Money Follows the Person Rebalancing Initiative

WISCONSIN

Target Population

Persons with developmental disabilities living in intermediate care facilities for the mentally retarded (ICF/MR) and persons with physical disabilities and frail elders living in nursing homes.

Geographic Focus

Statewide.

Primary Focus

• The primary focus of this grant is to develop funding mechanisms to allow institutional funding to follow persons transitioning to homes in the community from ICF/MR and nursing facilities. In addition to developing the funding mechanisms and supporting data systems, judges and guardians will be educated about community living and needed resources.



• The grant emphasizes the Money Follows the Person (MFP) principles of informed choices about long-term support options and accessible and available community services.

Planned Use of Medicaid Statistical Information System (MSIS): Yes.

Goals, Objectives, and Activities

Goal: Develop a new mechanism and supporting data systems to enable funding to follow individuals moving from ICF/MR facilities to homes in the community.

Objectives/Activities

• Fund a contract specialist to ensure that all necessary systems are in place for relocations to begin as soon as the legislature's ICF/MR downsizing initiative is in effect.



• Evaluate data systems to determine best method of tracking service utilization.



• Adapt State and county fiscal systems to transfer funding.

Goal: Transition 200 individuals currently living in ICF/MR facilities, and their funding, to the community.

Objectives/Activities

• Identify ICF/MR facilities to be downsized or closed.



• Meet with county officials and develop plans for downsizing and closing facilities and relocating residents.



• Develop reporting to track expenditures on a person-by-person basis.

Goal: Create a regional support system that will enable participants and their guardians, county administrators, and other key stakeholders to understand and choose alternatives to ICF/MR facilities.

Objectives/Activities

• Expand existing guardian mentor program used in state-level facilities to include guardians of all people with developmental disabilities.



• Educate guardians and other judicial personnel about resources needed for community living.

Goal: Determine the feasibility of an MFP mechanism for individuals in nursing homes.

Objectives/Activities

• Determine feasibility of a new funding mechanism to facilitate use of institutional funding for community living.



• Work with legislature to achieve enactment of legislation.



• Implement the funding mechanism to enable funds to follow the person.



• Work with counties to develop community resources for transitioned individuals.

Key Activities and Products

• Identify ICF/MR facilities to be downsized or closed.



• Develop system so counties can track residents for whom they have responsibility on a person-by-person basis.



• Educate guardians and other judicial personnel about resources needed for community living.



• Determine feasibility of a new funding mechanism for nursing home residents to facilitate use of institutional funding for community living.

Consumer Partners and their Involvement in Implementation Activities

• Individuals with developmental disabilities transitioning to the community will provide input into where they want to live.



• Members of People First, a group of persons with developmental disabilities, are willing to partner to help people and their families return to community living.



• The State will form a subcommittee of the State Council on Long Term Care Reform will be formed to obtain input from consumers, families, advocates, and other stakeholders as to the progress of this initiative.

Public and Private Partners and their Involvement in Implementation Activities

Public Partners

• The Bureau of Developmental Disabilities Services will work with the Bureau of Aging and Long Term Care Resources will have responsibility for developing the funding mechanisms to allow funds to follow individuals from facilities to the community.



• County human services departments and administrators of county nursing homes and ICF/MR facilities will help develop support plans for individuals transitioning from facilities and develop plans for accommodating for the downsizing of their facilities



• The State will provide grants to counties interested in transitioning many individuals to increase provider capacity.

Private Partners

• Guardians will help select where individuals want to live and what services they desire.



• The Department of Health and Family Services will provide grants for guardian ad litem training to organizations with experience in this area.



• The Department will rely on the Centers for Independent Living for outreach, advocacy, and peer support.



• The Department will hire a consultant to work with county elected officials and county management on plans for transitioning individuals and downsizing facilities.



• The Department will work with private ICF/MR providers as they look to downsize or reconfigure their operations.

Advisory Body, Committee, or Task Force

• The New Freedom Initiative Advisory Committee currently fulfills the role of Wisconsin's Consumer Task Force for purposes of Systems Change grants. The committee consists of 11 members representing consumers, advocates, ICF/MRs, vocational rehabilitation interests, and others.



• The committee meets on a monthly basis for the purpose of tracking New Freedom Initiative grant activities, tracking upcoming grant opportunities, monitoring the Americans with Disabilities Act Title II goals and periodically reporting to the State Council on Long Term Care Reform.

Formative/Process Evaluation Activities

• Project staff and their immediate supervisors will provide day-to-day tracking of project activities and deliverables and report on progress to the co-directors.



• As products and processes are developed or are being developed under this grant, quality assurance and improvement principles will guide the assessment of the viability of those products and processes.



• If a grant product or process will not meet the goals of this project, project staff and management will reassess the product or process and take steps to redirect activities.



• Feedback loops will include project staff to management, counties to project staff and department management, regional staff to central office staff, and consumers and guardians to department staff.

Summative/Outcome Evaluation Activities

No summative evaluation activities are planned at this time.

Strategies to Ensure Sustainability

• The Department's process to transfer funding from the ICF/MR to the county in which the individual resides will provide the needed mechanism to facilitate relocations to the community. This change will initially benefit 200 people but ultimately change Wisconsin's system by providing the needed funding for permanent system change.



• The significant downsizing of ICF/MR facilities will result in Wisconsin citizens with developmental disabilities living in the most integrated community settings based on their personal choices. Decrease in bed capacity may eventually phase out ICF/MR facilities as an option.



• State legislation has ensured that this system's change will be implemented and ongoing beyond the time of this grant.