Maryland

This memorandum presents data on Medicaid long-term care expenditures in Federal Fiscal Year 2006 (Oct 2005-Sept 2006). Table 1 presents national data on Medicaid expenditures for Long-Term Care from 1994-2006. Other tables present state-by-state data for Nursing Homes, ICF/MR, Personal Care, HCBS Waivers, Home Health, Home Care, Inpatient Hospital Care, Inpatient DSH, Inpatient Mental Health, Mental Health DSH, Medicaid Managed-Care, Prescribed Drugs, Targeted Case Management and PACE.

SAIL, the Service Access and Information Link is an example of a web-based screening and application tool that allows Maryland applicants to complete a series of questions to help them decide which social services benefits to start an application process for. Consumers can start an application online for more than 9 programs, complete a redetermination, report changes and print verification forms. Organizations can become community partners to help customers apply for benefits.

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.

Need an overview of the basic components of the nation’s largest health coverage program? Medicaid covers 55 million low-income individuals and is the dominant source of long-term care financing. Examine the structure of the program, who it covers, what services it provides, and spending. Because Medicaid is jointly financed by the federal and state governments programs vary across states. Tables examining the state-to-state variation in eligibility, enrollment, and spending are included.

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for home and community services; workforce shortages; lack of affordable and accessible housing and transportation; and outdated or inflexible administrative, statutory, and regulatory provisions.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 case study describes an approach to public and private sector agencies coordinating and leveraging resources at a state and local level to expand affordable and accessible housing options for persons with developmental disabilities. Homes for America utilized low-income housing tax credits to set aside six units of housing in an affordable multifamily development to be converted to ownership at the end of a fifteen-year lease period for Medicaid beneficiaries.

A new database showcases the efforts of many of the TA providers serving CMS’ grantees. The database allows users to see the wide range of activities that support and enrich the grantees under the New Freedom Initiative. The database contains important information regarding existing and upcoming research products, conferences, and significant meetings as well as a wide variety of toolkits, surveys, and policy briefs, intended to be of interested to the disability and long-term care community.

A goal of the Maryland Real Choice grant was to “provide information and assistance to consumer in acute care hospitals to aid decision-making and assist with transitions back to the community.” In 2003, a hospital discharge initiative was used to pay for nurses to work with patients being discharged from acute-care hospital stays. This paper reviews and answers whether there has been any change in discharge patterns from pilot sites to nursing homes relative to the rest of the state.