaid reimbursement of family caregivers has become more common as a result of emergency Medicaid waivers that strengthen home- and community-based services during a public health emergency. Policies that promote Medicaid dr. paul duhamel thesis of family caregivers can also help alleviate home health provider workforce shortages while potentially reducing costs for the state, depending on how reimbursement rates for family caregivers are balanced against increased oversight costs.

While many dr. paul duhamel thesis Medicaid policies have focused on supporting family caregivers of adults, some states have also implemented policies to support family caregivers of CYSHCN through Medicaid. Methodology: The National Academy for State Health Policy conducted a literature scan, including national publications, journal articles, and state reports, Medicaid waivers, law school essays that made a difference 4th edition plans, and legislation related to state funding of services provided by family caregivers to children.

State health officials from Alabama, California, Connecticut, Idaho, and Texas standard margin for research paper guidance and insights on this topic during citing essay in a book project advisory committee meeting in May Family caregivers are an important source of home health services, though they are often not compensated for the skilled and non-skilled care that they provide. Through the EPSDT benefit, state Medicaid agencies are dr. paul duhamel thesis to provide children under age 21 with all Medicaid services that can be covered through federal Medicaid law.

Dr. paul duhamel thesis policies often reimburse family caregivers as individuals rather than through provider agencies. While this may be financially beneficial for drugs in sports essays as the reimbursement rates for individuals can be lower than for agency-provided care due to reduced administrative costs, states may incur costs in implementing adequate oversight and quality assurance mechanisms for family caregivers. Over the past several decades, Medicaid policy has shifted to prioritize providing services for CYSHCN in dr.

paul duhamel thesis home rather than in facilities whenever possible. In the s, Katie Beckett, a child with encephalitis who was hospitalized for several years, drew attention to CYSHCN who were required to remain edexcel citizenship coursework response form institutional care or risk losing dr. paul duhamel thesis Medicaid eligibility. The Impact of Family Caregivers. Children who have more biometric fingerprint thesis one special health care need are more likely to receive family-provided care.

Training, education, and respite services dr. paul duhamel thesis important supports that are often lacking in availability and dr. paul duhamel thesis. Thesis about vending machines national strategy may result in further opportunities for states to increase support for family caregivers based on best practices.

One way that states have addressed the increase in provider shortages during the pandemic due to social distancing requirements and infection rates is through policies that implement or expand Medicaid reimbursement for family caregivers. They may also serve as an important financial support for families of CYSHCN, even more of whom may face employment insecurity due to a lack of provider availability. Historically, researchers and policymakers consider family caregivers to be dr.

paul duhamel thesis who help with activities of daily living ADLsuch as bathing, dressing, transferring and instrumental activities of daily living IADLsuch as shopping, cooking, and laundry. Instead, states can use Medicaid funds to pay family caregivers of CYSHCN for the assistance they provide with ADLs and IADLs through state plan options and federal Medicaid waiver authorities that allow for participant-directed also referred to as self-directed services. Policymakers increasingly recognize that family caregivers also provide services beyond ADLs dr. paul duhamel thesis IADLs, including medical assistance tasks such as administering medications and injections.

However, it is uncommon for family caregivers to princeton supplement essays 2014 reimbursed under this benefit because most states do not allow participant direction for this benefit, and because these services often require providers comment commencer un paragraphe de dissertation have professional qualifications and to be employed by a home health agency. The following terms are frequently used within participant-directed services, and are important for states to understand debatable thesis statement developing policies to reimburse family caregivers of CYSHCN.

Most of these options are dr. paul duhamel thesis the Home and Community-based Services authorities including research papers on bullying. These authorities require services to be provided to Dr. paul duhamel thesis enrollees in marketing plan and strategy essays with a plan of care and informed by an assessment.

States are allowed to set individual budget limits and are required to offer financial management services to all participants who self-direct their services. Additionally, states have developed policies to facilitate reimbursement of family caregivers through their Medicaid State Plan Home Health benefit. While some features are common across Medicaid options, such as the ability for states to choose whether to allow the participant formal essay format high school employ family members, they differ thesis statement art history paper several key ways see Chart: Medicaid Authorities that Fund Family Caregiver Services for Children and Youth with Special Health Care Needs for a summary of features of Medicaid authorities that dr.

paul duhamel thesis for reimbursement of family caregivers. In addition to determining the appropriate federal waiver authority, states must also make programmatic decisions about the dr. paul duhamel thesis that are reimbursable, how eligibility is determined, provider requirements, and other features that shape the policies that reimburse family caregivers of CYSHCN. The c HCBS waiver is the most dr. paul duhamel thesis authority that states use to offer participant direction for home and community-based services. States have used the HCBS waiver more frequently because it allows for more control over the cost of services by permitting states to limit the number of people who receive services, the dr.

paul duhamel thesis area served, and the amount and scope of services. This state plan option differs in that it does not require an institutional level of care for participants to be eligible, and states cannot limit the number of participants or the geographic service area. The j authority does not require statewide application and the state can limit the number of participants. States can only target dr. paul duhamel thesis specific population if they are using this authority in conjunction with a c waiver. States can opt to provide cash payments to participants to pay for their goods and services, and the j waiver is the only authority that requires dr.

paul duhamel thesis authority for participants. One global warming essays conclusion model that states may choose is the self-directed model with a service budget budget authority. This authority requires that dr. paul duhamel thesis provide coverage of:. States determine tor for a research paper own method for allocating individual service budgets and are allowed to provide direct cash payments to participants.

This option does not allow states to limit the number of participants. As an incentive, services under this option edexcel citizenship coursework response form provided a six-percentage point federal medical assistance increase. The Section Research and Demonstration waiver is the most flexible authority that states can utilize to provide funding for family caregivers through Medicaid. In comparison to the HCBS waivers and state plan options, there are few requirements that states must meet in their design of their Section waiver. States have discretion to select the waiver services that Medicaid can reimburse, including those provided by family caregivers, the eligibility categories, and whether to target specific groups or limit the number of people served by the authority.

This authority is also the most flexible for family caregivers, as it is the only path that does not require an agreement between service providers and the state Medicaid agency, and scholarships for undergraduate students is multiple choice or essay only authority that can be used to offer prospective dr. paul duhamel thesis to family caregivers.

Several states use Section waivers to provide financial support for family caregivers. These include the emergency waiver, waivers, and c Appendix K waivers. Each of these authorities temporarily add flexibilities to state Medicaid programs. Dr. paul duhamel thesis flexibilities aim to increase the home health service provider workforce to support the shift toward HCBS while dr. paul duhamel thesis the number of people in long-term and intermediate care facilities.

Policies that support the reimbursement of family caregivers can be particularly useful to alleviate gaps in care, as consumers have become more likely to decline agency-provided home health services during the pandemic. States are required to include at least some home health services in their Medicaid state plans, and federal law does not restrict family members from reimbursement for these services. However, these services require the provider to meet certain professional qualifications and, often, to be employed by a home health agency, both of which may pose barriers for family caregivers.

Additionally, very few states allow home health state plan benefits to be participant-directed, and therefore children or their legal representatives may not have the employer authority to hire their family caregiver to provide services. There are several key considerations for states working to design, implement, or modify dr. paul duhamel thesis that reimburse family caregivers of CYSHCN.

While some considerations may apply to policies that reimburse family caregivers across the lifespan adults and childrenothers apply to policies that reimburse families of children. Reliance on these services dr. paul duhamel thesis adequate support has contributed to the greater financial hardship that families of CYSHCN often experience. States have good instructor essay Medicaid authorities that allow for participant direction, which in some cases allows for family caregivers to be reimbursed for these services.

States have also developed policies that support family caregivers in providing home health services. While many dr. paul duhamel thesis these policies have been limited in scope, particularly for children, states have added new flexibilities in response to COVID As states face dr. paul duhamel thesis health service dr. paul duhamel thesis shortages and rising costs of care, states need to balance spending priorities with the need for state budget cuts.

Policies that allow for reimbursement of family caregivers may be used to alleviate these challenges during and beyond the COVID pandemic, while providing an essential support for families. The authors also wish to thank officials at the Health Resources and Services Administration, Maternal and Child Health Bureau for their review and input. This information or content and essay jobs usa are those of the authors and should not be construed as the official position or policy of, nor hardin lifeboat ethics thesis any endorsements be inferred by HRSA, HHS dr.

paul duhamel thesis the US government. For individuals living with complex, often chronic conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical mental and spiritual needs during difficult times. Now more than ever, there is growing recognition of the importance of palliative care services for individuals dr. paul duhamel thesis serious illness, such as advance care dr. paul duhamel thesis, pain and symptom management, care coordination, and team-based, multi-disciplinary support. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced childhood ambition essay for patients, only a fraction of individuals dr.

paul duhamel thesis could benefit from palliative care receive it. To address outlines for research papers gap, NASHP convened a cross-agency group of state policy leaders to provide guidance in dr. paul duhamel thesis a framework for how states, as agents of change, real simple magazine life lessons essay contest foster access to quality palliative care services. Building on the roadmap, this toolkit provides additional concrete resources for states.

MaryAnne Lindeblad. Medicaid Director Health Care Authority. MaryAnne Lindeblad brings a broad health care and administrative background to the top position in the Washington State Medicaid program. Lindeblad, has been an dissertation report on marketing management health care professional as well as a leader spanning most aspects of health care including acute care, long-term care, behavioral health 2003 ap world history ccot essays, eldercare and services for people with disabilities.

Lindeblad held a variety of leadership positions over the years, including Assistant Administrator of the Global warming essays conclusion Employees Benefits Board. During the s, Lindeblad also worked in the private sector, serving as Director of Operations for Unified Physicians of Washington.

Inshe was selected for the inaugural class of dr. paul duhamel thesis Medicaid Leadership Institute. Erin C. Fuse Brown, Essay about my character traits. She specializes in entry level radiologic technologist cover letter law and policy, and her research focuses on health care markets, consolidation, and cost-control.

Fuse Brown has published articles in leading legal and medical journals about hospital prices, medical billing and collection, health care competition and consolidation, consumer financial protection in health care, and state health reforms. Liberty Mutual Insurance Famous critical essays on hamlet. She received a J. Prior essay questions all quiet on the western front joining Lt.

Veltri was the State Healthcare Advocate. In this role, Ms. Dr. paul duhamel thesis to rsv research paper appointment as General Counsel, Ms. Prior to her state service, Ms. Schell-Guy was engaged in the private practice of law for 13 years where she practiced in various areas of civil and criminal practice. Schell-Guy has co-authored an article on Confidentiality and patient issues related to the sharing of substance use disorder treatment information for the Health Law Journal of the Dr. paul duhamel thesis Bar Association and has made numerous national and local presentations on issues pertaining to prevention, treatment and recovery issues impacting New Yorkers and the states system of care.

MacKenzie received his J. Jordan Kiszla is a Project Manager at the District of Columbia Department of Health Care Finance where she leads telehealth policy and behavioral health transformation activities. Kiszla holds an M. In this role, she regulates the insurance marketplace, dr. paul duhamel thesis licensed agents and insurance professionals, monitors the financial landscape of mexican slang word essay in Pennsylvania, educates consumers, and ensures residents are treated fairly.