1. Montana Community Choice Partnership Money Follows the Person (MFP) Demonstration Grant Stakeholder Advisory Council Meeting March 10, 2015

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

3. * September 2012 – Montana receives a MFP Award * August 2013 – Montana’s initial MFP budget is approved * December 2013 - MFP Director starts * April 2014 - Draft process and materials are developed * May 2014 – 2 pilot transitions from MDC * July 2014 – 3 staff start, materials finalized, MFP webpage established, online referral form active * August 2014 – Transitions begin * January 2015 – Statewide MFP trainings complete, 5 of 10 Demonstration Services finalized and coded * February 2015 – Sustainability Planning

4. PARTICIPANTS MUST: * Be 90 consecutive days in an inpatient facility * Be Medicaid eligible at least one day prior to transition * Enroll in HCBS waiver or 1915 (i) State Plan HCBS program * Transition into MFP qualified housing

5. PARTICIPANTS RECEIVE: * Significant planning time focused on finding appropriate housing, services, and other transition work * 365 days MFP participation/funding – does not include pre-transition work * Waiver or State Plan program benefits form services baseline * MFP demonstration services provide extra service options especially to help transition

6. 2017 88 Elderly 15 ID/DD 5 PD 22 Mental Illness 12 Other 34 2016 77 Elderly 13 ID/DD 7 PD 15 Mental Illness 12 Other 30 2015 47 Elderly 5 ID/DD 5 PD 10 Mental Illness 3 Other 24 2014 23 Elderly 2 ID/DD 3 PD 3 Mental Illness 3 Other 12 235 * Other = Youth with SED

7. REFERRALS BY WAIVER TYPE 2014 = 672015 = 22Total = 89 DSD MDC-0208 PRTF-0208 NH-0208 1915(i)-CMHB 20 8 3 1 2101021010 22 9 8 4 1 Big Sky Elderly8311 Big Sky Physically Disabled 231134 SDMI13114 Unknown358

8. TRANSITIONS BY WAIVER TYPE 2014 = 152015 = 6Total = 21 DSD 7-MDC 0208 3-PRTF 0208 0-1915(i) 96309630 11001100 10 7 3 0 Big Sky Elderly213 Big Sky Physically Disabled 347 SDMI101

9. * 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) * Must have living, sleeping, bathing, and cooking areas * Must have lockable access and egress

10. MFP HOUSING PLACEMENTS Total Placements to Date: 21 MDC 0208 PRTF 0208 PRTF 1915(i) SDMIElderlyPhysically Disabled Group Home (4 bed or less) 22 Assisted Living 21 Apartment4 114 Home11 2

11. SUBSIDIZED HOUSING 6 transitioned into subsidized housing. * 2 – MDC (Project Based Section 8) * 3 – Physically Disabled (1-Public Housing, 1- Project Based Section 8, 1-Housing Choice Voucher) * 1 – Elderly 1 (Project Based Section 8) 2 transitioned with Housing Bridge Assistance * 1 – MDC * 1 – Physically Disabled

12. SCHEDULE OF REPORTS Monthly: * Quality of Life * New Edition’s (monthly call) * Quarterly: * ABCD Report (Financial) * Mathematica Files (Quantitative Financial) * QOL * Semi-annual: * Truven Report * Yearly: * Supplemental Budget * Travel Log

13. SUCCESSES * Referrals from many sources * Opportunities to transition that would not have been available without MFP * Complex, high needs transitions * Good collaboration of effort * Moving participants from settings other than nursing homes (MSH, PRTF, MDC) * Success stories

14. CHALLENGES * Lack of direct service providers * Resistance to a new program * Complex, high needs transitions * Housing * Expanded target populations * Benchmarks do not include ID/DD in nursing home * 1915(i) is not expanding – how to serve youth * Agencies resistant to upfront transition expenses * Regional Transition Coordinator Service * Billing across two Medicaid systems

16. POLICY GUIDANCE * Statute allows MFP programs to continue expending funds through September 30, 2020 by supplemental budgets awarded in FFY 2016 * MFP grant 2016 budget submission must include all expenses anticipated through 2020 – no new budgets after October 1, 2015 * Plan must detail grantee’s efforts to rebalance the LTC systems and maintain increasing transition activities during the final years of the program

17. POLICY GUIDANCE CONTINUED… * Detail how to sustain staffing, transition activity, services, demonstration projects, and structural changes initiated under MFP * Detail any services, structural changes, or demonstration projects that will not be continued after the grant and explain why * Include a timeline Sustainability Plan due by April 30, 2015

19. Mandatory Elements: * Executive summary * Stakeholder involvement * Plan for continuing to transition out of institutions * Decision to include MFP Demonstration Services and services funded by MFP Administrative funds (or not) and explain how and why * Decision to continue funding for MFP staff * State’s plan for utilizing all rebalancing funds by 9/30/20. * Timeline for the above * Estimated budget summary

20. Optional Elements: * State’s plans to expand HCBS * State’s efforts to develop an adequate supply of accessible, affordable housing * State’s efforts to support state of the art quality improvement systems for HCBS

21. Other requirements : * Cover letter signed by the State Medicaid Director * Plan to not exceed 50 pages excluding cover letter. * Must address all mandatory elements

23. Check your calendars for June

24. Thank you and Safe Travels