Dear Advocates for Rebalancing the Institutional Bias in Long Term Services and Supports:

CMS has just announced the award of the Money Follows the Person to 17 states. (see below)

Those state now have to develop and submit to CMS for approval a "Demonstration Operational Protocol."

This DOP must "...formally engage all needed stakeholders...". As the saying goes "the devil is in the details". If MFP funds are going to really end up getting folks out of institutions, we need to be at the table aggressively advocating for these funds to be spent "right".

The other states that submitted a MFP proposal, but didn't get the initial award will get a letter from CMS telling them they have to revise their proposal, and return it to CMS in 30 days. We understand there will be a second round of awards in March for those states that do the revisions requested.

If you know your state submitted a MFP proposal, but didn't get the initial award, you have a real opportunity. Contact your Medicaid Director to offer your assistance to make the needed revisions. Rebalancing your state's long term care system is what CMS is looking for.

Don't Mourn...ORGANIZE!

FREE OUR PEOPLE

The ADAPT Community

The Initial 17 States are: Arkansas, California, Connecticut, Iowa, Indiana, Maryland, Michigan, Missouri, Nebraska, New Hampshire, New York, Ohio, Oklahoma, South Carolina, Texas, Washington, Wisconsin.

CMS Awards Demonstration Grants to 17 States
For Alternatives to Institutional Care

Seventeen states will receive more than $23 million in grants for FY 07 and up to $900 million over 5 years for demonstration programs that will help build Medicaid long-term care programs to keep people in the community and out of institutions.

Today’s awards, announced by Leslie Norwalk, acting administrator for the Centers for Medicare and Medicaid Services (CMS), are the first round of grants that will total $1.75 billion over five years (2007-2011) to help states shift Medicaid’s traditional emphasis on institutional care to a system offering greater choices for individuals and a full range of home- and community- based services. This Money Follows the Person (MFP) “rebalancing” initiative was included in the Deficit Reduction Act of 2005 (DRA) currently being implemented by CMS.

“There is more evidence than ever that people who need long-term care prefer to remain in their own homes and communities whenever possible,” Acting Administrator Norwalk said. “States will also get more for their money by giving the elderly and people with disabilities more control over how and where they get the Medicaid services they need. With these grants, the states propose to transition over 20,000 individuals from institutions and into community settings.

“Because experience shows that money following the person’s own preferences improves satisfaction and can reduce Medicaid costs too, we intend to continue taking steps, such as those taken through these grants, to remove barriers, real or perceived, that prevent them from participating fully in community life.”

The Medicaid program traditionally pays for care for elderly and disabled individuals living in institutions who need help with activities of daily living. Previously, in order to fund home and community-based services, states had to establish a “waiver program” apart from the approved State Medicaid plan.

To assist states in offering greater choices, the DRA made changes in Medicaid that will allow states to add home- and community- based services to their permanent array of benefits without having to go through a waiver program. Under a DRA provision separate from the MFP initiative, states now have the option to provide home and community-based services without a waiver program.

States receiving grants today under the MFP initiative (see list below) will design programs with four major objectives:

• Increase the use of home and community-based, rather than institutional, long-term care services;
  
  
• Eliminate barriers or mechanisms that prevent Medicaid-eligible individuals from receiving support for appropriate and necessary long-term services in the settings of their choice;
  
  
• Increase the ability of the state Medicaid program to assure continued provision of home and community based long-term care services to eligible individuals who choose to move from an institutional to a community setting; and
  
  
• Ensure that procedures are in place to provide quality assurance for individuals receiving Medicaid home and community-based long-term care services and to provide for continuous quality improvement in such services.

All states were eligible to apply for participation in the five- year demonstration that requires a commitment to participate in the demonstration services for at least two consecutive years. A second round of state grants may be announced later this year using 2007 grant money.

States receiving grant funds may be eligible to receive a higher percentage of federal matching dollars to help cover the costs for people moving out of institutions and into community settings. The higher matching rate will be applied to certain services provided to an individual for a one-year period after the individual moves out of an institution and into the community. The state must continue to provide community services after that period as long as the person needs community services and is Medicaid eligible.

“These demonstration grants are a clear sign of our continued commitment to expand choice to all individuals wanting to live meaningful lives in the community,” acting administrator Norwalk said. “These grants will help give them the independence to live at home and be an active part of their communities."

For more details about the New Freedom Initiative, of which this demonstration is part, visit the CMS website.

2007 Money Follows the Person
Rebalancing Demonstration Awards