New Opportunities in Long Term Services and Supports
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- Job Barker
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1 Profiles of State Innovation: Long -Term Supports and Services CHCS Webinar November 22, 1010 New Opportunities in Long Term Services and Supports Mary Sowers Director, Division of Community and Institutional Services Disabled and Elderly Health Programs Group
2 Provisions of the ACA: Individuals with Disabilities, Chronic Conditions and Individuals who are Aging The Affordable Care Act includes numerous opportunities to improve the care and services available to individuals with disabilities, individuals with chronic conditions, and individuals who are aging These opportunities can be used in conjunction with existing authorities to improve a State s community based continuum. 2
3 Section 2402: Removing Barriers to HCBS Removing Barriers to HCBS 2402(a) Secretary to Develop Rules Related to HCBS Directs the Secretary to promulgate rules on HCBS to ensure that systems have systems in place for HCBS related to allocation of resources, providers, maximum choice and control. CMS is working in a cross-hhs workgroup on this provision. 3
4 Section 2402: Removing Barriers to HCBS, Cont d Section 1915(i) established by DRA of Effective January 1, 2007 State option to amend the state plan to offer HCBS as a state plan benefit Unique type of State plan benefit with similarities to HCBS waivers Breaks the eligibility link between HCBS and institutional care now required under 1915(c) HCBS waivers 1915(i) was modified through the ACA with the changes becoming effective October 1,
5 Section 2401: Community First Choice Option Adds Section 1915(k) to the Social Security Act. Optional State Plan benefit to offer Attendant Care and related supports to individuals, providing opportunities for self-direction. Includes 6% enhanced FMAP Statewide in community (not institutions) 5
6 Section 2403: Money Follows the Person Provides for the extension and expansion of Money Follows the Person through Extension of the MFP Demonstration Program offers States substantial resources and additional program flexibilities to remove barriers. New States can apply to join program. 6
7 Section 2703: Health Homes for Individuals with Chronic Conditions Adds Section 1945 to the Social Security Act Enables States to offer Health Homes to individuals with certain chronic conditions. Provides opportunity for person-centered system of care Coordinated care to ensure access to a multidisciplinary array of services to treat the whole person For State designed programs that meet the requirements, enhanced FMAP (90%) is available for the coordination services. 7
8 Section 10202: Balancing Incentive Program Effective October 1, 2011 BIP offers a targeted FMAP increase to States that undertake structural reforms to increase nursing home diversions and access to HCBS. The enhanced matching payments are tied to the percentage of a State s long-term services and supports that is offered through HCBS. Requires States to implement structural changes including: a no wrong door single entry point system, conflict-free case management services, and core standardized assessment instruments. 8
9 Section 2701: Adult Health Quality Measures Development of core set of quality measures for adults eligible for Medicaid. Establishment of a Medicaid Quality Measurement Program 9
10 Common Themes Uncommon Opportunities This is a time of unprecedented opportunity to transform the system of care for individuals with disabilities 10
11 The Triple Aim Population Health Experience Of Care Per Capita Cost
12 Challenge: Pull it All Together Opportunities for Efficiencies in Program Design and Development Opportunities to Coordinate Efforts to achieve improved care, improved experiences of care, and cost savings.the Triple Aim Role of managed care in the delivery of these new authorities for long-term services and supports 12
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