Medicaid Waivers

Essentials of Housing Teleconference was held with Guest Person, Stephen Gold, regarding a systems change strategy to provide training with regards to the largest housing programs in the nation with a focus on recipients of SSI. These included: 1) low-income housing tax credit program, with nearly $600 billion available annually for units, and 2) the HOME Partnership program, with $1.4 billion available annually. Jay Klein facilitated this call.

This State Policy in Practice brief describes the process of sustaining Connecticut's nursing home transition program. Connecticut focused on bringing key stakeholders (including consumers) together and building evaluation into their efforts to make the case for obtaining state funding for the transition program. This brief is intended to help state policy and program leaders, advocates, and providers learn from their peers and colleagues across the states.

This State Policy in Practice brief describes Michigan's nursing home transition program and summarizes evaluation findings. The program has been sustained statewide through the addition of transition services to Michigan's 1915c waiver for the aged and disabled. This brief is intended to help state policy and program leaders, advocates, and providers learn from their peers and colleagues across the states.

This Special Edition of NCHSD’s monthly eNews summarizes promising practices, information sharing, and strategic thinking from the November 2005 National MIG Technical Assistance Conference. Topics include: Work and Recovery, Strategies to reach full eligibility, Outcomes tracking requirements, Strategic planning, Attitudinal barriers to employment, The future of Medicaid, Research efforts and challenges and Advocates as key stakeholders. Presentation materials are available on CD or on-line.

With the recent enactment of the Deficit Reduction Act, states who are interested in increasing their home and community based programs have three new opportunities. The DRA has many components but the three provisions that increase flexibility over benefits and cost sharing include the Home and Community-Based Services (HCBS) option (section 6086-page 118), a Money Follows the Person (MFP) demonstration project (section 6071-page 99)and a Cash and Counseling option (section 6087-page 124).

The Big Sky Bonanza (BSB) quality management strategy was included in the state's CMS waiver application and has recently been approved by CMS. The process will weave together quality assurance and quality improvement strategies using a three-tiered process. Tier I of the process is the individual/provider level. Tier II is the Regional level. Tier III is the State/Division level.

The December Gerontologist highlights a study which reviewed the state-level Medicaid 1915c data from 1992-2001 and compared state predictors of waiver utilization and expenditures for waivers serving both older and working age individuals relative to waivers serving individuals with intellectual and developmental disabilities. The results found that increased community-based-care capacity appears to be an important factor in efforts to expand the availability of Medicaid community-based-care.

The Center for Personal Assistance Services has prepared this case study of the Washington state Medicaid Personal Care Services (PCS) program. This report first presents an overview of the states characteristics, and then reviews the Medicaid program and management of HCBS programs including the personal care in waivers. The primary focus is on the organization and management of the Medicaid PCS optional state plan program. The report highlights eight best practices.

CMS has developed the final revised working draft of the 1915 (c) HCBS waiver application, Instructions and Technical Guide, Resource Documents, and the CMS Review Instrument. This is the version that CMS is currently automating for use as a web-based application available in Feb 2006. The new application was designed to solicit more complete information from states about the design of their waiver program to better determine whether a proposed waiver has the capacity to meet the requirements.

CMS is pleased to announce the new and improved CMS website. The new site employs a user-friendly design to get visitors the information they need with the least amount of clicks. It introduces one-stop shopping “centers” targeted to specific professionals such as providers and partners, who frequent the site. The main changes include timely, relevant and accurate content, improved Google search features, and consistent organization and navigation sections.