OHIO’S MONEY FOLLOWS THE PERSON DEMONSTRATION Ohio Balancing Efforts February 2011

2 Ohio’s Vision for Long Term Services and Supports Ohioans who need long-term services and supports... Get services and supports they need in a timely and cost-effective manner, In settings they want from whom they want, And if needs change, services and supports change accordingly.

3 Connecting the Transition Program to System Reform Ohio’s MFP program is cross-disability – One must look at the whole system before understanding the parts. –Recognize “no wrong door” with focus on integration and information – improved discharge planning through partnerships –Connected MFP to PASRR to MDS 3.0 Section Q Ohio has transitioned over 900 people since October 2008 in all population categories and all ages with an additional 650 in process as of January 2011.

4 Connecting the Transition Program to System Reform Ohio created a Money Follows the Person Enhanced Reimbursement Fund in Amended Substitute House Bill Number 562 SECTION MONEY FOLLOWS THE PERSON ENHANCED REIMBURSEMENT FUND The Money Follows the Person Enhanced Reimbursement Fund is hereby created in the state treasury. The federal payments made to the state under subsection (e) of section 6071 of the "Deficit Reduction Act of 2005," Pub. L. No , shall be deposited into the Fund. The Department of Job and Family Services shall use money deposited into the Fund for system reform activities related to the Money Follows the Person demonstration project.

5 Balancing Ohio’s Long Term Services and Supports System Strategies to reform the long-term services and supports system fall within all eight components of a balanced delivery system: housing, workforce, services, quality, self-direction, access (also known as the front door), organization and institutional supply controls. Balance in Ohio means: –Choice in services and settings –Flexibility –Transparency –Integration –Seamless, Cost-Efficient, High Quality and Responsive Service Delivery –Personal Responsibility in Making Decisions

6 Balancing Ohio’s Long Term Services and Supports System Ohio uses the HOME Choice Transition Program as a catalyst to break down system barriers and increase partnerships at the local and state level. Examples include: Progress toward cross-disability partnerships Breaking down the siloed nature of Ohio policy and operations (e.g. PASRR policy changes, Unified Long Term Care Budget, Deeming of providers across settings within HOME Choice operations) Deliberate pilots to determine what is needed to help persons with MH and children to move and remain in community settings 100% funding from CMS to break down system barriers unique to the MH population. Partnering with Public Housing Authorities to connect Medicaid to Housing resources (e.g., Cuyahoga Metropolitan Housing Authority Pilot, Lucas and Cinci HUD NOFA Awards)

7 Balancing Ohio’s Long Term Services and Supports System Examples include: Cross-Disability HOME Choice Consumer Advisory Council developed through Ohio Olmstead Task Force and Ohio DD Council Funding to support Olmstead Conferences and empowerment tools “Profile of Ohio’s LTSS System” with performance measures of systems improvement tracked by a web-based tool (Sub-grant with Miami University of Ohio) Enhancements to Direct Support Workforce and development of a career lattice (Sub-grant with The Ohio State University) Partnerships with State and Local Housing Authorities (e.g. Partnership with Ohio Housing Finance Agency - developed a PSH/Medicaid Toolkit – see

8 Balancing Ohio’s Long Term Services and Supports System Examples include: Testing innovative services (e.g. community support coaching) and strategies to help persons move home (e.g. Expedited SSI) and maintain continuity (e.g. PASRR policy changes) Modifying functional eligibility in a four phase approach Connecting data resources to see the “whole person” Developing a matrix of long term services and supports and a guide to “inform” all doors in the system to assure consistency and efficiency Building Local Housing and Services Cooperatives in local communities (e.g. back up supports, home modifications, transportation) – partly funded at 100% from the MFP grant.

9 Building a Partnership between MFP and ADRC MDS 3.0 Section Q – Interim Plan: Medicaid Agency as a clearinghouse to Local Contact Agency Current Plan: Move Section Q Local Contact Agency to ADRC once statewide (connected to the 5 year plan)

10 Building a Partnership between MFP and ADRC Connecting Local Housing and Services Cooperatives (LHSC) to ADRC –A HOME Choice Local Housing and Services Cooperatives is defined as a broad-based group of persons, whose mission is driven by persons with disabilities, including providers of affordable housing, and service and transportation supports, working together to address the needs of people with disabilities in their community. Through partnership with the HOME Choice Housing Workgroup, these cooperatives will work to improve access to housing, transportation and supports that are integrated, accessible, and affordable. –A cooperative is a group of individuals working together to share resources in order to achieve a common goal. Resources may be fiscal (money), products, or services.

11 Building a Partnership between MFP and ADRC –Local Housing and Services Cooperatives under development with Ohio Centers for Independent Living include: 1.) Funding to support an inventory of home modifications and assistive equipment as well as a potential “loan” program within Ohio’s Centers for Independent Living. 2.) Person Assistance 3.) Housing 4.) Transportation Current plan: Use LHSC with the CILs to form a partnership with AAAs and the ADRC so that the ‘d’ is a ‘D’.

12 For More Information: Erika Robbins, Ohio Project Director Visit the website at /mfpgrant/info.stm /mfpgrant/info.stm (webpage for technical aspects of the grant) homechoice.stm (webpage for consumers, providers, case managers, transition coordinators)