Transcript Slide 1

CIL-NET Presents…
Creating a Community-Based
Services Report Card for Your State
A National Teleconference & Webinar
March 9, 2011
Presenter:
Suzanne Crisp
[email protected]
New Community Opportunities Center at ILRU
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Today We’ll…..
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Identify grading/scoring/ranking strategies
Discuss performance indicators
Examine resources to collect information
Consider analysis
Explore next steps
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Scoring / Ranking / Grading
• Scoring - # of points
• Ranking – relationship between set of items –
designates higher, lower, or equal
• Grading – evaluates performance
• Measuring is a complex initiative
• If done quickly – could draw wrong conclusions
• Today – provide you with tools to obtain an overall
picture of the state of your long-term system but
you draw your own conclusions
• “What is important to you” is key
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Performance Indicators
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Review of actions/activity to evaluate success
How you draw your own conclusions
Observe & analyze performance
Look at numbers, data, actions, inactions, to
decide the level of success:
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Transparency
Funding
Inclusion
Commitment
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Focus Areas to Consider Success
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Olmstead compliance
Choice and control options
Money follows the person initiatives
Medicaid options
Community partnerships
– Aging and Disability Resource Centers (ADRCs)
– Area Agencies on Aging
– HUD
• Interest in the Affordable Care Act
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Olmstead Compliance
• Suits may be filed by multiple entities, including
individuals
• US Justice Department may file – top priority
• Department has filed two suits
• Amicus briefs filed in 8 states
Indicator: Has your state been involved in a
compliance suit? Has there been discussion about a
suit? Any plans to file?
Source:
http://www.pascenter.org/state_based_stats/pick_a_state.php?url=http%3A%2
F%2Fwww.pascenter.org%2Fstate_based_stats%2Folmstead_home.php&title=
Olmstead+Plans+Lawsuits
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Questions and Answers
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What Is Participant Direction?
Participant
controls
What
How
When
Who
“Not doing things by yourself – but being in charge
of how things are done.”
Judith Heumann
New Community Opportunities Center at ILRU
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Growth of Budget Authority Programs
AK
WA
ME
MT
ND
VT
MN
OR
ID
NY
WI
SD
MA
MI
WY
Hawaii
CA
AZ
KS
MO
OK
CT
PA
IL
CO
RI
IA
NE
NV
NH
IN
NJ
OH
WV
MD
KY
NM
AL
DC
NC
TN
AR
DE
VA
SC
GA
MS
TX
LA
FL
15 Cash & Counseling States
19 Additional States with Budget Authority
Programs
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Choice and Control
Indicators:
1. Does your community offer individuals the ability to
mange their own services?
2. Is there flexibility to hire and manage and make
permissible goods and services?
3. Is the program easily understandable and
accessible?
4. Is the program comparable to traditional services?
5. Waiver application, state plan option or 1915(j)?
Source: www.participantdirection.org
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Money Follows the Person
• 2/22/11 Thirteen additional states added
• To date – moved 12,000; with new funding will
move an additional 13,000
• Extended another 5 years with Health Care Reform
• Time to be institutionalized is reduced
• Provides enhanced match for services and staff
Indicator: Are you an MFP state? Are your goals
reasonable? Are you meeting your goals?
Source:
https://www.cms.gov/CommunityServices/20_MFP.asp
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Medicaid Considerations
• Medically Needy:
– Allows individuals with too much income to qualify
temporarily for Medicaid if medical/clinical eligible
• Spousal Impoverishment:
– Allows community spouse to retain ½ of couple’s
combined income
• Presumptive Eligibility:
– Urgent need – presumed eligible
• State Plan Personal Care
– Receive long-term services in community without
institutionalization criteria applied
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More Medicaid Considerations
• Assisted living – community-based character?
• Free technical assistance – state contacted
CMS?
• Managing budget crisis – Eligibility tightened?
Staff reductions? Benefits reduced? Benefits
reduced in institutional setting?
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Aging Network
• Partnership needed – parents of adult children with
disabilities and persons with disabilities aging
• Older Americans Act – requires modernization
(maximizing independence)
• Veterans-directed Home and Community-based
Service Program (VD-HCBS)
Indicators: Close partnership with AAA, conduct
training on independent living movement, share
capacity to support to Veterans, & how many VDHCBS programs in state?
Source: www.adrc-tae.org
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Aging & Disability Resource Centers
(ADRCs)
• Collaboration between Administration on Aging &
the Centers for Medicare & Medicaid
• Streamlines long-term services
• Empowers people to make informed decisions
through information, assistance and access
• 200 operationalized in 54 states
• 13 states have statewide coverage
• 30 states passed legislation
• Additional $10 million each year through 2014
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ADRCs
Indicators:
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State has received grant (s)
Reached fully functioning status
Build solid partnerships
Statewide access
State legislation protects
Sustainability plan
Data Source:
www.adrc-tae.org
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Housing & Urban Development
• Set aside vouchers for Money Follows the Person
and persons with disabilities
• Department of Health and Human Services and HUD
• 2010 - $40 million over 12 month period, 5,300
housing vouchers to non-elderly
• 10 MFP states have set asides
Indicators: Does your state have a MFP set aside?
Has your state applied for housing vouchers?
Source:
http://portal.hud.gov/hudportal/HUD?src=/press/press_releases_media_advisories/2
011/HUDNo.11-003
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Additional Considerations
• Affordable Care Act
– Advancing the availability and use of home and
community services
– Rebalancing (2% or 5% enhanced Federal Medicaid
match)
http://www.healthcare.gov/law/introduction/index.html
• Behavioral Risk Factor Surveillance System
– State specific data
– Asks standard core questions about health risk behaviors
– More than 300,000 adults interviewed
http://www.cdc.gov/brfss/
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Valuable Resources
• http://www.aarp.org/health/health-carereform/info-10-2010/health-panel-10201.html
• http://www.statehealthfacts.org/profile.jsp
• http://www.ancor.org/news/2010/09/thompsonreleases-newest-medicaid-long-term-servicesstate-by-state-expenditure-data
• http://apps.nccd.cdc.gov/brfss/display.asp?cat=D
L&yr=2009&qkey=4001&state=UB
• http://www.census.gov/hhes/www/disability/data
collection.html
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Analysis
• Decide what is important to you, your
organization, and your constituency
• Do your homework – know how your state
measures-up
• Strengths + weaknesses = opportunity
• Compare with neighboring states – similar states
• Understand the options
• Position for Health Care Reform to consider new
enhanced funding prospects
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Questions and Answers
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Wrap Up and Evaluation
• Please complete the evaluation of this program by
clicking here:
https://vovici.com/wsb.dll/s/12291g48f5f
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New Community Opportunities
This webinar is presented by New Community Opportunities,
a national training and technical assistance program of
Independent Living Research Utilization. This webinar was
organized and facilitated by the National Council on
Independent Living (NCIL). Support for development of this
presentation was provided by the U.S. Department of
Education, Rehabilitation Services Administration under grant
number H400B100003. No official endorsement of the
Department of Education should be inferred. Permission is
granted for duplication of any portion of this slide
presentation, providing that the following credit is given to
the project: Developed as part of the New Community
Opportunities program at ILRU.
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