Consumer/Participant Direction

Interested in how self-directed options in the 1915(c) Medicaid Aged and Disabled Waiver program are succeeding? In June of 2008 PPL, a nationwide company that provides financial management and supports for self-directed programs, conducted a survey of all 241 participants enrolled in Personal Options for the West Virginia Bureau for Medical Services. The attached report, includes results and summary.

Developed by an FMS provider, this handout offers guidance to participants on becoming employers, through fiscal intermediary services, as determined in their Person Centered Plan.

As part of Research on Program Management Techniques by States to Rebalance their Long Term Care Systems, Final Case Studies were conducted in each State for the time period ending December 2007. These Case Studies focus particularly on the reflections of State government officials on rebalancing goals, accomplishments, and next steps as they reflect on all the State’s experiences in moving towards more community-based services.

Community Living Program and Aging & Disability Resource Center grantees, and Veteran Directed Home and Community Based Services programs, evaluators, researchers, and other stakeholders are welcome to answer this call for proposals. Attendance is invitation only, but interested subject matter expert are encouraged to submit sessions and/or recommend a consumer to attend. Deadline is Dec. 15, 2009, “Changing Systems, Changing Lives” will be Feb. 22-24, 2010 in Alexandria, VA.

In FY07 CMS awarded 13 PCP Implementation Grants. The purpose twofold 1) to change the basic model of care planning from one that is directed by the needs of institutions and provider agencies to one that responds to the needs of the individual, and 2) to assist states and territories in developing ways to identify the strengths, capacities, and preferences. This report presents factors that facilitated and/or impeded progress and how stakeholders were included in development and implementation.

Guidance is offered on the implementation of section 6087 of the Deficit Reduction Act of 2005 (DRA) Public Law Number 109-171. Section 6087, the “Optional Choice of Self-Directed Personal Assistance Services (PAS) (Cash and Counseling)” amended section 1915 of the Social Security Act by adding subsection (j). Guidance also applies to section 1915(c) HCBS waiver programs when states offer the self-direction opportunity and permit participants to purchase “individual directed goods and services.”

This biennial workshop was held in Baltimore, November 16 & 17. The conference offered two workshop tracks: a Strategic Track dedicated to big picture FMS issues facing state and program administrators and a Tactical Track dedicated to technical and operational issues. The IRS unveiled updated guidance specifically for participant direction Fiscal/Employer Agents and will even offered an informal, face-to-face question and answer booth. Review the presentations for further guidance.

This report is the result of a study exploring management techniques and programs States have put in place to rebalance their Medicaid long-term supportive services. It summarizes the methods, products and findings of this project then suggests conclusions and recommendations for State officials, legislators, advocates, and providers and CMS on ways to increase and improve LTSS systems for people with disabilities, enhance participant choice, and reduce reliance on institutions.

Idaho’s, My Voice, My Choice training program, is an online resource for those wishing to be Support Brokers. The site’s main categories include a section for Computer Instructions, Meeting the Trainers, Readings and Activities. The course itself stresses several key concepts: Self-Determination, the Philosophical Shift that is occurring from traditional supports to a self-directed model, Person-Centered Planning, and the Ethics and Professionalism required as a successful Support Broker.

The population is aging & the demand for long term care and services at home is increasing. Medicaid is the most critical program for individuals who are aged & disabled because it pays for almost 46% of all nursing home care & 38% of home health. Medicaid HCBS have been the focus of efforts by the federal & state governments to expand access for several reasons. The focus of this article is to examine issues of access, cost, & quality for Medicaid HCBS programs and to suggest policy changes.