State Resource

Example NWD Accessibility

States must ensure that NWD sites are accessible to older adults and indivduals with disabilities, and users of public transporation. States must submit a description of the NWD features that promote accessibility. 

Example HIE Coordination

States must make an effort to coordinate their NWD/SEP system with the Health Insurance Exchange IT system. States should answer the following questions to meet this deliverables:

  • Is the state using the Federally-Facilitated Marketplace or a State-Based Exchange?
  • How does the state route individuals from the Exchange portal to the Medicaid portal?
  • How does the state identify individuals who are ineligible for Medicaid under the rules of Modified Adjustment Gross Income (MAGI), but eligible for Medicaid-funded LTSS under special income rules?

Example Advertising Materials

Nursing homes, hospitals, community-based organizations, medical providers, and other governmental social programs should be aware of and refer clients to the NWD system.  Therefore, the State must advertise the system to all potential referring partners.

Example NWD Service Shed Coverage

NWD/SEP entities are access points where individuals can inquire about community LTSS and receive comprehensive information, eligibility determinations, community LTSS program options counseling, and enrollment assistance. The Programs requires that states identify service shed coverage of all NWD/SEP entities. A NWD/SEP’s service shed covers all residents within a certain distance.  Ideally, the combined service sheds of all NWD/SEPs should cover the State’s entire population.  

Example Sustainability Plans

States must have a clear idea on the cost of maintaining the structural changes once they are in place.  Therefore, States should submit the overall maintenance budget of the structural changes and sources of funding.

Example Training

All staff should be trained on the NWD/SEP processes by the time the system is implemented for testing. As a related deliverable, States should submit the training documents used by NWD/SEP staff to follow the NWD/SEP processes, in addition to the training agenda.  To be effective, documents should include flow diagrams and clear guidelines for each type of NWD/SEP staff member.

Example Detailed Design of NWD System

This task involves a much more detailed design structure of the NWD/SEP system.  If the State plans to contract a vendor to build an automated system, the deliverable associated with this task could be the Request for Proposal (RFP) disseminated to potential vendors.  The RFP should include the data flow, highlighting which entity(ies) will house the data, data transfer mechanisms, levels of user access, and data security measures.

Example Toll Free Number Call Script

 A single toll free number should route individuals to central NWD/SEP staff or to a local NWD/SEP, where they can find out about community LTSS options in the State, request additional information, and schedule appointments at local NWD/SEPs for an assessment.  The number should be accessible to non-native English speakers and those with disabilities, providing translation services and TTY.

Example Core Standardized Assessment Instruments (Level II)

The Balancing Incentive Program requires states to use a Core Standardized Assessment (CSA) instrument(s) to 1) determine eligibility for Medicaid-funded community long-term services and supports (LTSS), 2) identify individuals’ support needs, and 3) inform their service and support planning (e.g., plan of care).

Example Conflict-Free Case Management Policies

One of the three structural change requirements Balancing Incentive States must implement is a conflict-free case management system. “Conflict of interest” is defined as a “real or seeming incompatibility between one’s private interests and one’s public or fiduciary duties.” Some State social services systems allow the agent that conducts the functional assessment and/or case management to also provide services to that individual.

Pages

Subscribe to RSS - State Resource