September 30, 2019: Health Data and People with Intellectual and Developmental Disabilities (IDD)
In an effort to better understand the health status and prevalence of people with IDD in the U.S., a workgroup comprised of key agencies within the U.S. Department of Health and Human Services (HHS) and other experts in the field of IDD convened during the first half of 2018 to review the current landscape and future directions related to surveillance for people with IDD.
The first report describes the need for, availability of, and recommendations for changes in surveillance data about people with IDD, particularly adults. Priority criteria for identifying people with IDD relate to measurements of learning, independent living, and age of onset. Additional identifying criteria relate to measurements of communication, self-direction, and expected duration.
The second report describes state level administrative datasets and systems, data collection efforts and surveys that hold promise for describing the population with IDD. Many data systems do not capture the whole population of people with IDD; rather, they identify only that portion who receive specific services. In other population level datasets, people with IDD cannot be identified within the data. The report reviews promising approaches that identify people with IDD in state level data, and that allow state level data to be examined within and across state data systems, including examples of data linkages.
August 27, 2019: Assistive Technology Issue Brief
Assistive technology (AT) includes software, devices, equipment and products that improve the functioning of individuals of all ages with disabilities. Assistive technology can affect a person’s well-being by improving their ability to walk, eat, bathe, communicate, see, speak and live independently. Technologies also can help address social isolation and improve quality of life by assisting people with communication, mobility, and other daily activities.
This issue brief discusses: 1) the important role of assistive technology in helping people of all ages with disabilities live full and independent lives in their communities; and 2) certain sources of public funding for the technology, including Medicare, Medicaid, and programs that the Administration for Community Living (ACL) manages. While other public programs, such as those for Veterans, may fund assistive technology, those programs are beyond the scope of this issue brief.
July 26, 2019: Wheelchair-Accessible Medical Diagnostic Equipment: Cutting Edge Technology, Cost-Effective for Health Care Providers, and Consumer-Friendly
On the 29th anniversary of the Americans with Disabilities Act, ACL is releasing an issue brief explaining why it is good business for providers to invest in accessible medical diagnostic equipment (MDE). This fact sheet describes what accessible medical diagnostic equipment is, how it can help address health care disparities, and how it can help promote compliance with providers' disability rights obligations. It highlights the many benefits of incorporating accessible MDE for providers including the reduction of occupational injuries, increased workforce retention, and enhanced patient experience. Finally, this document highlights the availability of tax credits and technical assistance resources to facilitate the adoption of accessible MDE.
July 22, 2019: Medicaid Buy-in Q&A (PDF): ACL, the Centers for Medicare & Medicaid Services (CMS), and the Department of Labor’s Office of Disability Employment Policy (ODEP) have developed a "question and answer" document to help grantees, stakeholders, and self-advocates better understand the "Medicaid buy-in" program.
Work is about more than a paycheck. It can offer a sense of purpose, community, and belonging. Unfortunately, people with disabilities often face barriers to employment and some even choose to suppress their income to gain or maintain access to critical community services. Medicaid Buy-In is an optional Medicaid eligibility group which allows workers with disabilities with income above traditional limits to access essential Medicaid community-based services.
July 11, 2019: Grandfamilies Issue Briefing: The number of grandparents and other older relatives who are caring for children is significant and growing, in part due to the opioid crisis. Although these caregivers can benefit from their experiences, providing full-time care to children can decrease caregivers' abilities to address their own health and well-being. In addition, these caregivers also may need assistance in meeting the children’s needs.
ACL produced this issue brief to describe grandparent caregivers and the grandchildren they are raising, the special challenges they face, and the resources that could be available to them. The issue brief also highlights examples of programs that assist kinship care families and other efforts under way at the federal level that policymakers intend to better address the needs of this population.
May 1, 2019: Opioids and TBI Grantees Briefing. In a previous brief, ACL's NIDILRR found that people with traumatic brain injuries (TBIs) have significantly greater risk for opioid misuse and overdose. People with TBIs often experience chronic headaches and musculoskeletal injuries for which physicians prescribe opioids. Not only is having a TBI a risk factor for opioid misuse, but opioid misuse can be a risk factor for an acquired brain injury resulting from a lack of oxygen to the brain. Because of the increased risks for someone with a TBI who may require opioids coupled with other pain management interventions, ACL’s TBI State Partnership Program has established a three-pronged approach to improve outcomes for people with TBIs. The brief also highlights promising practices from states.
March 7, 2018: Summary of ACL Stakeholder Discussion: Opioid Public Health Emergency. The meeting is a product of a collaboration among ACL’s Center for Policy and Evaluation, the Administration on Aging, and the National Institute for Independent Living and Rehabilitation Research (NIDILRR), along with other colleagues across ACL.
January 17, 2018: Joint Report: Ensuring Beneficiary Health and Safety in Group Homes Through State Implementation of Comprehensive Compliance Oversight. Model Practices to help states strengthen systems as part of efforts to ensure that group homes are safe and healthy places for people with disabilities, as part of a spectrum of integrated options.
December 2017: The Opioid Public Health Emergency and Older Adults. ACL has authored an issue briefing on opioids. Opioid misuse and addiction have become a large, nation-wide issue. Opioid use disorder can affect people of all ages; racial, ethnic, sexual and gender minorities; income classes; and geographic areas. Older adults are among the groups affected by this problem because they often use prescription opioids to cope with painful chronic conditions, such as arthritis, or procedures, such as surgery.
ACL Issue Briefings
ACL’s Center for Policy and Evaluation is developing issue briefings that document how the Aging or Disability Networks and their partners could work to promote community living by addressing each person’s unique needs for health and long-term services and supports. Each issue briefing discusses the scope of a particular challenge that older adults or adults with disabilities face, describes evidence-based programs that could address the challenge, and provides examples of how relevant ACL programs and others can work together to address the challenge. Examples of state and local innovations are included.
Community Living for American Indian, Alaskan Native, and Native Hawaiian Elders. The Administration for Community Living’s (ACL) mission includes assisting American Indian, Alaskan Native, and Native Hawaiian Elders to live with dignity and self-determination, while participating fully in their communities. This issue briefing provides helpful information to the Aging Network, which includes many organizations serving American Indian, Alaskan Native, and Native Hawaiian Elders; and shares some of the innovative programs that promote health and support community living for Elders.
Educating Adults about Chronic Disease Self-Management. Describes the evidence underlying the successful, nationwide implementation of chronic disease self-management education programs. Provides options for states and localities to consider related to financially sustaining these programs. These evidence-based programs use peer leaders to educate adults with chronic diseases about how to self-manage their conditions and live healthier lives. The programs can lead to improvements in healthy behaviors and less use of hospital and emergency department services.
Principles for Person-directed Services and Supports during Serious Illness. At ACL we believe that every person has the right to make choices and to control their own decisions. This right is independent of age or disability or stage of illness. To help ensure that people who have serious illnesses are able to control their care and services, ACL will be using these principles to inform policy discussions and enhance its existing programs and services related to serious illness among adults and individuals with disabilities. To develop these principles, ACL engaged in several activities: development of educational materials and resources, review of relevant literature, discussions with aging and disability stakeholders, and stakeholder review of draft principles.
Promoting Community Living for Older Adults Who Need Long-term Services and Supports. ACL describes how states could provide home and community-based services to adults with disabilities and help them remain in their homes and communities. The special circumstances of older adults with dementia, who are at high risk of nursing home use, are also described.
Dementia-capable States and Communities: the Basics. Discusses how states and communities can become dementia-capable, that is, able to help people with dementia and their caregivers. To show how this can be done, there are examples of innovative programs.
Responding to the Wandering and Exit-seeking Behaviors of People with Dementia. Describes how to address the wandering and exit-seeking behavior of people with dementia who live in the community. Person-centered care is the key to responding to wandering. Knowing people and their needs and history helps caregivers anticipate ways to meet needs and prevent injury.
Opportunities to Improve Nutrition for Older Adults and Reduce Risk of Poor Health Outcomes. There are examples for states and others to consider when seeking to improve adults’ health and well-being through malnutrition interventions for community-living older adults, and those experiencing hospitalization.
Oral Health and Its Impact on Adults who are Older or Have Disabilities. Describes how a person’s overall health is related to their oral health and a number of options states have for expanding access to oral health.