Medicaid Long Term Care Task Force: Where Are We Now?

1. Medicaid Long Term Care Task Force: Where Are We Now? Michigan’s Long-Term Care Conference Troy Hilton March 23, 2006 RoAnne Chaney, MPA Chair, Medicaid Long-Term Care Task Force Marsha Moers Chair, Long Term Care Commission

2. Eager vs. Engler/Granholm lawsuit

3. Eager vs. Engler/Granholm lawsuit

4. Eager vs. Engler/Granholm lawsuit Stipulation for settlement: • Admission of the named plaintiffs to the MI choice program • Waiver slots for FY04 • Public information, training, and education

5. Eager vs. Engler/Granholm lawsuit • Stipulation for settlement: • Uniform Medical/Functional Eligibility Criteria • Contact Logs and Waiting Lists • Transition Services • Medicaid Long Term Care Task Force

6. Medicaid Long Term Care Task Force The task force shall include representatives of: • state agencies, • providers, • legislators or their representatives, • advocates and consumers.

7. Medicaid Long Term Care Task Force Executive Order 1 of 2004 The charge to the task force: • Promote a full array of community based care options for Michigan citizens in need of long term care, • Identify barriers to the creation of and access to a system of community based care, and to • Make recommendations to the Governor and the Legislature.

8. Medicaid Long Term Care Task Force Vision Statement • Within the next ten years, Michigan will achieve a high quality, easily accessible system of publicly and privately funded long-term care supports. These supports will include a full array of coordinated services available wherever an individual chooses to live and will be mobilized to meet the needs of each person with a disability or chronic condition, of any age, who needs and wishes to access them. • The arrangement and type of care and supports for each person will be determined by that person. Person-centered planning, which places the person as the central focus of supports and care planning, will be used to determine all facets of care and supports plans. Each person, and his or her chosen family, friends, or professionals, will initiate or re-start the process whenever the person’s needs or preferences change.

9. Key Recommendations • # 1: Require and Implement Person-Centered Planning Practices. • # 2: Improve Access by Adopting “Money Follows the Person” Principles. • # 3: Establish Single Point of Entry Agencies for Consumers.

10. Single Point of Entry • Information and Referral/Assistance • Financial Eligibility Determination – remains with FIA/DHS • Case Coordination/Supports Coordination/Care Planning • Nursing Home Transition • Long Term Care through Proactive Choice Counseling

11. Key Recommendations • # 4: Strengthen the Array of Services and Supports. • Supports in Michigan an accessible, integrated service system which assures that those in need of supports or services have a range of options that allow them to live where they choose. • Identify a range of services and supports for inclusion in an coordinated system of care.

12. Key Recommendations • # 5: Support, implement, and sustain prevention activities through (1) community health principles, (2) caregiver support and injury control, and (3) chronic care management and palliative care programs that enhance the quality of life, provide person-centered outcomes, and prevent unnecessary hospitalizations or institutionalization.

13. Key Recommendations • # 6: Promote Meaningful Consumer Participation and Education by Creating a Long-Term Care Commission and Informing the Public about the Available Array of Long-Term Care Options. • # 7: Establish a New Quality Management System

14. Key Recommendations • # 8: Michigan should build and sustain culturally competent, highly valued, competitively compensated and knowledgeable long term care workforce teams that provide high quality care within a supportive environment and are responsive to consumer needs and choices.

15. Key Recommendations • # 9: Adapt Financing Structures that Maximize Resources, Promote Consumer Incentives, and Decrease Fraud. • Financing Single Point of Entry. • Maximizing Resources for Long-Term Care. • Funding Mechanisms. • Case Mix • Incentives.

16. The Vision • Money Follows the Person • Maximizing Consumer-Direction and Choice • Stable and Respected Workforce • Rebalanced system through “proactive choice counseling.”

17. What Has Happened • July 9, 2005 Rally • Governor’s Executive Order: • At least 3 SPE pilots • Office of Long-Term Care and Supports • Long-Term Care Commission • SPE RFP issued November 2005

18. What’s Happening • Office of LTC position - interviews • Commission appointed – 17 members • Nursing Facility Transition policies • MIChoice waiver dollars • Use of CMP funds for transition services

19. Legislation • HB 5389 to establish Single Points of Entry – Rep. Shaffer and many co-sponsors • HB 5762 to consolidate laws and an Executive Order to affecting Long-Term Care – Rep. VanderVeen and many co-sponsors • HB 4337 to allow up to $1800 tax exemption for providing care/support to senior parents

20. Appropriations • Governor requested an increase in the Home Help budget to enable worker wage increases. • Senate appropriations committee approved wage increases for Home Help workers.

21. Federal Initiatives • The Deficit Reduction Act signed by President Bush in February 2006: • Includes a Money to Follow the Person provision for individuals in nursing facilities. • Includes a provision allowing many C waiver requirements to be included in the Medicaid state plan. • Implementation details developing.

22. Medicaid Long Term Care Task Force http://www/ihcs.msu.edu/LTC/