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Annotation: This paper reviews the statutory basis and mechanics of demonstrations and program waivers, as well as their history and political context in shaping Medicaid and the State Children's Health Insurance Program. It also explores the ways the changing state-federal relationship and the ever-growing demand for state flexibility have driven waiver policy and examines the impact of the Deficit Reduction Act of 2005 on the need for or desirability of waivers.

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Keywords: Federal programs, Health care financing, Medicaid, State Children’s Health Insurance Program, State programs, Waivers

Annotation: This paper examines 11 State Children's Health Insurance Programs (SCHIPs) that cover parents as well as children. The paper discusses (1) the federal SCHIP waiver policy (which allows states to use SCHIP funds in ways that are not otherwise permitted by law); (2) why states sought to cover parents with SCHIP waivers; (3) eligibilty; enrollment, and benefits under SCHIP parent waivers; (4) spending under SCHIP waiviers; and (5) impact of SCHIP parent waiver coverage. A conclusion and endnotes are included. Statistical information is presented in figures and tables throughout the paper.

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Keywords: Costs, Eligibility, Enrollment, Low income groups, Parents, Public policy:, State Children's Health Insurance Program, Waiver programs, Waivers

Annotation: This report to the U.S. Senate Committee on Finance discusses a review of Social Security Act section 1115 waiver requests by states to modify Medicaid and the State Childrens Health Insurance Program (SCHIP). Topics of the review were (1) types of waiver proposals that have been submitted and approved; (2) whether the U.S. Department of Health and Human Services (HHS) has ensured that the approved waivers are consistent with the goals and fiscal integrity of Medicaid and SCHIP; and (3) the extent to which there has been opportunity for public input into the expedited process. The report offers recommendations for Congressional and executive action, agency and state comments about the review, and the General Accounting Office's (GAO)evaluation. The appendices include descriptions of four recent Section 1115 waiver approvals; waiver applications under review; the response of the HHS General Counsel's Office and HHS; comments from the states of Arizona, Illinois, and Utah, along with GAO contact and staff information.

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Keywords: Arizona, California, Federal programs, Health insurance, Illinois, Medicaid, State children's health insurance program, State programs, Utah, Waivers

Annotation: This report provides (1) a brief description of approximately 140 federally funded programs directed specifically toward children and their families, as well as the programs' tax rules, (2) federal funding amounts, (3) participation data, (4) information about how the program/tax rule is targeted, (5) selected program characteristics such as entitlement status, whether features of the program are indexed, matching requirements, and whether major waivers or federal rules are allowed, and (6) Congressional committee involvement. Programs are grouped into the following categories: education and training, health, housing, income support, nutrition, and social services. Tables at the end of each section summarize selected information about the programs and tax rules described in the section. The report concludes with copies of two letters requesting the report, and a list of credits. It was originally published by the Congressional Research Service in 1999 and republished by IEL under a different title.

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Keywords: Children, Data, Entitlements, Families, Federal programs, Financing, Health, Housing, Nutrition, Participation, Social services, Taxes, Training, Waivers

Annotation: This oversized chart enumerates the basic required Medicaid services and shows the optional services offered by the individual states, the District of Columbia, American Samoa, Guam, Puerto Rico, and the Virgin Islands in a tabular display. The reverse side of the poster indicates changes made in state Medicaid programs listing services added or deleted in each state.

Keywords: Health services, Medicaid, Medicaid managed care, State programs, Supplemental Security Income, Waiver 1115

Annotation: This report presents the results of analyses of the implementation of waivers to the regulations for the Aid to Families with Dependent Children program in five states. The programs analyzed were located in Florida, Indiana, New Jersey, Virginia, and Wisconsin. The report provides information on the purpose, context, and methodology of the study and presents and discusses the findings. The states used the waivers to add work requirements, place time limitations on the provision of services, and impose family caps which deny cash benefits for children born to families already participating in Aid to Families with Dependent Children. The states reorganized the operations and the management of their programs to redefine how the staff and clients interact, to increase the involvement of employers and communities, and to restructure their service delivery systems. Not all of the programmatic changes or management revisions were used in each of the five states.

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Keywords: Aid to Families with Dependent Children, Florida, Indiana, New Jersey, State initiatives, Virginia, Waiver programs, Welfare programs, Wisconsin

Annotation: This report examines the four Medicaid demonstration Section 1115 waiver programs that were approved since 1993 and fully implemented at the time of this study, in Hawaii, Oregon, Rhode Island, and Tennessee. The study examined the impact of the waivers on children, in particular on service access issues, especially for children with special health needs. [Funded by the Maternal and Child Health Bureau]

Keywords: Access to health care, Children, Children with special health care needs, Hawaii, Medicaid managed care, Oregon, Rhode Island, State programs, Tennessee, Waiver 1115, Waiver programs

Annotation: This report examines states' experiences in utilizing the flexibility offered by the Medicaid waiver program to provide care for adults with developmental disabilities in alternative settings. Appendices include scope and methodology; waiver programs in Florida, Michigan, and Rhode Island; and licensure, certification, and other standards for waiver program services.

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Keywords: Developmental disabilities, Long term care, Medicaid, Waiver programs

Annotation: This report is a product of a technical assistance project for Maryland's Office of Children's Health and Division of Medical Assistance. The technical assistance project focused on the development of guidance on contract language for managed care providers serving children with special health care needs. The report gives an overview of Maryland's Section 1115 waiver, the framework for care provided by federal EPSDT law, critical issues for children with special health care needs, and quality monitoring. A list of references is included. [Funded by the Maternal and Child Health Bureau]

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Keywords: Children with special health care needs, Contract services, Managed care, Maryland, Medicaid managed care, Quality assurance, State health care reform, Technical assistance, Technical assistance, Waiver programs

Annotation: This collection of fact sheets contains materials on various aspects of Medicaid managed care. They provide an introduction to Medicaid managed care, and cover the Section 1915(b) and Section 1115 health care reform waivers. Individual fact sheets review issues relating to access and utilization, cost, quality, patient satisfaction, EPSDT, children with special health needs, the public health role, planning and monitoring, and quality assurance. The fact sheets were originally prepared for the "PIC Briefing Book: Medicaid Managed Care and MCH" which was produced for the October, 1994 meeting of the MCH Partnership for Information and Communication (PIC) Interorganizational Work Group. [Funded by the Maternal and Child Health Bureau]

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Keywords: Access to health care, Cost effectiveness, Costs, Evaluation, Health care financing, Health care utilization, MCH programs, Medicaid managed care, Public health infrastructure, Quality assurance, State health care reform, Waiver 1115, Waiver 1915, Waiver programs

Annotation: This loose-leaf binder is a collection of materials on recent developments in Medicaid managed care prepared for a September, 1994 meeting of the MCH Partnership for Information and Communication (PIC) Interorganizational Work Group. The book is divided into three main sections: fact sheets, bibliographies, and background materials. Fact sheets provide an introduction to Medicaid managed care, including an overview of Section 1915(b) and Section 1115 health care reform waivers. Bibliographies on the topic contain citations and abstracts to journal articles and to materials from the National Center for Maternal and Child Health's Reference Collection. Background papers focus on state health care reform measures, the impact of Medicaid managed care on children with special health needs, legislative issues, and Medicaid managed care waiver programs. [Funded by the Maternal and Child Health Bureau]

Keywords: Access to health care, Bibliographies, Children with special health care needs, Cost effectiveness, Costs, Evaluation, Health care financing, Health care utilization, MCH programs, Medicaid managed care, Public health infrastructure, Quality assurance, State health care reform, Waiver programs

Annotation: The purpose of this report is to examine the likely impact of Medicaid programs on children with special health care needs by looking at four states that have had waiver applications approved and are currently implementing demonstration programs—Hawaii, Oregon, Rhode Island, and Tennessee. It also considers the likely impact of waiver programs on the major publicly funded programs with responsibility for special needs children—state programs for children with special health care needs (CSHN). Following an introduction on the concept of waivers and demonstration programs, the report is divided into three other chapters. Chapter 2 describes demonstrations of waiver programs in the four states and assesses the impact of the programs on children with special health care needs. Chapter 3 contains an analysis of the ways in which the four programs have affected, or are likely to affect, the CSHN programs in those states. Chapter 4 provides a summary of the findings and offers suggestions regarding the issues that states might want to consider in planning future waiver programs and the new roles and responsibilities that CSHN programs adopt in waiver program states. [Funded by the Maternal and Child Health Bureau]

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Keywords: Access to health care, Children with special health care needs, Demonstration programs, Hawaii, Health care financing, Health care reform, Medicaid managed care, Oregon, Rhode Island, Service delivery systems, State CSHCN programs, Tennessee, Waivers

Annotation: This audiocassette describes Medicaid program experiences to date in Tennessee and Oregon and indicates possibilities for future activities.

Keywords: Medicaid, Medicaid managed care, Oregon, Tennessee, Waiver 1115, Waiver programs

Annotation: This report examines managed care program initiatives developed by state governments, focusing on states' use of managed care programs; the difficulty states face in implementing certain program components; the effect of the managed care approach on health care access, quality, and cost; and the presence of features that assure the quality of health services and providers' financial stability. Appendices include detailed examinations of programs in Arizona, Kentucky, Michigan, Minnesota, New York, and Oregon.

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Keywords: Access to health care, Consumer education, Cost containment, Enrollment, Insurance, Medicaid managed care, Provider participation, Public health infrastructure, Quality assurance, State government, State programs, Waiver programs

Annotation: This report describes the experience of nine states in applying for, renewing, and administering Medicaid waivers to permit payment for home care provided to chronically ill children, including difficulties experienced and levels of satisfaction.

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Keywords: Children with special health care needs, Home care, Medicaid, State programs, Waivers

Annotation: The primary objective of the study resulting in this report was to examine the services and costs associated with serving chronically ill children in alternative care settings, namely Medicaid waiver programs serving these children. Other objectives were: to determine whether serving chronically ill children in alternative care settings under Medicaid waiver programs is a cost-effective alternative to institutionalization; to profile the population served under these waivers; and to determine what measures and assurances of quality care were and are being utilized by waiver program administrators. 9 states serving chronically ill and/or disabled children were visited and client level data were abstracted from each site. The 4 major findings of the study were: 1) that Medicaid waiver programs serving chronically ill children in home care settings result in lower costs to Medicaid; 2) that the population served by the waiver programs is a severely ill and disabled one; 3) that the role of State Crippled Children Services Agencies varied widely among states; and 4) that waiver programs in many states were infrequently used, used only by a specific disease group population, or used primarily by the patients of a specific provider institution.

Keywords: Children with developmental disabilities, Children with special health care needs, Chronic illnesses and disabilities, Health care financing, Infants with developmental disabilities, Infants with special health care needs, Medicaid, Waiver programs