1. Action Tracker · Status Report | Bill Moss, Assistant SecretaryOct 7, 2015 Aging and Long-Term Support, Administration Background Group Topic / Strategic Plan Goal / Commitment 2: Promote access to a variety of home and community-based service options Sub Topic / Strategic Objective: Ensure that individuals with complicated personal care and behavioral challenges who reside in State Hospitals have an appropriate community placement option through Enhanced Service Facilities. Strategic Objective # 2.7 Measure Title: Number of Individuals served in ESF by July 2016. ID#Problem to be solvedStrategy/Approach Task(s) to support strategyLeadStatusDueExpected OutcomePartners 2.7.1 Complete WAC and program revisions Gather input from project leads. Review feedback received through provider outreach. Seek Centers for Medicare and Medicaid Services (CMS) approval to add ESFs as a qualified provider of Residential Support Waiver Services. Hold necessary meetings with project leads and other subject matter experts to review and make WAC recommendations. Route WAC change and program change recommendations through required approval and submission process. Waiver unit submission to CMS for approval. Doug Mora and Sandy Spiegelberg Complete5/29/2014 Revised WAC and program revisions will more accurately reflect and support the needs of individuals served in Enhanced Service Facilities (ESFs). CMS approval received. Regional Support Network (RSN) Department of Health (DOH) 2.7.2Identify individuals to be served in the first ESF. Coordinate across multiple service providers through scheduled case staffing to identify individuals to be served Conduct meeting with Behavioral Health and Service Integration Administration (BHSIA) to ensure care coordination with mental health system Conduct 1-2 webinars with Home and Community Services (HCS) regions to identify clients to be served in the first ESF. Collaborate with state hospitals and RSNs to finalize list of identified clients. Traci AdairComplete7/31/2015Will identify 12 Western State Hospital (WSH) and/or Eastern State Hospital (ESH) Medicaid eligible residents that meet long- term care eligibility and require ESF level of community support. HCS Region Staff WSH and ESH RSNs Proposed Action Type of Status Report Strategic Plan SO ESF 2.7Last modified 10/7/2015 1

2. Action Tracker · Status Report | Bill Moss, Assistant SecretaryOct 7, 2015 Aging and Long-Term Support, Administration Background Group Topic / Strategic Plan Goal / Commitment goal 2: Promote access to a variety of home and community-based service options Sub Topic / Strategic Objective: Ensure that individuals with complicated personal care and behavioral challenges who reside in State Hospitals have an appropriate community placement option through Enhanced Service Facilities. Strategic Objective # : 2.7 Measure Title: Number of Individuals served in ESF by July 2016. ID#Problem to be solvedStrategy/Approach Task(s) to support strategyLeadStatusDueExpected OutcomePartners 2.7.3License the first ESFRequires extensive coordination regarding licensing procedures, ESF provider policy development, and training implementation Site review and approval of plans by Residential Care Services (RCS) Division and DOH Support provider to meet all licensing filing dates and processes License the ESF Coordinate signing of ESF contract Penny Rarick, Claudia Baetge and Sandy Spiegelberg In progress12/1/2015The first ESF will be licensed. RSN BHSIA DOH ESF Provider HCS Region Staff WSH RSNs 2.7.4Move 12 individuals into the first ESF. Coordinate development of transition plans across agencies and create detailed, individualized service plans designed to maximize individual success and safety in community transition Develop Transition and Coordination Planning Tool Conduct individualized case planning meeting for each transitioning resident with representatives from hospital, HCS region, RSN and ESF provider. Transition 2-3 individuals a week from Western and Eastern State Hospitals over the course of one month. Traci AdairBehind Schedule12/15/201512 individual from WSH/ESH will have successfully moved into the first ESF with comprehensive support and service plans that meet their individual needs. RSN ESF Provider HCS Region Staff WSH/ESH Proposed Action Type of Status Report Strategic Plan SO ESF 2.7Last modified 10/7/2015 2

3. Action Tracker · Status Report | Bill Moss, Assistant SecretaryOct 7, 2015 Aging and Long-Term Support, Administration Group Topic / Strategic Plan Goal /Commitment goal 2: Promote access to a variety of home and community-based service options Sub Topic / Strategic Objective: Ensure that individuals with complicated personal care and behavioral challenges who reside in State Hospitals have an appropriate community placement option through Enhanced Service Facilities. Strategic Objective # : 2.7 Measure Title: Number of Individuals served in ESF by July 2016. ID#Problem to be solvedStrategy/Approach Task(s) to support strategyLeadStatusDueExpected OutcomePartners 2.7.5Develop additional ESFs in strategic geographic areas. This includes all steps taken in developing the first ESF. Identify next viable provider based on provider readiness tool and geographic need Assist next ESF provider(s) with licensing; policy development and training implementation. Penny Rarick, Claudia Baetge and Sandy Spiegelberg On track6/1/2015- 6/30/2016 One or two additional ESFs will be licensed and ready to accept ESF residents. RSN BHSIA DOH ESF Provider HCS Region Staff WSH RSNs 2.7.6Move 10 additional individuals into newly established ESF. Coordinate development of transition plans across agencies and create detailed individualized service plans designed to maximize individual success and safety in community transition Conduct individualized case planning meeting for each transitioning resident with representatives from hospital, HCS region, RSN and ESF provider. Transition 2-3 individuals a week from Western and Eastern State Hospitals over the course of one month. Traci AdairOn track7/31/201610 individuals from WSH/ESH will have successfully moved into the first ESF with comprehensive support and service plans that meet their individual needs. RSN ESF Provider HCS Region Staff WSH/ESH 2.7.7Serve a total 22 individuals in ESF. On track7/31/2016 Proposed Action Type of Status Report Strategic Plan SO ESF 2.7Last modified 10/7/2015 3