Long-Term Care

This report describes the Commonwealth of Pennsylvania’s Office of Mental Retardation's efforts to implement a system-wide reform of its supports for people with mental retardation. The objective of this Transformation Project is to improve the quality of life of people who use publicly funded supports by providing them with more choices and greater control over these supports.

This document describes New Hampshire’s community based service system for people with developmental disabilities. The document provides a brief overview of the community based system and a discussion on the integration of services and programs, as well as the funding sources.

This report looks at attempts by different states to allow money to follow the person. Money Follows the Person refers to a system of flexible financing for long-term services that enables available funds to move with the individual to the most appropriate and preferred setting as the individual’s needs and preferences change.

Wisconsin uses a variety of initiatives to support Medicaid participants who want to leave nursing facilities, including ensuring services are available as soon as the person is ready to move and providing funding for transition. This document describes some of these initiatives.

In 1996, Vermont began to shift resources from nursing facilities to home and community-based services. To implement the legislation, several programs, new services, and policy changes were created that offered individuals more choices for long-term services. This report describes how Vermont changed its long-term care system to reduce institutional reliance by supporting people with physical disabilities and older people in the most appropriate and least restrictive environment possible.

This document describes Utah’s efforts to educate nursing home residents about community-based long-term care options. Group and individual educational sessions and assessments are conducted through organizations knowledgeable about community services. The document provides further information on the implementation of this program.

This document describes Community Choice, New Jersey’s permanent, state-operated nursing facility transition program. The program provides information about nursing home alternatives and assistance moving from nursing facilities. This program’s implementation and impact are illustrated in this document.

This document describes Colorado’s Fast Track program, which aims to improve access to home and community-based services after a hospital discharge. In this program, staff work to facilitate quick eligibility determination for hospital patients who need long-term care after discharge. The program seeks to decrease unnecessary nursing home admittance. The implementation and impact of this program are described in the document.

This was a teleconference held on March 17, 2004. The purpose of the teleconference was to have CMS Medicaid and Medicare staff discuss Dual Eligibility in both programs, particularly as it relates to children transitioning to eligibility as adults. Programs which paid for Medicare premiums, coinsurance and deductibles were also discussed.

On May 28, 2004, Glenn Stanton Acting Director of CMS’ Disabled Elderly Health Programs Group transmitted modifications and additions to the Interim Procedural Guidance for oversight of Medicaid waivers to all CMS Regional Administrators. The Guidance documents include the memo from Mr. Stanton, a diagram detailing the HCBS Waiver Quality Life Cycle and several attachments. The Guidance was updated in Feb. 2007, the link to that letter is also attached.