1 Division of Aging Services Dr. James J. Bulot

2 11- year demonstration project funded by CMS Single largest investment in Medicaid Long Term Care 43 states and D.C. utilizing $2.25 billion Grant through the Federal Deficit Reduction Act of 2005 Shift Medicaid long-term spending from institutional to home and community-based services (HCBS)

3 DCH began implementation on 09/01/2008 DAS became the sub-contractor to transition the elderly/disabled population on 07/01/2011 DBHDD contracts with DCH to transition the DD population from facilities

4 Transition 1558 persons to HCBS waivers by CY 2015 Increase Home and Community Based Services (HCBS) expenditures related to LTC each year Reduce the number of DD beds in State ICFs by the end of the demonstration Increase the rate of successful transition each year Establish trusted, visible, reliable Point-of-Entry system Increase the number of participants choosing self- directed Personal Support Services (PSS) Note: Grant funding is available through 2020

5 Reside in an inpatient facility (nursing home, hospital or ICF) for at least 90 days Receive Medicaid benefits for facility services for at least one day Continue to meet institutional level of care criteria

6 Peer Community Support Trial Visits (Personal Support or PCH) Household Furnishings Household Goods and Supplies Moving Expenses Utility Deposits Security Deposits

7 Skilled Out-of-Home Respite Caregiver Training LTC Ombudsman Equipment and Supplies Vehicle Adaptations Environmental Modifications Transition Support Transportation

8 Outreach and Recruiting Screening and Referral Person-directed Planning Circle of Friends/Support Community Access (Housing, Transportation, etc) Self-direction Support Post-demonstration Quality of Life Survey and Evaluation

9 365 days of MFP services from discharge date Waiver services begin on date of discharge Transition Coordinators make monthly contact Waiver case managers follow regular waiver procedure for contact LTCO may make face-to-face visits at 1, 6, and 12 months in 3 pilot areas of the state Quality of Life survey is conducted by surveyor at 12 and 24 months post-discharge

10 Average total monthly Medicaid cost savings post transition is 40% Projected Annualized Medicaid Savings per member is $32,341 on average Quality of Life Improvement

11 Living Situation Choice and Control Access to Personal Care Respect and Dignity Community Integration and Inclusion Satisfaction Health Status

12 12 AAAs Cover the entire state and know their local resources Options Counseling work already begun: ADRCs are the designated Local Contact Agency CCSP Care Coordinators have a history of transitioning consumers from nursing facilities…159 consumers in CCSP in SFY 2010 were admitted from nursing facilities outside of the MFP process

13 Transition Coordination Options Counseling LTC Ombudsman Advocacy Target: Transition 125 Individuals back to the community in SFY 12

14 Transportation Housing

15 Issued contracts to 12 Area Agencies on Aging DAS Currently Managing 187 Consumers in MFP Conducted Training (ongoing) Weekly calls w/the AAAs Weekly meetings w/DCH

16 Automate the Manual Processes Continue Training Continue to work w/AAAs to transition people back into the Community