Deficit Reduction Act (DRA)

CMS awarded Money Follows the Person awards to 17 states and another 21 states may receive awards in the near future. Supporting individuals in institutions to move to the community is a critical component of MFP. Transition coordination, relocation coordination, supports coordination and case management are terms often used to describe this complex activity. This brief reviews optional targeted case management services, 1915(c) home and community based waivers and administrative activity.

The Georgetown University Long-Term Care Financing Project has two newly-revised fact sheets National Spending on Long-Term Care, looks at total spending for nursing home and home care services nationwide, in total and by major payers. Medicaid and Long-Term Care, describes Medicaid's role in financing long-term care, with a particular focus on home and community-based services and how states' provision of these services may be affected by the policy changes in the Deficit Reduction Act of 2005.

The DRA may have significant effects, given the high proportion of young children enrolled in Medicaid-28 percent of all children under age 6 in 2001-and the broad range of services covered. This report analyzes the provisions of the DRA and assesses their implications for the provision of early childhood preventive and developmental services. Changes include citizenship documentation, the use of a benchmark option, cost-sharing benefits and the financing of targeted case management.

On October 5, 2006, Secretary of HUD, Alphonso Jackson wrote a \"Dear Executive Director\" letter to each Public Housing Authority regarding how Housing Authorities could implement both the Money Follows the Person legislation and the Presidents' New Freedom Initiative.

The annual 50-state survey of Medicaid officials finds an improved economy combined with the implementation of the new Medicare prescription drug benefit has contributed to the lowest rate of Medicaid spending growth in a decade and the fourth consecutive year in which Medicaid spending growth has slowed. Review the news release, read the report, or listen to conference materials and view the presentation slides.

HHS announced on September 15, 2006, the award of $20 million in grants to states to develop programs for people with disabilities or long term illnesses. The eight states receiving a 2006 award are California, Virginia, Michigan, North Carolina, New York, New Jersey, Rhode Island and Kansas. The award will help states and territories “rebalance” their long-term support programs to help people with chronic illness or disabilities to reside in their homes and participate fully in community life.

As part of the 2004 Real Choice grants, New Hampshire and Wisconsin proposed to complete a feasibility study and then develop LIFE Account programs. With no federal legislation creating a savings program, grantees are restricted to modified program that works under existing law. This paper considers six options: Section 1115 Demonstrations, Waivers under Section 1915(c) & 1915(b), Section 1915(i) & 1915(j) State Plan programs, and Section 1937 Benchmark programs and suggests some next steps.

Family to Family Centers provide information and other supports both to family members and to professionals who serve children and youth with special health care needs. This topic paper highlights innovative strategies developed by individual Family to Family Centers to develop partnerships to expand their reach, to enhance outreach to parents, to serve a culturally diverse clientele, to help youth prepare for transition, and to ensure organizational sustainability.

This letter is one of a series that provides guidance on the implementation of the Deficit Reduction Act. Section 6044, State Flexibility in Benefit Packages, adds a new section 1937 to the Social Security Act. Review the options that states have to amend plans to provide alternative benefit packages to beneficiaries, without regard to comparability, statewideness, freedom of choice, or certain other traditional Medicaid requirements.

Review the archives from the June 28, 2006 Deficit Reduction Act teleconference with Kathy Rama and Donna Schmidt of the Centers for Medicare and Medicaid Services. The call includes discussion of section 1937 and the option of states to amend their state plan to provide alternative benefit packages to beneficiaries, without regard to comparability, statewideness, freedom of choice or other traditional Medicaid requirements.