Resources

Percent of total LTSS spent on community LTSS by state during period of Program participation.

Summary of States’ tools to collect service, quality, and outcome data  

Summary of States’ uses of enhanced FMAP for activities such as supporting the NWD system, developing and implementing CSA components, promoting CFCM, and expanding LTSS. 

Examples of how BIP states are facilitating enrollment into community LTSS for the mental health population. 

Summary of state strategies for mitigating conflict within their case management system  

Summary of States’ NWD system description, including: entry points, Level I screen, Level II assessment, financial eligibility, and coordination/automation. 

Summary report of State’s progress on the three main program components: structural changes (NWD System, CSAs, CFCM), balancing benchmark, and the use of enhanced FMAP. 

During the January 21, 2015 National Call, BIP states asked clarifying questions about Conflict Free Case Management (CFCM) and Conflcit of Interest. Attached are these responses. 

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. 

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?

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.

Medicaid Beneficiaries Who Need Home and Community-Based Services: Supporting Independent Living and Community Integration: http://kff.org/medicaid/report/medicaid-beneficiaries-who-need-home-and-community-based-services-supporting-independent-living-and-community-integration/

How is the Affordable Care Act Leading to Changes in Medicaid Long-Term Services and 

Supports (LTSS) Today? State Adoption of Six LTSS Options: http://kaiserfamilyfoundation.files.wordpress.com/2013/04/8079-02.pdf

An analysis of Maryland's Money Follows the Person (MFP) system:

http://kff.org/medicaid/issue-brief/marylands-money-follows-the-person-demonstration-support-transitions-through-enhanced-services-and-technology/

Health Insurance Portability and Accountability Act (HIPAA) Privacy:  http://www.hhs.gov/ocr/privacy/hipaa/understanding/index.html

The Office of Management and Budget (OMB) Circular A-87 regarding allowable costs and cost allocation for Federal grants: http://www.whitehouse.gov/omb/circulars_a087_2004

Web-based Level I Screen Examples

 

Level II Assessment Examples

Medicaid Expenditures for Long-Term Services and Support:  2011 (Thomson Reuters): http://www.hcbs.org/files/205/10211/MedicaidManagedLTSSExpenditures.pdf

Medicaid Expenditures for Long-Term Services and Support:  2011 Update (Thomson Reuters): http://www.hcbs.org/files/208/10395/2011LTSSExpenditures-final.pdf

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.  

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