Montana Community Choice Partnership Money Follows the Person (MFP) Demonstration Grant Stakeholder Advisory Council Meeting March 10, 2015.

Montana Community Choice Partnership

Money Follows the Person (MFP)Demonstration Grant

Stakeholder Advisory Council Meeting

March 10, 2015

MFP Vision

*Montana will create a sustainable system that supports community options as a first choice for individuals needing long term care services.

Timeline of MFP

*September 2012 – Montana receives a MFP Award

*August 2013 – Montana’s initial MFP budget is approved

*December 2013 - MFP Director starts

*April 2014 - Draft process and materials are developed

*May 2014 – 2 pilot transitions from MDC

*July 2014 – 3 staff start, materials finalized, MFP webpage established, online referral form active

*August 2014 – Transitions begin

*January 2015 – Statewide MFP trainings complete, 5 of 10 Demonstration Services finalized and coded

*February 2015 – Sustainability Planning

Eligibility Requirements

PARTICIPANTS MUST:*Be 90 consecutive days in an inpatient facility

*Be Medicaid eligible at least one day prior to transition

*Enroll in HCBS waiver or 1915 (i) State Plan HCBS program

*Transition into MFP qualified housing

Benefits to Participants

PARTICIPANTS RECEIVE:*Significant planning time focused on

finding appropriate housing, services, and other transition work

*365 days MFP participation/funding – does not include pre-transition work

*Waiver or State Plan program benefits form services baseline

*MFP demonstration services provide extra service options especially to help transition

Benchmarks

201788

• Elderly 15• ID/DD 5• PD 22• Mental Illness 12• Other 34

201677

• Elderly 13• ID/DD 7• PD 15• Mental Illness 12• Other 30

201547

• Elderly 5• ID/DD 5• PD 10• Mental Illness 3• Other 24

201423

• Elderly 2• ID/DD 3• PD 3• Mental Illness 3• Other 12

235

* Other = Youth with SED

MFP Referrals

REFERRALS BY WAIVER TYPE 2014 = 67 2015 = 22 Total = 89DSD MDC-0208 PRTF-0208 NH-0208 1915(i)-CMHB

208831

21010

229841

Big Sky Elderly 8 3 11

Big Sky Physically Disabled

23 11 34

SDMI 13 1 14Unknown 3 5 8

MFP Transitions

TRANSITIONS BY WAIVER TYPE 2014 = 15 2015 = 6 Total = 21DSD 7-MDC 0208 3-PRTF 0208 0-1915(i)

9630

1100

10730

Big Sky Elderly 2 1 3

Big Sky Physically Disabled

3 4 7

SDMI 1 0 1

MFP Qualified Housing

*Home owned or leased

*Apartment with individual lease, secure access, as well as living, sleeping, bathing and cooking areas over which you or your family has control

*Community-based residential setting, such as a group home, with a maximum of four unrelated people (excluding caregivers and personal attendants)*Must have living, sleeping, bathing, and cooking

areas

*Must have lockable access and egress

MFP Housing Placements

MFP HOUSING PLACEMENTSTotal Placements to Date: 21 MDC

0208PRTF 0208

PRTF 1915(i)

SDMI Elderly PhysicallyDisabled

Group Home (4 bed or less)

2 2

Assisted Living

2 1

Apartment 4 1 1 4Home 1 1 2

MFP Housing Placements

SUBSIDIZED HOUSING

6 transitioned into subsidized housing.

*2 – MDC (Project Based Section 8)

*3 – Physically Disabled (1-Public Housing, 1-Project Based Section 8, 1-Housing Choice Voucher)

*1 – Elderly 1 (Project Based Section 8)

2 transitioned with Housing Bridge Assistance

*1 – MDC

*1 – Physically Disabled

MFP Reporting

SCHEDULE OF REPORTSMonthly:

*Quality of Life

*New Edition’s (monthly call)

*Quarterly:

*ABCD Report (Financial)

*Mathematica Files (Quantitative Financial)

*QOL

*Semi-annual:

*Truven Report

*Yearly:

*Supplemental Budget

*Travel Log

Challenges and Successes

SUCCESSES*Referrals from many sources

*Opportunities to transition that would not have been available without MFP

*Complex, high needs transitions

*Good collaboration of effort

*Moving participants from settings other than nursing homes (MSH, PRTF, MDC)

*Success stories

Challenges and Successes

CHALLENGES*Lack of direct service providers

*Resistance to a new program

*Complex, high needs transitions

*Housing

*Expanded target populations

*Benchmarks do not include ID/DD in nursing home

*1915(i) is not expanding – how to serve youth

*Agencies resistant to upfront transition expenses

*Regional Transition Coordinator Service

*Billing across two Medicaid systems

Sustainability Planning

POLICY GUIDANCE*Statute allows MFP programs to continue

expending funds through September 30, 2020 by supplemental budgets awarded in FFY 2016

*MFP grant 2016 budget submission must include all expenses anticipated through 2020 – no new budgets after October 1, 2015

*Plan must detail grantee’s efforts to rebalance the LTC systems and maintain increasing transition activities during the final years of the program

Sustainability Planning

POLICY GUIDANCE CONTINUED…*Detail how to sustain staffing, transition activity,

services, demonstration projects, and structural changes initiated under MFP

*Detail any services, structural changes, or demonstration projects that will not be continued after the grant and explain why

*Include a timeline

Sustainability Plan due by April 30, 2015

Sustainability Template

Mandatory Elements:*Executive summary

*Stakeholder involvement

*Plan for continuing to transition out of institutions

*Decision to include MFP Demonstration Services and services funded by MFP Administrative funds (or not) and explain how and why

*Decision to continue funding for MFP staff

*State’s plan for utilizing all rebalancing funds by 9/30/20.

*Timeline for the above

*Estimated budget summary

Sustainability Template

Optional Elements:*State’s plans to expand HCBS

*State’s efforts to develop an adequate supply of accessible, affordable housing

*State’s efforts to support state of the art quality improvement systems for HCBS

Sustainability Template

Other requirements:

*Cover letter signed by the State Medicaid Director

*Plan to not exceed 50 pages excluding cover letter.

*Must address all mandatory elements

Discussion

Next Meeting

Check your calendars for June

The End…..

Thank you and Safe Travels