Fiscal Intermediary

The Handbook was developed to provide state staff, policymakers, service providers, program participants, and other stakeholders with a comprehensive source of information about participant direction programs and policies. Its primary purpose is to explain how States can increase program participants’ choice of and control over their services and supports. In addition to providing detailed information, the Handbook also provides links to additional web resources on the selected topics.

In this collection of informational materials, Ohio outlines what its Medicaid Buy-In for Workers with Disabilities (MBIWD) program is. Documents include an explanatory booklet, flyer and fact sheets. A website link with the government site that houses these documents, application forms and additional information is also included. While this material was intended for consumer use, it could serve as a guide to other states contemplating or running a similar MIG program.

This group of presentations were offered around the state of Colorado in regional training sessions. The day focused on various aspects of consumer direction, including case managers, Medicaid options, and working with personal-care attendants. Other presentations include transitioning a child to consumer-directed health care and a presentation on the benefits, rights, and responsibilities of consumer direction.

This paper focuses on the experiences and perceptions of community liaisons and the managers of Consumer-Directed Agencies (managers) who participated in the Massachusetts Real Choice Pilot. The experiences of the Real Choice community liaisons and managers provide insight relevant for the larger implementation of the support brokerage component for an Independence Plus option that will be available within the Massachusetts Community First waiver.

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.

This brief focuses on one consumer-direction model within the Family Care program-the Agency with Choice model-in which a \"co-employment agency\" serves as the Employer of Records and the consumer acts as the Managing Employer. In the other consumer-directed model, the consumer takes on all employer responsibilities. Slightly more than one in five Family Care members choose the co employment option, demonstrating how a managed care program can incorporate consumer direction.

Kansas operates four Medicaid waivers that allow program participants to self-direct their care. These programs permit participants to hire a worker or their choice and choose an organization to act as the Employer of Records for their worker. The programs are noteworthy because of the large number and wide variety of organizations that fulfill this function and the many different ways in which they serve their clients, providing a high level of choice to participants and their representatives.

In these reports, the National Conference of State Legislatures (NCSL) traces the budget issues that states confronted in 2002 & 2003 and examines how they addressed those issues. The report also describes long-term care legislation enacted in 2002 & 2003 and long-term care planning work that is under way in many states.