1. HEALTH CARE AND HUMAN SERVICES POLICY, RESEARCH, AND CONSULTING - WITH REAL-WORLD PERSPECTIVE. Administration on Aging’s Community Living Program: Experiences from Four States Lisa Alecxih (Lewin) and Joseph Lugo (AoA) November 20, 2009

2. www.lewin.com 2 Presentations Today Massachusetts’ ADRCs: Community focal points for nursing home diversion and consumer direction Integrating cash and counseling into a caregiver respite program: Early outcomes (Connecticut) Nursing home diversion in Georgia Bridging the Veteran’s Health Administration and Aging Services Systems in New York

3. www.lewin.com 3 LTC System Challenges Fragmented Institutional bias Invisible/Confusing Increase in population

4. www.lewin.com 4 AoA Vision AoA’s long-range vision is to have a long-term care service system that is person-centered, consumer-directed and helps people at risk of institutionalization to continue to live at home for as long as possible.

5. www.lewin.com 5 CLP Background AoA’s Community Living Program (CLP) is designed to assist individuals who are at risk of nursing home placement and spend down to Medicaid to live in and remain in their communities. The CLP grants are administered through the State Units on Aging (SUAs), in partnership with Area Agencies on Aging (AAAs) and in collaboration with community service providers, and other key long-term care stakeholders.

6. 6 Nursing Home/Medicaid Diversion Strategy Home/Community Nursing Home Spenddown to Medicaid Low-Risk of NH Placement & Spenddown to Medicaid Medium-Risk of NH Placement & Spenddown to Medicaid High-Risk of NH Placement & Spenddown to Medicaid Nursing Home/Medicaid Diversion

7. www.lewin.com 7 Challenge to States This initiative encourages the Aging Services Network to modernize and transform the funding they receive under the Older Americans Act, or other non-Medicaid sources, into flexible, consumer-directed service dollars. This grant opportunity complements the Centers for Medicare & Medicaid Services (CMS) “Money Follows the Person Initiative” by strengthening the capacity of states to reach older adults before they enter a nursing home and spend down to Medicaid. It also supports states’ long-term care rebalancing efforts.

8. www.lewin.com 8 Veteran’s Initiative Starting in 2008, the AoA began working closely with the Veterans Health Administration to provide an additional opportunity to State Units on Aging (SUAs) and Area Agencies on Aging (AAAs) to serve veterans of all ages at risk of nursing home placement.

9. www.lewin.com 9 Technical Assistance Exchange Technical Assistance Resources  Website  Resource Materials (e.g. Issue Briefs)  National Meetings  Weekly Electronic Newsletters  Grantee Surveys  Examples from the Field Building a Grantee Community  Monthly Teleconferences/Web casts  Bi-monthly Workgroup Teleconferences  On-line Discussions  Electronic Bulletin Board