RTI - Systems Change Evaluation

This report describes the activities of 12 Grantees that received Independence Plus (IP) grants in FY 2003 and are using them to increase self-directed services options for persons of all ages with disabilities or chronic illnesses. Grantees encountered a range of issues while implementing. This report provides information for states and stakeholders planning, implementing, or expanding self-direction programs, whether through solely state-funded programs or the Medicaid program.

This report describes the enduring changes brought about by the NFT Grantees who either established or improved nursing facility transition programs or helped establish infrastructure. This two-part paper first examines changes and remaining challenges, lessons learned and recommendations, and later provides state-specific summaries. Review grantee activities including new statutes, policies, funding and expense changes, plus outreach and technical materials developed to facilitate transition.

This report describes grant activities (accomplishments and progress) in three major LTC systems areas: Access to LTC Services and Supports, Services, Supports, and Housing, Administrative and Monitoring Infrastructure. The report also provides illustrative examples of the challenges Grantees have faced as they implement grant activities, and consumers’ roles in the implementation and evaluation of these activities.

This report provides an overview of 35 states’ initiatives to improve their LTC systems and includes lessons learned and recommendations that can guide states undertaking similar initiatives. Despite accomplishments and improvements, Grantees described continuing barriers including insufficient funding for home and community services; workforce shortages; lack of affordable and accessible housing and transportation; and outdated or inflexible administrative, statutory, and regulatory provisions.

To help States build the infrastructure needed to remove barriers and create more consumer responsive LTC systems, CMS awarded $70 million in Real Choice Systems Change Grants. Fifty-two Grants were awarded in Sept. 2001 (25 Real Choice, 10 Community-Integrated Personal Assistance Services & Supports, 17 Nursing Facility Transition). This report describes the progress FY01 Grantees have made on their activities during the first year of the three-year Grant period (Oct 1, 2001-Sept 30, 2002.)

The Compendium contains basic information about each of the Real Choice Systems Change Grant awards in FY03–FY04 plus the Family to Family and Systems Transformation Grantees awarded in FY05 and FY06. The Compendium will help Grantees identify others with similar goals and activities. Learn more about how the 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. The sixth edition replaces all previous editions.

This report is the first in a series of final reports that RTI will prepare to document the outcomes of the Real Choice Systems Change Grants. The principal sources of data for this report are Grantees semi-annual, annual, and final reports, a 2005 topic paper on the NFT Grantees and Grantee-prepared final reports and evaluation results as well as publications and materials developed under the grant. This report was referenced on page 48 of CMS MFP Demonstration Solicitation Document.

This report describes grant activities in three major LTC systems areas: Access to Long-Term Care Services and Supports, Services, Supports, and Housing, Administrative and Monitoring Infrastructure. For each of the focus areas the report describes Grantees’ accomplishments, illustrates the challenges and discusses the consumers’ role in the implementation and evaluation of activities. The report uses information provided during the reporting period October 1, 2004 to September 30, 2005.

This report highlights the work of nine CMS Money Follows the Persons Grantees, with a focus on Texas and Wisconsin. The report describes the initiatives, and discusses policy and design factors states should consider when developing MFP programs, including developing legislation and budget mechanisms for making transfers of funds, assuring availability of services and housing, identifying potential consumers for transition, developing NFT infrastructure, and monitoring and quality assurance.

This paper discusses the activities of 11 grantees and the program and policy issues they have encountered. The paper’s primary purpose is to provide information that states and stakeholders will find useful when planning or implementing consumer-directed initiatives, whether through solely state-funded programs or the Medicaid program. In particular, the report highlights program and state and federal policy challenges and how Grantees are addressing them.