The Affordable Care Act: Opportunities for States to Increase Home- and Community- Based Services in Medicaid Dee Mahan, Families USA October 7, 2010.

Slides:



Advertisements
Similar presentations
FamiliesUSA Health Action 2010 Conference January 29, 2010 Gene Coffey National Senior Citizens Law Center.
Advertisements

Long Term Solutions for Long-Term Care Families USA Health Action 2009 Conference Gene Coffey National Senior Citizens Law Center.
State Balancing Incentive Payments Program (§10202 of HR 3590, The Patient Protection and Affordable Care Act)
What the Affordable Care Act Means for Aging Consumers October 1, 2010 Alliance for Health Reform Briefing JoAnn Lamphere, DrPH Director, State Government.
The Affordable Care Act: Individuals with Disabilities, Individuals with Chronic Conditions and Individuals Who Are Aging Building A Strong Foundation.
Center on Budget and Policy Priorities cbpp.org Medicaid To Expand or Not to Expand ACA Implementation in Indiana: Challenges, Strategies and Solutions.
Statewide advocacy coalition of over 130 organizations representing the interests of Medicaid consumers Lara Kassel, Coordinator --
DataBrief: Did you know… DataBrief Series ● February 2011 ● No. 12 Dual Eligibles Across the States In 2008, dual eligibles as a percent of the total Medicare.
Medicaid for Transition Age Youth and Workers with Disabilities Annette Shea, Center for Disability and Aging Policy December 12, 2013.
T HE B ALANCING I NCENTIVE P ROGRAM May 6, Program Overview  Section of the Affordable Care Act  Provides incentives for states to increase.
Employment in a Medicaid Environment: State Agencies’ Strategic Investment in System Improvements to Increase Employment Outcomes APSE June 2012 Rie Kennedy-Lizotte.
MEDICAID – CONTEXT FOR CHANGE Mike Cheek Vice President, Medicaid and Long Term Care Policy.
1 Medicaid Long-Term Services and Supports Eric Saber, Health Policy Analyst Long Term Care and Community Support Services Maryland Department of Health.
September 5, 2012 For the 4 th Annual Long Term Care Policy Summit.
Indiana FSSA Division of Aging Ellen Burton. Flexible financing for long term care Increased options for those in need of long term care. Largest demonstration.
1 Balancing Incentive Program Governor’s Conference on Aging & Disability.
Medical Assistance Program Oversight Council March 14, 2014.
SoonerCare and National Health Care Reform Oklahoma Health Care Authority Board Retreat August 26, 2010 Chad Shearer Senior Program Officer Center for.
Medicaid, BHP, and CHIP: Current Issues in ACA Implementation Eliot Fishman, PhD Director, Children and Adults Health Program Group Center for Medicaid.
Delaware Health and Social Services Delaware’s Delivery of Long Term Services and Supports The Need for Change Delaware Health Care Commission January.
Medicare Improvement for Patients and Providers Act of 2008 Preliminary Summary of Beneficiary and Plan Provisions July 14 th,
Long-Term Care Policy Summit Suzanne Crisp Director of Program Design & Implementation Boston College.
SustiNet Health Partnership Overview December 2010 Anya Rader Wallack Katharine London Linda Green Stan Dorn.
Maryland’s Money Follows the Person Rebalancing Demonstration Maryland Medicaid Advisory Committee Stacey Davis March 26, 2007.
Affordable Care Act Aging Network Opportunities Judy Baker Regional Director Health and Human Services October 18, 2010.
Montana Community Choice Partnership Money Follows the Person (MFP) Demonstration Grant Stakeholder Advisory Council Meeting March 10, 2015.
Stephanie Hull MGA Conference Chief, Long Term Services and Supports June 7, 2012 Maryland Department of Aging.
Balancing Incentive Program and Community First Choice Eric Saber Health Policy Analyst Maryland Department of Health and Mental Hygiene.
The Affordable Care Act: Individuals with Disabilities, Individuals with Chronic Conditions and Individuals Who Are Aging Damon Terzaghi Nancy Kirchner.
Summary of the Future of Medicaid Long-Term Care Services in PA: A Wakeup Call Report cosponsored by University of Pittsburgh Institute of Politics & the.
New York State Department of Health Office of Long Term Care Long Term Care Restructuring Annual Long Term Care Ombudsman Training Institute October 18,
MARY SOWERS 1 Medicaid Basics: Long Term Services and Supports Center for Medicaid and State Operations Disabled and Elderly Health Programs Group.
Medicaid Employment: Options and Incentives
Overview of the Maryland Primary Adult Care (PAC) Program Rhode Island Policy Makers Breakfast November 17, 2010 Stacey Davis Deputy Director of Planning.
Terence Ng MA, Charlene Harrington, PhD Department of Social & Behavioral Sciences University of California, San Francisco 3333 California Street, Suite.
K A I S E R C O M M I S S I O N O N Medicaid and the Uninsured Figure 0 Robin Rudowitz Associate Director Kaiser Commission on Medicaid and the Uninsured.
New Community Opportunities Center at ILRU 0 New Community Opportunities Center at ILRU Presents… New Community Opportunities from the Affordable Care.
1 Health Care Reform: The Patient Protection and Affordable Care Act (PPACA) Impact on Medicaid John G. Folkemer Deputy Secretary Health Care Financing.
THE COMMONWEALTH FUND Figure 1. Medicare’s Success in Achieving Major Goals “How successful has Medicare been in accomplishing each of the following specific.
TEFT Demonstration Testing Experience and Functional Tools in Community Based LTSS Mike Smith Director, Division of Community Systems Transformation Disabled.
Stan Rosenstein Former California Medicaid Director Retired December 22, 2008.
December 20, A Brief Overview: Real Choice and Independence Plus Systems Change Grants Connect the Dots Meeting December 20, 2004.
The Road Forward: Simple Seamless Path to Affordable Coverage Vikki Wachino Director, Children and Adults Health Programs Group Center for Medicaid and.
1 The Patient Protection and Affordable Care Act.
An Overview of Federal and State Funding and Programs for Long-Term Services and Supports September 2015.
The Generations Project Working to inform, educate, organize, and offer creative solutions to rebalance Indiana’s long term care system Established in.
Mark Leeds Director of Long Term Care and Community Support Services April 26, 2012 Maryland Medicaid Advisory Committee: Balancing Incentive Program.
Patient Protection and Affordable Care Act The Greens: Elijah, Amber, Kayla, Patrick.
The State Perspective: Rebalancing Long-Term Services and Supports Cynthia H. Woodcock Alliance for Health Reform Briefing October 3, 2011.
A Strong Foundation for System Transformation Barbara Coulter Edwards Director Disabled and Elderly Health Programs Group Center for Medicaid, CHIP and.
Oregon: A Leader in Long-Term Care Reform Kathy Wilson, MS, MBA University of Massachusetts Boston American Public Health Association Conference November.
The Deficit Reduction Act of 2005 – Selected Features Robert Mollica.
Posted 5/31/05 Module 4: Public Financing of Long-Term Care Services.
A Strong Foundation for System Transformation Barbara Coulter Edwards Director Disabled and Elderly Health Programs Group Center for Medicaid, CHIP and.
State of Vermont Demonstration to Integrate Care for Dual Eligible Individuals Financing Model Workgroup Meeting #3: August 26, 2011.
Medicaid Programs to Improve care and access Overview of Medicaid Programs & Affordable Care Act Provisions that impact care transitions.
Update on Long Term Care Initiatives within NYSDOH LeadingAge NY Annual Conference Saratoga Hilton May 22, 2013 Mark Kissinger, Director Division of Long.
Home & Community-Based Services Policy Forum March 17, 2015 Peter Notarstefano, Director of HCBS.
The Medicaid waiver program
Healthcare Reform: Where do we go from here?
Congress Considers Major Medicaid Changes
Older American Act Amendments of 2006
Mental Health and SUD: Opportunities in Health Reform
MDS 3.0 Section Q Revisions Coming on April 1, 2012 and Overview of Medicaid Affordable Care Act Provisions Marybeth Ribar MS, RN Technical Director,
Duke Carolina Visiting Professorship in Geriatric Nursing
Mark Trail, Managing Principal
Affordable Care Act & Medicaid Vital for West Virginia
Amy Westling, Director of Policy
Where do the Democratic Candidates Stand on Health Reform
Texas Council Managed Care Summit
Presentation transcript:

The Affordable Care Act: Opportunities for States to Increase Home- and Community- Based Services in Medicaid Dee Mahan, Families USA October 7, 2010

LLCP HEALTH CARE MANAGEMENT, LLP A TRAINING INSTITUTE ADVOCACY SUPPORT RECOGNITION SPONSORS THIS PPT DEMONSTRATION: THE MATERIALS IN THIS PPT DEMONSTRATION IS FOR EDUCATIONAL EMPHASIS IN SUPPORT OF THE AFFORDABLE CARE ACT DEMONSTRATED AS A LEARNING AND EDUCATIONAL TOOL. AS PART OF THE ADVOCACY FOR THIS INITIATIVE STUDENTS AND AGENCY PROVIDERS ARE ENCOURAGED TO SUPPORT THE BACK TO HOME PERSON-CENTERED PROGRAMS AND BECOME A VOICE FOR THEIR OWN STATE PLANS FOR COMMUNITY CHOICE PROGRAMS LINDA R SMITH, CEO/PRESIDENT LLCP HEALTH CARE MANAGEMENT LLP & TRAINING INSTITUTE RESEARCH INITIATIVES FAMILIESUSA.ORG SEND ALL RESPONSES TO CARE OF

The Affordable Care Act: Several options for states to expand home- and community-based services in Medicaid State Balancing Incentive Payments Program Change to Money Follows the Person Community First Choice Option Changes to the existing state plan option, 1915(i) 3

Supporting systems balancing: State Balancing Incentive Payments Program 4-years starting October 2011, $3 billion available Incentives for states to make administrative changes Eligible states – Spent less than 50% of total Medicaid long-term services dollars on non-institutional care in FY 2009 – Must agree to administrative changes – Must submit a plan for expanding community-based care 4

Required administrative changes No wrong door/single entry point system Conflict free case management services Uniform core assessment tool for establishing eligibility for home- and community-based services 5

Other state requirements Collect service, quality, and outcomes data Use added funds to expand non-institutional services in Medicaid Maintain eligibility for non-institutional services at December 31, 2010 level 6

Spending targets and FMAP increases HCBS spending as % of total Medicaid LTC spending, FY 2009 Target HCBS spending percentage FMAP increase Less than 25 percent25 percent5 percentage points 25 percent but less than 50 percent 50 percent2 percentage points 7

State Balancing Incentive Payments Program: Opened questions How can states count non-institutional spending? Six month timeframe and administrative changes: how far along do they need to be? What if targets are missed? 8

Extending Money Follows the Person Extends to 2016, with added $2.25 billion Reduced institutional residency requirement Proposals from new states due January 7,

New state plan option: Community First Choice Option New personal attendant benefit Must be: statewide; provided without regard to age, type of disability, or form of community- based services and supports needed States taking up option receive 6 percentage point FMAP increase One year maintenance of effort requirement 10

Eligibility and Services Two eligibility tiers –Medicaid eligible, up to 150% FPL –State option to extend to income level for institutional care; individuals must meet institutional level of care criteria Covers support with activities and instrumental activities of daily living, health related tasks Option to cover some transition costs, added services 11

Community First Choice: Advocating for expansion Consider how the program will work with existing programs in your state Option does not sunset—could use Balancing Incentive Program to help set up systems to support moving forward with this new program 12

Changes to 1915(i) Changes to the existing state plan option for community-based care for people not meeting institutional level of care requirement –States given greater flexibility in benefits offered –More protections for program enrollees –Must be statewide, no caps, no waiting lists –Can be targeted 13

Advocating for Change Use state data, personal stories Expanding community-based care is politically popular Evaluate which options your state could best pursue now and push for those Keep the drumbeat going for broader change 14