1. VISIONING SESSION May 29, 2015

2. NWD Planning Grant  One year planning grant, started October 1, 2014; draft plan by September 30, 2015; final plan by December 2015)  Funded by the Administration on Community Living (ACL), in partnership with the Centers for Medicare and Medicaid Services (CMS) and the Veteran’s Health Administration (VHA)  DC must work with stakeholders to develop a three- year plan to transform current Long-Term Supports and Services (LTSS) programs and processes in the District into a No Wrong Door system for all populations and all payers. 2

3. Federal Vision  Four key functions:  Public Outreach and Coordination with Key Referral Sources – How will the NWD System have formal linkages with Information and Referral Entities, Nursing Homes and other Institutions, Acute Care Systems, and VA Medical Centers?  Person Centered Counseling- And planning by private community partners and public. Competencies, training and credentialing, performance.  Streamlined Access to Public LTSS Programs – All processes and requirements to determine eligibility that are required by any of the state administered programs that provide LTSS to any NWD System population, and how PCC interfaces with streamlined access? Preliminary and final, financial and program.  State Governance and Administration of the NWD System. 3

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5. No Wrong Door Person Centered Counseling Functions Shaded=> Core competencies required for all staff performing Person-Centered Counseling Unshaded => Specialties Broken lines => Streamlined access 5

6. Stakeholder Input  People with disabilities and seniors have told us they want:  Help navigating the system  Single case management system for all services  Continuity of support throughout the lifespan  Better coordination between government agencies  Great customer service  Focus on what people can do  Support to live in the community as independently as possible  Person centered counseling, planning and service delivery  Support for family caregivers  Holistic approach that goes beyond just paid LTSS  Community-based (access and services)  On-line with one website for everything

7. NWD System Funding Opportunity Expectations of Applicants  Clear description of state approach for using grant dollars to strategically advance the Federal vision of NWD System  Vision reflected in Key Elements of a NWD System of Access to LTSS for All Populations and All Payers  Applicants flexibility to target 1 or more functions and/or to target a sub-area of a state  Letter from Office of the Governor (Required)  Specific Letters from all agency leaders committing to participation  Fully Developed 3 Year Plan (within 3 Months)  NWD System Capacity Assessment (within 12 months)  Required participation in Learning Collaborative Monthly Calls on NWD System Key Elements, CQI, etc.  At the completion of the grant (within 36 months), creation of an updated 3 Year Plan FY 18-20

8. ACL’s Evolving Vision of the Structure and Role of Community Services in Providing LTSS  Charting the Life Course  The Role of the Community, Community Services and Natural Supports  Need to Build the Capacity of Community System to Support NWD  The Importance of Supporting Families  Integrated Supports Across the Lifespan

9. Timeline  June 14 th – Letter of Intent for Funding Opportunity Due  Proposal due – July 27 th (funding to start before September 30 th )  Draft 3-Year Plan due to ACL – September 30 th (4-months remaining)  Final 3-Year Plan due to ACL – December 31 st

10. Visioning the Future Be specific about business process, who, what, and how Keep in mind the federal vision of community partners, all populations, all ages and “all payers”

11. Governing Body Shared interests of our agencies? What should the roles and responsibilities be of the NWD governing body? What role will it play in monitoring the implementation of the NWD 3 year plan? 11

12. Governance and Administration A collaborative effort among multiple state agencies lodged in a Cabinet level body and part of the state’s oversight of the LTSS System The criteria or process to determine what organizations at the state and local level will play a formal role in carrying out NWD functions Creation of formal agreements and funding arrangements with state and local organizations selected to carry out the NWD functions Recommendations to the Mayor on key aspects of design, development, financing and on-going administration of the NWD System Identification of existing resources used to support access functions across multiple state administered programs and determining how those resources can be best coordinated and integrated Access to Medicaid funding for NWD activities A robust MIS A CQI process that includes performance goals and indicators related to the NWD System’s key aims: visibility, trust, ease of access, responsiveness, efficiency and effectiveness. 12