Montana Community Choice Partnership Money Follows the Person Stakeholder Advisory Council Meeting October 21 st, 2014

* Montana will create a sustainable system that supports community options as a first choice for individuals needing long term care services.

* Traci Clark – Project Director * Jonathan Arnold – Project Manager * Hazel Noonan – Transition Coordinator * Brian Barnes – Housing Coordinator

* September 2012 – Montana receives a MFP Award * August 2013 – Montana’s initial MFP budget is approved * November MFP Director is Hired * April Draft Materials are developed * May 2014 – 2 pilot transitions are moved out of MDC * July 2014 – MFP staff are hired

* July Present: * Finished developing MFP outreach materials, policy guidelines, and training manual * MFP webpage is added to DPHHS website as well as an online referral form * Continued work on demonstration services definitions * We have attended and conducted nearly a dozen different conferences and trainings * Continued to meet with Steering Committee and Stakeholder Advisory Council * Received approval of our 2014 Supplemental Budget and submitted a supplemental budget for 2015 * Transitions have begun

* Increase the use of home and community-based services (HCBS) and reduce the use of institutionally-based services * Eliminate barriers in State law, State Medicaid plans, and State budgets that restrict the use of Medicaid funds to let people get long-term care in the settings of their choice * Strengthen the ability of Medicaid programs to provide HCBS to people who choose to transition out of institutions * Put procedures in place to provide quality assurance and improvement of HCBS

* Minimum residency requirements: * 90 consecutive days in an inpatient facility * Transition work can begin in advance of the 90 th day * Medicaid eligibility: * Must be Medicaid eligible for at least one day prior to transition * Transition work can begin without Medicaid eligibility * Enroll in HCBS waiver or State Plan HCBS program

* Significant planning time focused on finding appropriate housing and other transition work * 365 days MFP participation – does not include pre-transition work * Waiver or State Plan program benefits form services baseline * MFP demonstration services provide extra support to keep consumers safely in the community

* Brochures * To date Montana has produced over 5,000 Brochures, flyers, manuals, and contact cards * General Brochure…

* Brochures * To date Montana has produced over 5,000 Brochures, flyers, and contact cards * General Brochure * Consumer Brochure * Manual * See the examples on your table. * Website * MFP now has a stand alone webpage on the state website:

* Brochures * To date Montana has produced over 5,000 Brochures, flyers, and contact cards * General Brochure * Consumer Brochure * Manual * Believe me this was not easy. * Website * MFP now has a stand alone webpage on the state website: * MFP also has an online referral form:

* October 23, 2014 * Missoula Hilton Garden Inn * November 5, 2014 * Hampton Inn – Great Falls * November 7, 2014 * Glasgow at the Job Service

Elderly 15 ID/DD 5 PD 22 Mental Illness 12 Other Elderly 13 ID/DD 7 PD 15 Mental Illness 12 Other Elderly 5 ID/DD 5 PD 10 Mental Illness 3 Other Elderly 2 ID/DD 3 PD 3 Mental Ilness 3 Other * Other = Youth with SED

Referral Sources * Number of referrals to MFP as of 10/20/14 = 41 * Source of referrals * MDC – 8 * LTC Ombudsman – 8 * Case Managers – 16 * Nursing Home SW and/or Discharge planners – 4 * Steering Committee Partners - 5

* Referrals by Waiver Type * DD (Developmentally Disabled) – 17 * ED (Elderly) – 3 * PH (Physically Handicapped) – 10 * SDMI (Severe Disabling Mental Illness) – 9 * PRTF (Psychiatric Residential Treatment Facilities) 3 transferred from PRTF’s but part of the 15 on * Unknown - 2

* Actual Transitions as of October 20, 2014 * DD – PRTF that are being served by 0208 * SDMI – 1 * ED – 1 * Projected Transitions through November 1, 2014 * DD – 2 * PD - 1

* Challenges * Claims and Billing * 1 st and 2 nd year QOL Follow-ups * Demonstration Services Defined * Housing * Direct Care staff shortages

* Successes

WARNING: Playing this video may cause our fearless leader to break out in dance and embarrass everyone in the room! By pushing play you assume all risk of embarrassment on behalf of everyone here!

* Home owned or leased * Apartment with individual lease, secure access, as well as living, sleeping, bathing and cooking areas over which you or your family has control * Community-based residential setting, such as a group home, with a maximum of four unrelated people (excluding caregivers and personal attendants)

* MFP Housing Bridge Assistance Policy * The Housing Bridge Assistance Policy has been finalized and approved. * Housing Bridge Assistance Program has been established utilizing short term, one-time only funding, appropriated by the Montana Legislature for SFY 2014 and SFY * It can be used to provide short term housing assistance for MFP participants until they are eligible to receive other housing assistance.

Prescreen MFP Referrals Application Process Section 8 Housing Choice Voucher (HCV) and/or other subsidized Housing. Montana Department Of Commerce Screening Landlord Agreement Housing Quality Standards (HQS) Inspection Approval

* HUD 811 Project Rental Assistance (PRA) Update * Currently waiting for HUD to give a final approval of the state’s 811 amended cooperative agreement. * Have to design Affirmative Fair Housing Marketing Plan (AFHMP) and a Tenant Selection Plan * The next step will be to sign Rental Assistance Contracts (RACs) with participating owners. * As soon as the RACs are signed and units are available, waiver/MFP participants will be able to apply and receive housing assistance.

* Online database developed in partnership with the MDOC Housing Division - MFP has been working on expanding the locator also known as: MTHousingSearch.com * Outreach to recruit new landlords and properties is ongoing. * Assisted Living residences from around the state will be incorporated. * You know you want to see what it looks like…….

* Existing:  Housing Questionnaire  Housing Tool Kit  Subsidized Housing Cheat Sheet * In the Works:  Qualified Assisted Living Survey  Qualified Group Home Survey  Housing 101 PowerPoint training for Regional Transition Coordinator

* Where are MFP participants moving? * Group Homes with 4 or fewer beds * RSS – Supported Living Apartments in Laurel, MT * Aware Group Home in Missoula * Aware Group Home in Anaconda * Aware Group Home in Billings * Home * Subsidized Apartments * Aspen Village – Helena, MT * Columbus Plaza – Butte, Montana

* Sustainability Timeframe * MFP programs can continue transitioning participants until Dec. 31 st, 2017 * They can also continue expending grant funding through September 30, 2020 * These continued expenditures must be approved through a sustainability plan that is due by April 30, 2015 * The approved sustainability plan must then be submitted along with the 2016 Supplemental Budget Request by Oct. 1, 2015 * In order to continue using available funding from the MFP Demonstration grant, grantees must include all expenses anticipated through 2020 as budgets may not be submitted after 2016 and extensions will not be permitted after 2020.

* Mandatory Plan Activities * 1. Continue to improve and sustain MFP transition activities including out-year projections for transitions through December 31, 2017 and services through December 31, 2018 * 2. Indicate if the state is planning to continue to provide transition services and identify and budget for the cost to transition from the grantee’s current MFP program into a new or existing 1915(c) or other Medicaid authority for the participants interested in transitioning to the community after the last day of service funding * 3. Account for how the remainder of all rebalancing funds will be utilized prior to the end of the grant period, including new projects and updates on existing projects * 4. Engage external stakeholders in the development of the final sustainability planning process * 5. Include funds necessary to continue the submission of all MFP grant and programmatic reporting requirements as listed in the MFP Timeline

* Optional Plan Activities * Expand accessible Home and Community Based Services * Develop and maintain new program activities and policies * Advance and preserve systems that support transitions among settings and services * Design and implement or expand a comprehensive Single Entry/No Wrong Door Systems for assessing community-based Long-Term Supports and Services (LTSS) * Create and expand a person-centered planning and service delivery * Enhance and advance employment supports for people with disabilities * Expand the supply of Direct Service Workforce and adequate supply of caregivers * Foster the continued development of an adequate supply of housing to support community-based living options * Improve or support quality assurance quality improvement systems

* Dates, Times, Locations

* Questions? * Comments? * Suggestions? * Feedback?