Medicaid Waivers

States now have more discretion in changing Medicaid policies; consumers and advocates want to make sure they have a voice in that. This AARP Public Policy Institute Issue Paper examines the processes states have in place to solicit public input into Medicaid policy changes developed and implemented through Section 1115 waivers or State Plan Amendments (SPAs). Recommendations are offered on how federal and state governments can improve or enhance existing opportunities for public involvement.

Supported by the Robert Wood Johnson Foundation, this toolkit features key facts, a brief background section, story ideas, lists of selected experts, websites, and a glossary. Designed for reporters, the resources will be useful for congressional staff, researchers, health policy students and many others. This toolkit explains who Medicaid covers, how it is financed, how it differs from Medicare, how states can alter Medicaid through federal waivers, and what the future holds for the program.

This memorandum and tables present data on Medicaid 1915(c) Home and Community-Based Services (HCBS) waiver expenditures from Federal Fiscal Years 2001 through 2006. Each HCBS waiver is classified by population served in order to show the distribution of HCBS waiver expenditures across long term care populations. This year's memo also identifies which waivers exclusively serve children.

The Rhode Island MIG project produced an issue brief, which outlined the State’s utilization of 1619(a) and 1619(b) waivers, their effect on disabled workers, the barriers these waivers present, and recommendations for eliminating barriers and other best practices.

This project was funded to a) gather descriptive information on HCBS waivers, both comprehensive and supports, operated for people with I&DD in 17 states with the supports waivers b) determine how supports waivers have emerged as separate and distinct HCBS waivers c) better understand the range of participant characteristics and experiences that distinguish supports waivers from other HCBS waivers d) more fully appreciate how states view supports waivers as a way to address demand for HCBS.

The 7th CMS New Freedom Initiative Conference was held March 5-7 in Baltimore. Presentations are available in both PDF and text formats. “Choice and Independence” is a key pillar of CMS’ vision for a person-centered long term services and supports system for the future. The 2007 conference focused on the policies, programs, and tools -including opportunities authorized by the Deficit Reduction Act– available to shape and carry out the vision.

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.)

CMS awarded Money Follows the Person awards to 17 states and another 21 states may receive awards in the near future. Supporting individuals in institutions to move to the community is a critical component of MFP. Transition coordination, relocation coordination, supports coordination and case management are terms often used to describe this complex activity. This brief reviews optional targeted case management services, 1915(c) home and community based waivers and administrative activity.

As part of its quality management program, Wisconsin revised its Individual Service Plan (ISP) form that was required as part of the Medicaid waiver process. The new revised forms address individual outcomes. Attached forms include the ISP Instructions, Medicaid form, and Individual Outcomes.

The following information was presented at the Illinois 2004 Systems Change Seminar. Topics presented included: trends in long-term care, progress on the Illinois Community-based Treatment Alternatives for Children (CTAC) grants, the Illinois Housing Development Authority and how its work pertains to persons with disabilities, and Michigan’s progress on its Real Choice Systems Change grants.