Money Follows the Person

This is the second 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: Connecting the Dots: Maryland; Money Follows the Person: Grantee Meeting in Nevada; Information Technology (IT) Systems Survey for Single Point of Entry; Housing Work Group Established for Real Choice Grantees; Children’s Mental Health Audio Conference.

The CMS Systems Change conference was February 28-March 2, 2005. Presentations from the 2005 sessions are available in both PDF and text formats. Topics range from ideas on sustaining systems change, employment services, Medicaid, integrating quality, policy implications and barriers to providing services. Full titles are listed in the keywords section.

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.

Case study reports on programs in 9 states that received federal Nursing Home Transition Grants from 1998 - 2000 are now available. New reports describe programs, implementation, and lessons learned from transition programs in Arkansas, Florida, New Jersey, Pennsylvania, Texas, Vermont, Michigan, Wisconsin and from a hospital to nursing home diversion program in Colorado.

This issue brief will present several approaches that attempt to tackle the underlying challenge of reducing nursing facility utilization and expenditures. These range from modifying the nursing facility reimbursement methodology; to converting nursing facilities to assisted living centers, paying nursing facilities to take beds off-line, and using capitated managed long-term care; to approaches with theoretical promise that have yet to be adopted in any state.

The Compendium contains basic information about each of the Real Choice Systems Change Grantees. The Compendium will help you learn more about how these grants will be used to allow more people of all ages with a disability or long term illness to live and participate in their communities. Real Choice Systems Change Grantees will also find the Compendium useful to identify other Grantees with similar goals and activities. The fourth edition of the Compendium replaces all previous editions.

This letter dated February 18, 2005 provides guidance on CMS disclosure of LTC/MDS data to State Medicaid Agencies, Section 1915 Waiver Programs, and “Real Choice Systems Change Grant” Programs in order to assist states in their efforts to comply with the integrated care setting and reasonable accommodation requirements of Title II of the ADA. Share this letter with appropriate state agency staff and designated entities that are working on waiver and grant programs.

Consumer advocates and state leaders have been exploring ways to identify nursing home residents who want to return to their homes and communities. One effort involves the potential use of the Long Term Care Minimum Data Set (MDS), particularly Section Q, which addresses residents’ discharge preference. This technical assistance document provides practical information about how state agencies can use these federal data on nursing home residents to improve their nursing home transition efforts.

The New Freedom Initiative, announced in February 2001, called for a comprehensive assessment of federal policies, programs, statutes, and regulations to identify barriers that impede community living for disabled individuals—and for recommended solutions. In October 2004 CMS awarded an additional $30 million in Real Choice Systems Change Grants—this money in addition to the 188 grants for over $158 million between fiscal years 2001-03. This report highlights accomplishments of those programs.

Explores states’ use of “global budgeting” to promote a public policy of supporting consumers’ long-term care choices. Prepared for NJ policymakers, this report defines global budgeting in the context of long-term care, provides five state models, and offers lessons learned about determining what is “in the globe,” legislative and administrative language to advance it, and how it can be implemented. Funded by the NJ Department of Health and Senior Services.