Indiana FSSA Division of Aging Ellen Burton. Flexible financing for long term care Increased options for those in need of long term care. Largest demonstration

Indiana FSSA Division of AgingIndiana FSSA Division of AgingEllen Burton

• Flexible financing for long term care

• Increased options for those in need of long term care.

• Largest demonstration program in CMS history

CMS Federal Initiative

HistoryHistory

HistoryHistory

•Individuals have a choice of where they live and receive services

•Strategic approach to providing person-centered, needs based quality of care and quality of life services

CMS Federal Initiative

• Transition program that helps people who wish to transition to the community

• Medicaid funds spent on home and community-based services when individuals move to the community

HistoryHistory

Two Part System

• Enhanced match to states through MFP program

• January 2007, Indiana was awarded funds to participate in MFP

HistoryHistory

Federal Funding

• Awarded $21,047,402 in 2007

• January 1, 2007 to September 30, 2011

MFP in IndianaMFP in Indiana

State Award


• Year 1 & 2– Planning

• Year 3-5 - Implementation

Program Plan


•Operational Protocol

•Contract with Indiana Association of Area Agencies on Aging (IAAAA) and Area Agencies on Aging (AAAs)

•Stakeholders

•Training

Planning


• Potential Participants

• Transition

• Post Transition

Implementation


•Identified by Minimum Data Set – Long Term Care (MDS-LTC) assessment tool as desiring to move back into the community

• Have lived in a qualified setting (nursing facility, hospital, etc.) for at least 6 months

Potential Participants


• Medicaid eligible 30 days prior

• Eligible for one of two waiver services

Potential Participants


•A&D•Individuals meeting nursing facility level of care, Medicaid eligible, & Aged (age 65+) or Disabled

• TBI•Individuals meeting nursing facility level of

care, Medicaid eligible, & Disabled and Traumatic Brain Injured

Waivers


•AAAs will provide transition specialist (case manager) and transition nurse for transition period

• Transition Team: transition specialist, transition nurse, participant, legal guardian, family, etc.

Transition


•Person centered planning based on participants goals

• Team coordinates all necessary supports for community setting

• Additional program services

• Qualified residence

Transition


•$1500 Transition Assistance

• Personal Emergency Response System (PERS)

• Enhanced Transportation

Additional Services


•The individual’s own home or family home

•An apartment with an individual lease, with lockable access and egress, and include living, sleeping, bathing, and cooking areas over which the individual or the individual's family has domain and control

Qualified Residence


•A shared home with no more than four unrelated housemates;

•An adult foster care home where no more than four unrelated individuals reside.

Qualified Residence


•Discharge checklist completed

• Individual chooses community case manager

• Move to community

Transition


•Participants resides in community

• Receives necessary supports and services through MFP for 365 days

• Meets with case manager regularly

Post Transition


•Day 366 – transition to waiver

• Seamless, transparent to client

• Continue to live in community, receiving necessary supports through the waiver

Post Transition


•Participation in program can be suspended for hospitalization or rehab stays

• Does not count toward 365 days of program participation

• Suspension can last up to 30 days

Suspension


•Goal: transition 1039 individuals over next 3.5 years

• Roughly 2000 individuals expressed interest and may be eligible

The Numbers


The Numbers

Questions??Questions??

Ellen BurtonDirector, Money Follows the Person

Division of AgingFamily & Social Services

Administration317.234.5715

[email protected]

Contact Information

Documents

Indiana FSSA Division of Aging Ellen Burton. Flexible financing for long term care Increased options for those in need of long term care. Largest demonstration