All States/Territories

While 1915(c) waivers are a prominent vehicle for the delivery of HCBS, they are not the only mechanism available to States. CMS developed a technical assistance paper that outlines the enrollment authorities that States may consider when designing managed HCBS programs, the review and approval process for each, and rate setting techniques that may be useful. The appendix offers a useful chart outlining the authorities, including their key flexibilities and limitations.

New job descriptions and titles are being developed to focus on the needs of individuals for activities such as support coordination, brokerage and personal resource management. This report helps to define the concept of “support brokerage” as it relates to persons with developmental disabilities. It addresses issues such as conflicting interests, self determination and structural requirements.

Explore this toolkit, which identifies some of the best reform timelines, resources to help explain temporary high-risk pools, Medicaid and Medicare changes, reform’s impact on private coverage, provisions for small businesses, and the important state role in implementing reform. Included are an extensive listing of experts, contact information, and websites. The toolkit was based on a briefing for journalists, and a link to a webcast of this briefing is included.

Are you looking to develop resources for a Veteran-directed HCBS program? Find materials developed for Southern Maine’s program, including a marketing brochure, a detailed guidebook defining concepts such as self-direction and financial services, forms and instructions for emergency backup, safety and prevention strategies, care plan development and budget worksheets, and detailed information and forms to help veterans in their role as an employer.

Looking for samples of MIG program training materials for consumers? The state of New York created a series of informative guides to educate New Yorkers with disabilities about their programs. These reports cover areas such as the earned income tax credit, how to build assets with a plan for achieving self support, and the impact of earnings on supplemental security income benefits. Samples are attached and could serve as guides to other states looking for clear, well designed models.

The US Department of Labor sponsored three national demonstration projects to research effective policies and practices that improve self-employment outcomes for people with disabilities. These projects represented a diversity of locations, economic environments and stakeholder groups, and resulted in new knowledge as well as local policy and program improvements that will help individuals achieve their entrepreneurship career goals. The projects are described in the attached report.

How is New York's MIG program helping train employers about the benefits of hiring disabled employees? New York created Employer Briefs. Examining effective business practices for improving the bottom line of organizations, such as recruiting and retaining a productive workforce is the basis of Employer Brief One. Employer Brief Two covers six action steps companies can take to create a more inclusive, productive workforce. Samples are attached, which could be useful to other MIG states.

Changes CMS is making in the State plan amendment (SPA) review process are explained in this letter. CMS has identified a process that will expedite the review of SPAs while ensuring that CMS and States resolve other questions that may arise. States will now have the option to resolve issues related to State plan provisions that are not integral to the SPA through a separate process. Several examples based on actual State plan issues are included.

How is New York providing concise information about the details and requirements for their MIG program? Fact sheets are one way New York is providing this information efficiently. Samples of some of these are attached and cover topics such as Earned Income Tax Credit, Building Assets and Local Asset Summits. These could be useful samples to other MIG states.

Find a synopsis of how state coordinating councils operate, including a 50-state reference table, and profiles of the 25 existing state coordinating councils. Focused on improving coordination at the state and local levels, the Councils are a key to successfully keeping people in the community. Some of these states have created their Councils by state statute, some by state executive order or governor initiative.