1915c

This memorandum and tables present data on Medicaid 1915(c) Home and Community-Based Services (HCBS) waiver expenditures from Federal Fiscal Years 2001 through 2006. Each HCBS waiver is classified by population served in order to show the distribution of HCBS waiver expenditures across long term care populations. This year's memo also identifies which waivers exclusively serve children.

South Carolina hired an environmental modifications specialist to improve the quality of home modifications funded by its Medicaid HCBS waivers. The specialist trains case managers to develop specifications for ramps, and develops specifications for other home modifications so contractors can quickly make an informed bid. South Carolina also leveraged a state-funded home modification program to expand the types of modifications available in its waivers.

The 7th CMS New Freedom Initiative Conference was held March 5-7 in Baltimore. Presentations are available in both PDF and text formats. “Choice and Independence” is a key pillar of CMS’ vision for a person-centered long term services and supports system for the future. The 2007 conference focused on the policies, programs, and tools -including opportunities authorized by the Deficit Reduction Act– available to shape and carry out the vision.

As part of its quality management program, Wisconsin revised its Individual Service Plan (ISP) form that was required as part of the Medicaid waiver process. The new revised forms address individual outcomes. Attached forms include the ISP Instructions, Medicaid form, and Individual Outcomes.

The “Quality Close to Home” papers are part of Wisconsin’s process to review the existing quality management system for Home and Community Based Services. The report on local practices was the result of a series of interviews conducted with local informants who conduct quality management activities. The second paper outlines the scope of quality management, challenges of quality management, federal rules and regulations, and provides a design for an improved quality management system.

These reports are reviews of Utah’s long–term care system and waiver programs and provide recommendations for change. The Focus Group Findings focused on non-institutionalized and community based settings. The Long-Term Care paper provides more generalized findings about the structure of Utah’s long-term care system and how to transition forward based on input from stakeholders and administrators, comparisons to other states, and review of current documents and policy.

Part of the Massachusetts Real Choice grants included community and consumer collaboration and input. The presentations work to introduce how the Real Choice grant aims to work on collaboration, integration collaboration into the pilot project, and review how consumer perspectives were used in the grant. Review the work and ideas on consumer involvement, the pilot evaluation and the consumer experience project.

As part of the Massachusetts Independence Plus grant, the workgroup recognized there was a certain amount of risk associated with individualized budgeting. They devised a “Incident Reporting” System that would document any incidents (such as fall, funding problems, injuries) that would compromise the health of an individual with disabilities being served under the program. The forms were created to assist a future Massachusetts IP waiver and have not yet been adopted

In September 2004, Minnesota’s Real Choice Systems Changes grantees presented at the Illinois 2004 Systems Change Seminar. Presentations covered the Minnesota’s Personal Assistance Care Program, QA/QI grant, ADRC grant, and its Senior Health Insurance Program. A variety of topics covered include quality assurance, stakeholder involvement and personal assisted services

The following information was presented at the Illinois 2004 Systems Change Seminar. Topics presented included: trends in long-term care, progress on the Illinois Community-based Treatment Alternatives for Children (CTAC) grants, the Illinois Housing Development Authority and how its work pertains to persons with disabilities, and Michigan’s progress on its Real Choice Systems Change grants.