DALTCP provides leadership on HHS policies that support the independence, health and productivity of elderly individuals and people with disabilities. DALTCP staff work on long-term care, post-acute care, personal assistance services, family care giving, integrated care (including for dual eligibles), rehabilitative services, employment of people with disabilities, mental health parity, and the direct care workforce.
Division of Behavioral Health and Intellectual Disabilities Policy
The Division of
Behavioral Health and Intellectual Disabilities Policy focuses on financing, delivery, and quality of services and
supports for individuals with mental illnesses, substance use disorders, or intellectual disabilities. Areas of
focus include coverage and payment issues in private insurance, Medicaid and Medicaid, quality and consumer
protection issues, and programs and policies of HHS agencies as they affect adults, children and youth with mental
health conditions, substance abuse, or intellectual disabilities.
Division of Long-Term Care Policy
The Division of Long-Term Care Policy focuses on the
long-term care and personal assistance needs of people of all ages with chronic disabilities. Areas of focus include
assessing the interaction between health care, chronic care, long-term care, and supportive services needs of
persons with disabilities across the age spectrum; determining service use and program participation patterns; and
coordinating the development of long-term care data and policies that affect the characteristics, circumstances, and
needs of people with long-term care needs, including older adults and people with disabilities.
Division of Disability and Aging Policy
The Division of Disability and Aging Policy is
responsible for policy development, coordination, research and evaluation of policies and programs focusing on
persons with disabilities and older Americans. This includes measuring and evaluating the impact of all programs
authorized by the Older Americans Act. Aging activities related to older Americans are carried out in coordination
with other HHS agencies and organizations. The Division is also responsible for supporting the development and
analysis of crosscutting disability and aging data and policies within the Department and in other federal agencies.
TOPIC AREAS:
- Acute/Long-Term Care Integration
- Aging Services
- Behavioral Health
- Care Coordination -- Medicaid Health Homes and Primary and Behavioral Health Integration
- Disability
- Dual Eligibles
- Elder Rights/Adult Protective Services
- Falls Prevention
- Housing with Services
- Informal Caregiving
- Long-Term Care Financing
- Long-Term Care Insurance
- Medicaid Home and Community-Based Services (HCBS)
- Mental Health Parity and Addiction Equity Act (MHPAEA)
- Residential Care
- Serious Mental Illness -- Early Intervention and Evidence-Based Practices
- Skilled Nursing Facilities/Nursing Facilities (SNF/NF) and Nursing Home Quality
OTHER HELPFUL INFORMATION:
VIEW REPORTS:
Advancing Integrated Care: Lessons from Minnesota
Jhamirah M. Howard and Jennifer Baron Office of the Assistant Secretary for Planning and Evaluation Printer Friendly Version in PDF Format (8 PDF pages)
What Do People Know About Long-Term Services and Supports?
Galina Khatutsky, Joshua M. Wiener, Nga Thach and Angela M. Greene RTI International Printer Friendly Version in PDF Format (18 PDF pages)
Long-Term Services and Supports: What are the Concerns and What are People Willing to Do?
Angela M. Greene, Nga Thach, Joshua M. Wiener and Galina Khatutsky RTI International Printer Friendly Version in PDF Format (17 PDF pages)
Which Way for Long-Term Services and Supports Financing Reform?
Joshua M. Wiener, Galina Khatutsky, Nga Thach and Angela M. Greene RTI International Printer Friendly Version in PDF Format (22 PDF pages)
Choosing Long-Term Care Insurance Policies: What Do People Want?
Derek Brown Washington University Benjamin Allaire and Joshua Wiener RTI International Printer Friendly Version in PDF Format (25 PDF pages)
National Plan to Address Alzheimer's Disease: 2016 Update
Printer Friendly Version in PDF Format (93 PDF pages)
Picture of Housing and Health Part 2: Medicare and Medicaid Use Among Older Adults in HUD-Assisted Housing, Controlling for Confounding Factors
The Lewin Group Printer Friendly Version in PDF Format (67 PDF pages)
Older Adults' Living Expenses and the Adequacy of Income Allowances for Medicaid Home and Community-Based Services
Richard W. Johnson and Stephan Lindner Urban Institute Printer Friendly Version in PDF Format (22 PDF pages)
Later-Life Household Wealth Before and After Disability Onset
Richard W. Johnson Urban Institute Printer Friendly Version in PDF Format (52 PDF pages)
Picture of Housing and Health Part 2: Medicare and Medicaid Use Among Older Adults in HUD-Assisted Housing, Controlling for Confounding Factors
The report Picture of Housing and Health (released by ASPE in 2014), found high prevalence of chronic conditions and higher health care utilization for HUD-assisted Medicare beneficiaries compared to unassisted beneficiaries. This second report seeks to understand whether the characteristics of the sample could explain the higher utilization. The study compares health care utilization and spending between HUD-assisted Medicare beneficiaries and unassisted beneficiaries taking into account confounding factors.
Older Adults' Living Expenses and the Adequacy of Income Allowances for Medicaid Home and Community-Based Services
This brief assesses the adequacy of the income allowances granted to older Medicaid HCBS enrollees and their spouses. We measure household expenditures made by older households and compare them to the Medicaid HCBS income allowances provided by the state in which they reside, to see how much they would have to reduce their spending if they enrolled in Medicaid HCBS and did not allow their expenses to exceed those income allowances.
Later-Life Household Wealth Before and After Disability Onset
To assess the financial impact on families of LTSS needs and the potential for families to set aside funds to cover future LTSS spending, this brief examines later-life household wealth before and after disability onset. We followed over time a large sample of older adults who did not have any functional limitations at baseline, comparing the distribution and composition of household wealth for those who did and did not develop severe disabilities, experience extended nursing home stays, and receive Medicaid-financed nursing home care.
Final Process Evaluation of the Balancing Incentive Program
Sarita L. Karon, PhD, Molly Knowles, MPP, Brieanne Lyda-McDonald, MS, Trini Thach, BS, and Joshua M. Wiener, PhD RTI International Diane Justice, MA, Scott Holladay, MPA, and John Tranfaglia, BA National Academy for State Health Policy Mary Sowers, BA National Association of State Directors of Developmental Disability Services Printer Friendly Version in PDF Format (38 PDF pages)
Evaluation of the Medicaid Health Home Option for Beneficiaries with Chronic Conditions: Progress and Lessons from the First States Implementing Health Home Programs, Annual Report - Year Four
Brenda C. Spillman, Eva H. Allen, Nicole Lallemand, and Emily Hayes Urban Institute Printer Friendly Version in PDF Format (78 PDF pages)
Minnesota Managed Care Longitudinal Data Analysis
This project studied the delivery of Medicare and Medicaid-funded services to dually eligible beneficiaries aged 65 and older in Minnesota. It compared fully-integrated managed care to service delivery when Medicare and Medicaid-funded services are delivered independently. The fully integrated Medicare-Medicaid managed care plans had greater primary care physician use and lower inpatient hospital and emergency department use. Similarly, home and community-based services use was greater and nursing home use was no greater. Once enrolled in the fully integrated plan, nearly all beneficiaries chose to remain, rather than switch to the alternative. In Minnesota, the fully integrated plan appears to be an improvement over the fragmented delivery systems of separate Medicare and Medicaid programs, yielding improved consumer satisfaction and service use.
Benefits of Medicaid Expansion for Behavioral Health
Across the country, state and local officials are increasingly focused on improving health outcomes for people living with mental illness or substance use disorders. This brief analyzes national data on behavioral health and reviews published research focused on how Medicaid expansion under the Affordable Care Act advances the goal of improving treatment for people with behavioral health needs.
How Much Nursing Home Care Can Home Equity Finance?
Stephan Lindner Urban Institute Printer Friendly Version in PDF Format (39 PDF pages)
How Much Nursing Home Care Can Home Equity Finance?
Older adults who have income and assets have choices should they need long-term services and supports (LTSS). In this paper we estimate the extent to which older adults could potentially use home equity to help pay for nursing home care. By estimating the relationship between home equity and care costs, we provide an upper bound on how much assistance with LTSS home equity might purchase. Using a large sample of older adults from the American Community Survey in 2011, we compare their estimated level of home equity to the cost of nursing home care in their area.
County Experiences with Medicaid Expansion Implementation: Case Study Report
Kathleen Farrell, BA, Tasseli McKay, MPH, Heather Beil, PhD, Lexie Grove, BA, Stephanie Kissam, MPH, Erin Mallonee, MS, and Melissa Romaire, PhD RTI International Printer Friendly Version in PDF Format (68 PDF pages)
Does Home Care Prevent or Defer Nursing Home Use?
Are chronically disabled elders residing in the community who use home and community-based services (HCBS) less likely to end up in a nursing home? The 2004 National Long-Term Care Survey (NLTCS), a nationally representative sample of Americans aged 65 and older, was linked to follow-up years of Medicare/Medicaid claims and other administrative data.
Does Home Care Prevent or Defer Nursing Home Use?
Brenda Spillman Urban Institute Printer Friendly Version in PDF Format (35 PDF pages)
Support and Services at Home (SASH) Evaluation: Second Annual Report
Amy Kandilov, Vincent Keyes, Noëlle Siegfried, Patrick Edwards, Ann Larsen, Kevin Smith, Celia Eicheldinger, Nancy McCall, Martijn Van Hasselt, and Doug Raeder RTI International Alisha Sanders and Robyn Stone LeadingAge Printer Friendly Version in PDF Format (71 PDF pages)
Review of Medication-Assisted Treatment Guidelines and Measures for Opioid and Alcohol Use
Stefanie Pietras, Melissa Azur and Jonathan Brown Mathematica Policy Research ABSTRACT
