Money Follows the Person

1. Money Follows the Person Division of Aging Services Dr. James J. Bulot

2. What is Money Follows the Person? • 11- year demonstration project funded by CMS • Single largest investment in Medicaid Long Term Care • 43 states and D.C. utilizing $2.25 billion • Grant through the Federal Deficit Reduction Act of 2005 • Shift Medicaid long-term spending from institutional to home and community-based services (HCBS)

3. When did it start in Georgia? • DCH began implementation on 09/01/2008 • DAS became the sub-contractor to transition the elderly/disabled population on 07/01/2011 • DBHDD contracts with DCH to transition the DD population from facilities

4. Six Georgia MFP Benchmarks • Transition 1558 persons to HCBS waivers by CY 2015 • Increase Home and Community Based Services (HCBS) expenditures related to LTC each year • Reduce the number of DD beds in State ICFs by the end of the demonstration • Increase the rate of successful transition each year • Establish trusted, visible, reliable Point-of-Entry system • Increase the number of participants choosing self- directed Personal Support Services (PSS) Note: Grant funding is available through 2020

5. Who is eligible to participate? • Reside in an inpatient facility (nursing home, hospital or ICF) for at least 90 days • Receive Medicaid benefits for facility services for at least one day • Continue to meet institutional level of care criteria

6. Demonstration and Supplemental Services Available • Peer Community Support • Trial Visits (Personal Support or PCH) • Household Furnishings • Household Goods and Supplies • Moving Expenses • Utility Deposits • Security Deposits

7. Demonstration and Supplemental Services Available continued • Skilled Out-of-Home Respite • Caregiver Training • LTC Ombudsman • Equipment and Supplies • Vehicle Adaptations • Environmental Modifications • Transition Support • Transportation

8. Planning for Transition • Outreach and Recruiting • Screening and Referral • Person-directed Planning • Circle of Friends/Support • Community Access (Housing, Transportation, etc) • Self-direction • Support Post-demonstration • Quality of Life Survey and Evaluation

9. After Discharge • 365 days of MFP services from discharge date • Waiver services begin on date of discharge • Transition Coordinators make monthly contact • Waiver case managers follow regular waiver procedure for contact • LTCO may make face-to-face visits at 1, 6, and 12 months in 3 pilot areas of the state • Quality of Life survey is conducted by surveyor at 12 and 24 months post-discharge

10. The Return on the Investment • Average total monthly Medicaid cost savings post transition is 40% • Projected Annualized Medicaid Savings per member is $32,341 on average • Quality of Life Improvement

11. Quality of Life Indicators • Living Situation • Choice and Control • Access to Personal Care • Respect and Dignity • Community Integration and Inclusion • Satisfaction • Health Status

12. DAS and the Aging NetworkMFP Strengths • 12 AAAs Cover the entire state and know their local resources • Options Counseling work already begun: ADRCs are the designated Local Contact Agency • CCSP Care Coordinators have a history of transitioning consumers from nursing facilities…159 consumers in CCSP in SFY 2010 were admitted from nursing facilities outside of the MFP process

13. DHS/DAS: 3 MFP Components • Transition Coordination • Options Counseling • LTC Ombudsman Advocacy Target: Transition 125 Individuals back to the community in SFY 12

14. Biggest Barriers to Transition • Transportation • Housing

15. DAS Activities to date • Issued contracts to 12 Area Agencies on Aging • DAS Currently Managing 187 Consumers in MFP • Conducted Training (ongoing) • Weekly calls w/the AAAs • Weekly meetings w/DCH

16. DAS Next Steps • Automate the Manual Processes • Continue Training • Continue to work w/AAAs to transition people back into the Community