Long-Term Care

The State of South Carolina implemented a state-wide automated monitoring system whose real time data allows for monitoring & verification of the providers delivering services under the state's home and community-based services waivers. The toll-free number allows providers to check-in and check-out as they deliver services in a participant's home, while the database inferfaces with claims data to minimize fraudulent billing. The database has empowered waiver service recipients.

South Carolina developed a simplified provider agreement to make Medicaid enrollment easier for providers that normally do not provide Medicaid services. The State piloted the agreement in an Independence Plus Medicaid Home and Community-Based Services Waiver and in a Nursing Home Transition Grant. The six-item agreement contains only the minimum federal requirements for Medicaid providers and can allow Medicaid participants to receive services, equipment, etc. from non-traditional providers.

The State of Minnesota contracts with the White Earth Nation to provide functional eligibility determination and case management for Medicaid and state-funded home and community-based services for seniors. Tribal staff report their member are more likely to use the services when they can access them through familiar tribal health services. The federal government pays 100% of costs for Medicaid services provided by tribal organizations.

Passport to Independence is a federally-funded pilot project led by Delaware Health and Social Services’ Division of Services for Aging and Adults with Physical Disabilities (DSAAPD). The overall goal of the program is to identify, inform and assist nursing home residents, especially those who are Medicaid-eligible, who want to move to a new home by offering individualized case management to accomplish the goal. Review the Program Brochure Nursing Home Transition Brochure and Transition Guide.

This is the third in a series of newsletters produced at the Exchange to provide assistance to our CMS Real Systems Change grantees. This newsletter is produced biannually. Topics include: Physicians’ Role in Determining Level of Care, Nurse Practice Policies for Home and Community Living, ADRC Toolbox, Massachusetts Connecting the Dots, Making Medicaid Work in the 21st Century, Assessment Instruments, HCBS Quality Management Roles & Responsibilities, Family Caregiving, and Housing.

The Formative Evaluation of the Real Choice Systems Change Grants evaluates how the Systems Change grantees are progressing towards meeting their goals. The Formative Evaluation identifies problems faced by the grantees and ways that they deal with the problems. This document provides summary information about each of the FY2004 Grantees.

This monograph summarizes the history of caregiver assessment; considers the reasons for assessing family care; discusses what, whom, when & where to assess; illustrates areas to assess; highlights examples of existing tools; explores commonalities as well as differences in caregiver assessment instruments; points out areas of caregiver assessment that have been neglected; identifies best practice criteria to consider in designing & implementing assessments; & discusses training issues.

This paper, prepared for presentation to NGA, discusses issues, problems and challenges facing Medicaid in 2005 and suggests principles and proposals for reform.

The Alliance for Health Reform offered a briefing on Medicaid fundamentals, for those wanting to brush up on their knowledge as well as those new to the subject. Speakers included Senator Jay Rockefeller, Alliance for Health Reform, Ed Howard, Alliance for Health Reform, Diane Rowland, Kaiser Commission on Medicaid and the Uninsured Rodney Whitlock, Senate Finance Committee Republican Staff, Alan Weil, NASHP The transcript, materials, webcast and evaluation are all available.

This topic paper summarizes how states can use Medicaid to pay for most institutional transition program costs on a permanent basis as a result of policy change since 2000. It also describes how states are currently using Medicaid HCBS Waivers to pay for community transition services-temporary supports people need when trying to move such as housing deposits, utility set-up fees, and furniture.