Transition/Diversion from Institutions

This is the third in a series of newsletters produced at the Exchange to provide assistance to our CMS Real Systems Change grantees. This newsletter is produced biannually. Topics include: Physicians’ Role in Determining Level of Care, Nurse Practice Policies for Home and Community Living, ADRC Toolbox, Massachusetts Connecting the Dots, Making Medicaid Work in the 21st Century, Assessment Instruments, HCBS Quality Management Roles & Responsibilities, Family Caregiving, and Housing.

The CMS Systems Change conference was February 28-March 2, 2005. Presentations from the 2005 sessions are available in both PDF and text formats. Topics range from ideas on sustaining systems change, employment services, Medicaid, integrating quality, policy implications and barriers to providing services. Full titles are listed in the keywords section.

This topic paper summarizes how states can use Medicaid to pay for most institutional transition program costs on a permanent basis as a result of policy change since 2000. It also describes how states are currently using Medicaid HCBS Waivers to pay for community transition services-temporary supports people need when trying to move such as housing deposits, utility set-up fees, and furniture.

Case study reports on programs in 9 states that received federal Nursing Home Transition Grants from 1998 - 2000 are now available. New reports describe programs, implementation, and lessons learned from transition programs in Arkansas, Florida, New Jersey, Pennsylvania, Texas, Vermont, Michigan, Wisconsin and from a hospital to nursing home diversion program in Colorado.

The Compendium contains basic information about each of the Real Choice Systems Change Grantees. The Compendium will help you learn more about how these 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. Real Choice Systems Change Grantees will also find the Compendium useful to identify other Grantees with similar goals and activities. The fourth edition of the Compendium replaces all previous editions.

The “Housing Search Guide” was developed to assist professionals who have a role in “relocation” of people with disabilities from nursing facilities to community living arrangements with appropriate services and supports. The Guide was developed by staff of the Texas Independent Living Partnership, a program of ARCIL, Inc. funded by the federal Centers for Medicare & Medicaid Services under the “Real Choice Systems Change” program.

The purpose of this project is to promote transition from an institution-based to a community-based system, in keeping with the goals of the federal New Freedom Initiative. This document summarized the policy recommendations of the Texas Independent Living Partnership over the three-year grant period, providing a resource to Texas state agencies, Centers for Independent Living, and other interested parties for ongoing systems advocacy and program development.

A number of states have developed rental housing locators that allow online searches for affordable housing units. These sites range from bare-bones databases of state-financed developments to elaborate sites with multiple search criteria, extensive information about accessibility for persons with disabilities, current vacancy information, and links to local service agencies. This report reviews several web-based sites based on several factors and compares the findings.

This guide was created as a resource to help you learn more about communication boards and how/when to use them. The boards in this kit were designed for a specific communication interaction, an intake interview to consider transition of an individual out of a nursing home. This handout provides a brief summary of the communication boards provided and some background information for you as you use the boards.

This handbook, drafted by Jane Schiele and edited and revised by Laura Hershey (HCPF Systems Change Section), is designed to help other advocates or agencies to inform many more individuals about their right to live in the community, and to assist those who desire a transition back to their community. The report defines transition and offers the nuts and bolts of the program and lastly overs tips for moving day and beyond.