1. Home and Community-Based Supports

2. Redesign of Long Term Care Empower and encourage work, housing and independence Redesign home and community-based services Coordinate and streamline services for people with complex needs Implement and further refine Nursing Facility Level of Care

3. Draft Conceptual Framework Availability of Personal Supports (e.g. Family, Friends, Community Resources, Money, Skills, Knowledge) Physical, Mental, Intellectual Challenges Bolster community and family supports Supports to maintain independence Supports to increase independence Intensive supports

4. Bolster Community and Family Supports Now – Caregiver support – Live Well at Home – DB101 – Linkage Lines New – Life planning and self advocacy – Universal Long Term Care Options Counseling – Care transitions

5. Supports to Maintain Independence Now – PCA – Respite care New – Personal assistance and training – In-home support benefit – Housing access and supports for stability – Employment supports

6. Supports to Increase Independence Now – Independent living skills (disability waivers) – ACT teams – Falls prevention New – Independent living skills for all populations – Crisis prevention and early intervention – Navigator/service coordination/care coordination

7. Intensive Supports Now – Conversion rates for Elderly Waiver – Intensive Residential Treatment Supports (IRTS) – Corporate foster care/supportive living service New – Case mix for Elderly Waiver to meet high needs – Provider capacity to respond to unique and higher needs – Reduce reliance on institutional care

8. What…Then How Design what we want Search for best vehicle(s) to achieve it – Community First Choice—1915 k – Home and Community Services state plan—1915 i – Home and community services waiver--1915 c – Demonstration--1115 Strategies identified – Individualized budgeting – Self directed options