TAC REPORTS

CA Needs Assessment Exec Summary

The primary purpose of this Mental Health and Substance Use System Needs Assessment, which was conducted by TAC on behalf of the California Department of Health Care Services (DHCS), was to review the needs and service utilization of current Medicaid recipients and identify opportunities to ready Medi-Cal, California’s Medicaid program, for the expansion of enrollees and the increased demand for services resulting from health reform. The full report can be found on DHCS' website. (2012)

Creating New Integrated Permanent Supportive Housing Opportunities For ELI Households

The long-awaited activation of the National Housing Trust Fund (NHTF) program, which will primarily be targeted to rental housing for extremely low-income (ELI) households, represents an important new opportunity for states to begin shaping the future of our nation’s ELI housing policies, including a robust expansion of integrated permanent supportive housing (PSH) units for the most vulnerable ELI populations. Over the past decade, in response to the enormous and growing demand for PSH, a number of state housing agencies – including Pennsylvania, North Carolina, and Illinois – have successfully pioneered new ELI financing approaches to increase the supply of integrated PSH units. This report documents innovative ELI financing strategies developed by these three states which could be adapted for NHTF capital and operating subsidy funding to begin closing the enormous gap in ELI and PSH supply.

Exploring Value-Based Payment to Encourage Substance Use Disorder Treatment in Primary Care

Expanding the capacity and ability of primary care providers to assess and treat substance use disorders is critical. With support from the Melville Charitable Trust, TAC and the Center for Health Care Strategies conducted interviews with stakeholders to understand how value-based payment (VBP) levers can be used to encourage this type of integration. Drawing from the interviews, this brief examines how states and health plans are exploring VBP to promote SUD treatment in primary care, and offers considerations for implementing these models.

Going it Alone

This report developed by TAC and the Consortium for Citizens with Disabilities (CCD) Housing Task Force assesses and documents barriers which have constrained the disability community’s efforts to expand housing opportunities, as well as best practices in communities to expand both homeownership and rental housing options for people with disabilities. (2000)

Hidden Housing Crisis

This report outlines a study that used data about households with severe rent burdens from the 2005 American Community Survey (ACS) to develop more accurate estimates of ‘worst case' housing needs among households containing non-elderly adult renters with disabilities. Worst case needs, a concept intended to measure renters with acute needs for housing assistance, are unassisted renters with incomes below half of their area’s median income who pay more than half of their income for housing or live in severely substandard housing. The study found that an estimated 2.1 - 2.4 million of the 6 million households in the U.S. with worst case housing needs are non-elderly disabled households. (2008)

Integrating Substance Use Disorder Treatment & Mainstream Medical Care

This brief offers four examples of the integration of SUD treatment and mainstream medical care. Rather than search for a uniform set of requisite traits, we decided to show why and how four very different groups of providers have moved toward integrated care.

Live in Aides

One of the issues that Public Housing Authorities (PHAs) often face when assisting people with disabilities through the Housing Choice Voucher Program is that of live-in aides. This Fact Sheet provides information on live-in aides including U.S. Department of Housing and Urban Development (HUD) regulatory requirements and key definitions as well as ideas for PHAs to consider in setting local standards for review and approval of live-in aides. (2003)

New Mexico BH Assessment

This report outlines a comprehensive assessment conducted by TAC of behavioral needs and gaps in New Mexico stemming from legislative and executive branch direction and funded by multiple state agencies and managed care organizations. (2002)

Olmstead at 20

Thanks to the historic Olmstead decision 20 years ago, many more people with mental illness now live in integrated, community-based settings rather than in psychiatric hospitals, nursing homes, or large board and care facilities. Yet for far too many people with mental illness who end up unnecessarily in jails and prisons, the promise of the ADA and Olmstead remains unfulfilled. Kevin Martone, Francine Arienti, and Sherry Lerch explore the reasons, and propose new directions in advocacy and policymaking for community integration.

Priced Out: The Housing Crisis for People with Disabilities

The tenth edition of TAC's Priced Out report, created with our partners at the Consortium for Citizens with Disabilities Housing Task Force, once again demonstrates that non-elderly adults with disabilities who rely on Supplemental Security Income are among the groups most severely affected by the extreme shortage of affordable rental housing across our nation. Learn more, and use our interactive tool to learn about the affordable housing crisis for people with disabilities in your own community, on our Priced Out page.

State Approaches to Developing the Residential Treatment Continuum for Substance Use Disorders

Learn how state Medicaid agencies are taking action to expand the continuum of care available to Medicaid recipients with substance use disorders - and how they are meeting the challenges that come with this newly expanded coverage. With the support of Arnold Ventures, TAC conducted interviews in five states that have been early leaders in modernizing their SUD treatment systems - download the report or watch a webinar for a summary of our findings.

State Funded Housing Assistance Report

Many states have established state funded programs to address the affordable housing crisis among people with disabilities or people who are homeless or at-risk of homelessness. This report presents findings of a review conducted by TAC of state funded rental assistance and homelessness prevention programs across the U.S. for people with mental illness or other disabilities. The report identifies several characteristics of programs that can be useful as a resource for states considering the development or modification of existing state funded programs. Some of the challenges associated with developing and administering state funded programs are highlighted as well. Profiles of state programs are also included. (2014)

State Strategies to Expand Medication-Assisted Treatment

This report is intended to support state Medicaid agencies and payers in improving access to substance use disorder treatment, with a special focus on medication-assisted treatment (MAT) for opioid use disorder. With support from Arnold Ventures, TAC and partners conducted a review of state activities that have significantly increased both the number of individuals receiving MAT for opioid use disorder, and the number of providers delivering MAT services.

Supported Employment Financing

The Assistant Secretary for Planning and Evaluation (ASPE) within the U.S. Department of Health and Human Services (HHS), in conjunction with the Federal Employment Workgroup on Disability, commissioned a review of the federal financing mechanisms used by state agencies to implement the evidence-based employment models known as Individual Placement and Support (IPS) and Customized Employment (CE). This report identifies strategies for improved access to federal financing of IPS and CE services for persons with mental illness through case studies of current state and local practices. Through a subcontract with Westat, TAC staff contributed to this report by detailing how Medicaid resources can be used to finance supported employment. (2011)