CIL-NET Presents…

New Community Opportunities Center at ILRU 1

CIL-NET Presents…CIL-NET Presents…

Creating a Community-Based Services Report Card for Your

State

A National Teleconference & Webinar

March 9, 2011

Presenter:

Suzanne CrispSuzanne [email protected]@bc.edu


Today We’ll…..Today We’ll…..

• Identify grading/scoring/ranking strategies • Discuss performance indicators• Examine resources to collect information• Consider analysis • Explore next steps


Scoring / Ranking / GradingScoring / 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


Performance IndicatorsPerformance Indicators

• 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: – Transparency– Funding– Inclusion – Commitment


Focus Areas to Consider SuccessFocus Areas to Consider Success

• 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


Olmstead ComplianceOlmstead 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 statesIndicator: 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%2F%2Fwww.pascenter.org%2Fstate_based_stats%2Folmstead_home.php&title=Olmstead+Plans+Lawsuits


Questions and AnswersQuestions and Answers


What Is Participant Direction?What Is Participant Direction?

What

When Who

How

Participant controls

“Not doing things by yourself – but being in charge of how things are done.”

Judith Heumann


15 Cash & Counseling States

19 Additional States with Budget Authority Programs

WAAK

Hawaii

OR

CA

NV

ID

MT

WY

UT

AZ

CO

NM

TX

OK

KS

NE

SD

ND MN

IA

MO

AR

LA

MS

TN

KY

IL

WI

MI

INWV

ALGA

FL

SC

NC

VA

PA

NY

DC

MD

DE

NJ

RI

MA

NH

VT

ME

OH

CT

Growth of Budget Authority Growth of Budget Authority ProgramsPrograms


Choice and ControlChoice 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


Money Follows the PersonMoney 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

staffIndicator: Are you an MFP state? Are your

goals reasonable? Are you meeting your goals?

Source: https://www.cms.gov/CommunityServices/20_MFP.asp


Medicaid ConsiderationsMedicaid 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


More Medicaid ConsiderationsMore 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?


Aging NetworkAging 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 VD-HCBS programs in state?

Source: www.adrc-tae.org


Aging & Disability Resource Aging & Disability Resource Centers Centers (ADRCs)(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


ADRCsADRCs

Indicators:

• 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


Housing & Urban DevelopmentHousing & 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/2011/HUDNo.11-003


Additional ConsiderationsAdditional 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/


Valuable ResourcesValuable Resources• http://www.aarp.org/health/health-care-

reform/info-10-2010/health-panel-10201.html• http://www.statehealthfacts.org/profile.jsp• http://www.ancor.org/news/2010/09/

thompson-releases-newest-medicaid-long-term-services-state-by-state-expenditure-data

• http://apps.nccd.cdc.gov/brfss/display.asp?cat=DL&yr=2009&qkey=4001&state=UB

• http://www.census.gov/hhes/www/disability/datacollection.html


AnalysisAnalysis

• 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


Questions and AnswersQuestions and Answers


Wrap Up and EvaluationWrap Up and Evaluation

• Please complete the evaluation of this program by clicking here:

https://vovici.com/wsb.dll/s/12291g48f5f


New Community OpportunitiesNew 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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CIL-NET Presents…