Money Follows the Person Working Group

1. Money Follows the Person Working Group December 20, 2010

2. Agenda • Update • Transition Processes • Housing 2

3. Status of development of Operational Protocol Document (OPD) and current issues • Components of OPD include: • Participant recruitment and enrollment • Housing - 12/20 meeting topic • Benefits and Services - with input from 11/12 • Outreach/Marketing/Education - with input from 12/3 • Self-Direction - with input from 12/3 • Stakeholder Involvement - ongoing work of Standing Olmstead Advisory Committee • Consumer Supports • Informed Consent and Guardianship • Quality • Continuity of Care Post Demonstration • Letters of endorsement needed 3

4. Money Follows the Person Overview Qualified Individuals/ Institutions Nursing Facilities Rehabilitation Hospitals Intermediate Care Facilities DPH Hospitals IMDs (age limits) Transition Activities Transition Svcs Demo HCBS Svcs Other Community Supplemen- tal Svcs Qualified Residences Individual’s or Family’s Home Individual’s leased apartment Community Residen- tial Setting (Max 4 individuals) HCBS Existing Waiver DDS waivers, Frail Elder Waiver, TBI Waiver, ABI waivers New Waivers State Plan Services Other Services

5. Projected MFP Participants • Assessing currently planned transition activities • Participant estimates are very preliminaryprojections • Subject to change; resources are a significant consideration

6. Projected MFP Capacity Development • Comprehensive Transition Support • Two new 1915c waivers (operating agency: MRC; administrative oversight: Masshealth) • MFP Residential Supports waiver (24/7) • MFP Community Living waiver • Comprehensive services; self-direction • Outreach & education • Administrative capacity development • Information & referral resources • Housing development & search • Utilization & outcome data collection • Quality Assurance & Evaluation

7. Transition Processes 7

8. Reminder of Framework for Transition Coordination • Definition: standardized set of administrative activities that assist a qualified individual to transition • Processes and roles and responsibilities of Transition Coordinators (state agency staff and contracted agents) performing the functions will evolve over the course of the Grant (as a result of changing scope and as we evaluate our effectiveness) • State agencies and their agents will continue to manage Transition Coordination processes; through MFP, we will enhance our activity to support a broader range of members and improve our efficacy • Acknowledgment that availability of community services is critical to assure successful community transition 8

9. Input from earlier meetings • Feedback has been sought on… • How new resources might best be applied to reach populations not currently assisted and improve our success • How best to stage enhancements • Measurement of transition coordination effectiveness • Modifications to MassHealth processes (e.g. prior authorization) 9

10. Considerations in Designing Enhancements to Transition Coordination • Addressing diversity of populations to be served • How best to leverage competencies of existing agents and state agency staff • How best to ensure consistency in approach across facilities and populations • How best to capture sufficient data on transition work across multiple data systems to ensure we can: • understand successes and understand barriers, issues, and trends; • evaluate effectiveness of transition coordination processes and of agents; • meet MFP reporting requirements • How to identify appropriate level of resources for populations to be served • How to locate transition coordination expertise in entities that will provide needed infrastructure for future developments in long term care 10

11. Enhancing Transition Coordination Capacity • EOHHS will competitively procure Transition Coordination expertise • Procurement of select number (5?) of regional entities with independent living and disability expertise • Transition Coordination entity must be able to provide behavioral health expertise – either directly or by sub-contracting  • Entities will resource Transition Teams and provide “consultants” to existing Transition Teams (e.g. DMH Hospital discharge planning teams; CSSM) • Transition Teams will have consistent requirements re: coordination tasks (medical and non-medical services needs; delivery system options; etc) • Housing locator resources would be resident in same entities 11

12. Other Transition Enhancements • Training, technical assistance, (and case consultation?) support to be provided to all regional entities and Transition Teams • Development of standardized tools across entities performing transition coordination work (e.g. Public Benefits check-lists) • Accelerated prior authorization approval processes to support discharges across settings 12

13. Housing 13

14. Over-arching framework: Assure high-level joint planning, resource identification & development capacity between EOHHS & DHCD Support statewide housing capacity identification and client linkage Improve existing housing search / access capacity Background TAC report, MassHousing, DHCD, EOHHS Steering Committee & STG documents Inventories; supply mapping; needs assessments; search tools; MFP Housing Strategies 14

15. Support EOHHS / DHCD Planning & Capacity Development • Establish EOHHS MFP State Housing Coordinator • Oversee implementation of MFP Housing Action Plan, including regional coordination support • Build on existing DHCD / local housing authority collaborations • Joint Housing Steering Committee • Ongoing development & administration of Home Modification Program • Ongoing housing unit selection under CBH & FCF • Training for DHCD architects re: accessibility requirements

16. Support EOHHS / DHCD Planning & Capacity Development • Joint development of Housing opportunities for MFP participants • Planned ABI & DDS housing development • Pending Category 2 non-elder Section 8 vouchers (215) • Ongoing bond cap planning to expand CBH, FCF as resources permit • Expanded universal design training & unit development • Determination of new opportunities regarding: • Improved affordability of MassHousing set-aside, FCF units; Project-based & MRVP Value Vouchers • Increased preferences / improved targeting for individuals leaving institutions for MassHousing set-aside, Supported Housing, Home Modification, CBH, Rural Housing Sec 515, & Alternative & Housing Choice Voucher programs; potential QAP inclusion

17. Support statewide housing capacity identification and client linkage • Establish Regional Housing Opportunity Teams • 11 ADRCs, 8 Regional Housing Non Profits, local PHAs, state agency regional housing staff, local providers, housing search entities, advocates • What is the right number of regions for planning purposes? • Purchase MFP Housing Search Assistance • Help the consumer identify appropriate housing • Assist in collection of any required documentation • Ensure housing applications are obtained and completed • Should this be a per person unit rate? Should we hire regional (3?) housing search providers? • Who should provide this service? ILCs? ADRCs? Homeless housing search agencies? Realtors? Others?

18. Improve existing housing search capacity • Enhance MassAccess (Massachusetts Accessible Housing Registry) • Improve the functionality to conduct housing searches for specific groups including elderly only and family; • Improve functionality for sorting developments with open wait lists versus developments with current vacancies; • Conduct complete review of the entire site for updates/upgrades with current web technology (current site is now two years old); • Update the Help and Resource Section of the Registry including fact sheets on housing search, reasonable accommodations and fair housing laws; and • Provide support for ongoing training for property managers and end users.

19. Next Steps • Signatures for Letter of Support Needed by December 28 • Budget & Final OPD Draft Development Still Underway • Final Stakeholder Meeting January 5