1A non-profit service and advocacy organization © 2011 National Council on Aging
State Activity and Opportunities to
Advan...
2A non-profit service and advocacy organization © 2011 National Council on Aging
Overview
1. Managed Long-Term Services an...
3A non-profit service and advocacy organization © 2011 National Council on Aging
Half of States Could Have
MLTSS Programs ...
4A non-profit service and advocacy organization © 2011 National Council on Aging
MLTSS Programs Adults with ID/DD, 2012
5A non-profit service and advocacy organization © 2011 National Council on Aging
MLTSS Programs Adults with ID/DD, 2012
St...
6A non-profit service and advocacy organization © 2011 National Council on Aging
MLTSS Programs Adults with ID/DD, 2012
Pr...
7A non-profit service and advocacy organization © 2011 National Council on Aging
MLTSS for Adults with ID/DD: 2014 Update
...
8A non-profit service and advocacy organization © 2011 National Council on Aging
What is Managed Care?
Traditional Medicai...
9A non-profit service and advocacy organization © 2011 National Council on Aging
Powerful Tool
• Managed care is neither i...
10A non-profit service and advocacy organization © 2011 National Council on Aging
Pros and Cons
11A non-profit service and advocacy organization © 2011 National Council on Aging
Key Issues and Potential Roles
of DD Cou...
12A non-profit service and advocacy organization © 2011 National Council on Aging
Disability Stakeholder Engagement
• The ...
13A non-profit service and advocacy organization © 2011 National Council on Aging
Choice and Self-Determination
• The Issu...
14A non-profit service and advocacy organization © 2011 National Council on Aging
Consumer Protections and Rights
• The Is...
15A non-profit service and advocacy organization © 2011 National Council on Aging
Quality, Data Collection, Research
• The...
16A non-profit service and advocacy organization © 2011 National Council on Aging
Community First Choice Option 1915(k)
• ...
17A non-profit service and advocacy organization © 2011 National Council on Aging
Community First Choice Option 1915(k)
• ...
18A non-profit service and advocacy organization © 2011 National Council on Aging
Aging and Disability Resource Centers
• ...
19
VD-HCBS launched
49 States awarded
new ADRC grants
(5 year plans)
2007
2008
2009
2010
2011
2012
10 CMS Hospital
Dischar...
20A non-profit service and advocacy organization © 2011 National Council on Aging
Aging and Disability Resource Centers
• ...
21A non-profit service and advocacy organization © 2011 National Council on Aging
Friday Morning Collaborative
• American ...
22A non-profit service and advocacy organization © 2011 National Council on Aging
FMC Webinars
• Way to connect with state...
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NACDD: Making Sense of LTSS Policy. Joe Caldwell

From NACDD's 2014 Annual Conference
Published on: Mar 3, 2016
Published in: Government & Nonprofit      
Source: www.slideshare.net


Transcripts - NACDD: Making Sense of LTSS Policy. Joe Caldwell

  • 1. 1A non-profit service and advocacy organization © 2011 National Council on Aging State Activity and Opportunities to Advance Home and Community-Based Services Joe Caldwell Director of LTSS Policy National Council on Aging Rachel Patterson Policy Analyst Association of University Centers on Disabilities
  • 2. 2A non-profit service and advocacy organization © 2011 National Council on Aging Overview 1. Managed Long-Term Services and Supports (MLTSS) 2. Opportunities for DD Councils in LTSS – Community First Choice Option – Aging and Disability Resource Centers 3. Implementation of HCBS Settings Rule
  • 3. 3A non-profit service and advocacy organization © 2011 National Council on Aging Half of States Could Have MLTSS Programs Within Next Year NASUAD State Medicaid Tracker, July 2013
  • 4. 4A non-profit service and advocacy organization © 2011 National Council on Aging MLTSS Programs Adults with ID/DD, 2012
  • 5. 5A non-profit service and advocacy organization © 2011 National Council on Aging MLTSS Programs Adults with ID/DD, 2012 State Statewide Mandatory Enrollment Private for- profit Surveys and Advisory Council Survey Arizona X X X Delaware X X X Hawaii X X X X Michigan X X X North Carolina X (2013) X X Pennsylvania X Washington X Wisconsin X
  • 6. 6A non-profit service and advocacy organization © 2011 National Council on Aging MLTSS Programs Adults with ID/DD, 2012 Program Primary/A cute ID/DD HCBS Institutional Behavioral Rx AZ Long Term Care System X X X X X DE Diamond State Health Plan-Plus X X X HI QUEST Expanded Access MI Managed Specialty Support & Services X X X NC MH/DD/SAS Health Plan Waiver X X X PA Adult Community Autism Program X X X WA Medicaid Integration Partnership X X X X WI Family Care Partnership X X X X X WI Family Care X X X
  • 7. 7A non-profit service and advocacy organization © 2011 National Council on Aging MLTSS for Adults with ID/DD: 2014 Update • Six new states are planning or are in the process of implementing MLTSS for adults with ID/DD – Kansas – Texas – Illinois – New Hampshire – New York – Florida Source: NASUAD State Medicaid Integration Tracker, April 2014. Retrieved from http://www.nasuad.org/sites/nasuad/files/Edited%20Final%20Tracker%20-%204.14.14.pdf
  • 8. 8A non-profit service and advocacy organization © 2011 National Council on Aging What is Managed Care? Traditional Medicaid Managed Care
  • 9. 9A non-profit service and advocacy organization © 2011 National Council on Aging Powerful Tool • Managed care is neither inherently “good” or “evil” • It is a powerful tool: If it is used correctly it can do a lot of good, but if not it can do a lot of harm. • Engagement of individuals with disabilities and families in the design and implementation is critical
  • 10. 10A non-profit service and advocacy organization © 2011 National Council on Aging Pros and Cons
  • 11. 11A non-profit service and advocacy organization © 2011 National Council on Aging Key Issues and Potential Roles of DD Councils 1) Disability Stakeholder Engagement 2) Choice and Self-Determination 3) Consumer Protections and Rights 4) Quality Measurement, Data Collection, and Research
  • 12. 12A non-profit service and advocacy organization © 2011 National Council on Aging Disability Stakeholder Engagement • The Issues: – MLTSS is very complicated – New terms, tools, and ways to advocate – No trainings have been developed for self-advocates • Potential Role of DD Councils: – Develop trainings for self-advocates – Support consumer-based aging and disability coalitions in states to influence programs and ensure consumer protections
  • 13. 13A non-profit service and advocacy organization © 2011 National Council on Aging Choice and Self-Determination • The Issues: – Opportunities to design programs that promote self- direction, rebalancing, unmet needs and addressing waiting lists • Potential Role of DD Councils: – Not allow states to “carve out” institutional services – Promote person-centered planning and options for self- direction in programs – Ensure savings are reinvested to help address unmet needs and waiting lists
  • 14. 14A non-profit service and advocacy organization © 2011 National Council on Aging Consumer Protections and Rights • The Issues: – Some states are moving too quickly and not ready to implement MLTSS programs – Need independent ombudsman programs • Potential role of DD Councils: – Strong involvement in all phases of design and implementation – Possible state legislation to ensure consumer protections – Require ombudsman programs
  • 15. 15A non-profit service and advocacy organization © 2011 National Council on Aging Quality, Data Collection, Research • The Issues: – Quality measures are powerful tools that advocates and states can use to make systems change • Possible Role of DD Councils: – Support development and use of HCBS measures (e.g. National Core Indicators and Council on Quality and Leadership) – Support independent, external research on implementation and outcomes for people with I/DD
  • 16. 16A non-profit service and advocacy organization © 2011 National Council on Aging Community First Choice Option 1915(k) • State plan option to provide personal attendant services and supports to individuals who meet an institutional level of care – Hands-on, supervision, and cueing assistance with activities of daily living and health-related tasks – Also includes some other services and transition costs • Requires person-centered planning and options for self- direction • Provides a 6% enhanced federal match for services that continues indefinitely
  • 17. 17A non-profit service and advocacy organization © 2011 National Council on Aging Community First Choice Option 1915(k) • Two states have been approved (CA, OR) • Many states are applying or seriously considering – AR, CO, MD, MN, MT, NY, TX Possible Role of DD Councils: • Forming Community First Choice Council • Commission or contract for a study • Work with state on analyses • Think about next state legislative session
  • 18. 18A non-profit service and advocacy organization © 2011 National Council on Aging Aging and Disability Resource Centers • No Wrong Door – ADRCs are intended to be trusted community sources where people of all ages, incomes and disabilities go to get information and one-on-one person-centered counseling on the full range of LTSS options • ACL’s new vision for ADRCs – Much more inclusive of disability – Emphasizes Person-centered planning
  • 19. 19 VD-HCBS launched 49 States awarded new ADRC grants (5 year plans) 2007 2008 2009 2010 2011 2012 10 CMS Hospital Discharge Planning grants to ADRC states Affordable Care Act Money Follows the Person CCTP and Balance Incentive Program launched 19 Milestones of ADRC Development 2003 12 states, 8 sites, 2% of pop. 24 states, 42 sites, 8% of pop. 43 states, 147 sites, 30% of pop. 47 states, 300 sites, 49% of pop. 53 states, 525 sites, 77% of pop. ACL, CMS, VHA NWD System FOA
  • 20. 20A non-profit service and advocacy organization © 2011 National Council on Aging Aging and Disability Resource Centers • Potential Role of DD Councils – ACL, CMS, VA issued an funding opportunity for state planning grants – Deadline for applications in July 15 – Main “deliverable” is a 3-year plan – States eligible include all states and territories, except the 8 states currently receiving Part A ADRC Grants (CT, MD, MA, NH, OR, VT, WA, WI). – Need to make sure the DD Council is at the table – Promote greater involvement of self-advocates and families
  • 21. 21A non-profit service and advocacy organization © 2011 National Council on Aging Friday Morning Collaborative • American Association on Health and Disability • American Association of People with Disabilities • AARP • Alliance for Retired Americans • American Federation of State, County and Municipal Employees (AFSCME) • American Network of Community Options and Resources • The Arc of the United States • Association of University Centers on Disabilities • Alzheimer’s Association • Bazelon Center for Mental Health Law • Center for Medicare Advocacy • Community Catalyst • Direct Care Alliance • Disability Rights Education & Defense Fund • Easter Seals • Families USA • Health and Disability Advocates • Leading Age • Lutheran Services in America • National Association of Area Agencies on Aging • National Association of Councils on Developmental Disabilties • National Association for Home Care and Hospice • National Committee to Preserve Social Security and Medicare • National Council on Aging • National Council on Independent Living • National Consumer Voice for Quality Long-Term Care • National Disability Rights Network • National Domestic Workers Alliance and Caring Across Generations • National Health Law Program • National PACE Association • National Senior Citizens Law Center • Paralyzed Veterans of America • Paraprofessional Healthcare Institute • Service Employees International Union • United Spinal Association
  • 22. 22A non-profit service and advocacy organization © 2011 National Council on Aging FMC Webinars • Way to connect with state advocates and build capacity • Many on MLTSS and ACA Opportunities • All archived: www.ncoa.org/HCBSwebinars

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