CIL-NET Presents…

1. CIL-NET Presents… Creating a Community-Based Services Report Card for Your State A National Teleconference & Webinar March 9, 2011 Presenter: Suzanne Crisp suzanne.crisp@bc.edu

2. Today We’ll….. • Identify grading/scoring/ranking strategies • Discuss performance indicators • Examine resources to collect information • Consider analysis • Explore next steps

3. Scoring / Ranking / Grading • Scoring - # of points • Ranking – relationship between set of items – designates higher, lower, or equal • Grading – evaluates performance • Measuring is a complex initiative • If done quickly – could draw wrong conclusions • Today – provide you with tools to obtain an overall picture of the state of your long-term system but you draw your own conclusions • “What is important to you” is key

4. Performance Indicators • Review of actions/activity to evaluate success • How you draw your own conclusions • Observe & analyze performance • Look at numbers, data, actions, inactions, to decide the level of success: • Transparency • Funding • Inclusion • Commitment

5. Focus Areas to Consider Success • Olmstead compliance • Choice and control options • Money follows the person initiatives • Medicaid options • Community partnerships • Aging and Disability Resource Centers (ADRCs) • Area Agencies on Aging • HUD • Interest in the Affordable Care Act

6. Olmstead Compliance • Suits may be filed by multiple entities, including individuals • US Justice Department may file – top priority • Department has filed two suits • Amicus briefs filed in 8 states Indicator: Has your state been involved in a compliance suit? Has there been discussion about a suit? Any plans to file? Source:http://www.pascenter.org/state_based_stats/pick_a_state.php?url=http%3A%2F%2Fwww.pascenter.org%2Fstate_based_stats%2Folmstead_home.php&title=Olmstead+Plans+Lawsuits

7. Questions and Answers

8. Participant controls What What Is Participant Direction? When Who How “Not doing things by yourself – but being in charge of how things are done.” Judith Heumann

9. Growth of Budget Authority Programs AK WA ME MT ND VT MN OR NH NY WI MA ID SD MI RI WY Hawaii CT PA IA NE NJ IN OH NV UT IL DE WV VA CO CA KS MD MO KY DC NC TN OK AR SC AZ NM GA AL MS LA TX FL

10. Choice and Control Indicators: • Does your community offer individuals the ability to mange their own services? • Is there flexibility to hire and manage and make permissible goods and services? • Is the program easily understandable and accessible? • Is the program comparable to traditional services? • Waiver application, state plan option or 1915(j)? Source: www.participantdirection.org

11. Money Follows the Person • 2/22/11 Thirteen additional states added • To date – moved 12,000; with new funding will move an additional 13,000 • Extended another 5 years with Health Care Reform • Time to be institutionalized is reduced • Provides enhanced match for services and staff Indicator: Are you an MFP state? Are your goals reasonable? Are you meeting your goals? Source: https://www.cms.gov/CommunityServices/20_MFP.asp

12. Medicaid Considerations • Medically Needy: • Allows individuals with too much income to qualify temporarily for Medicaid if medical/clinical eligible • Spousal Impoverishment: • Allows community spouse to retain ½ of couple’s combined income • Presumptive Eligibility: • Urgent need – presumed eligible • State Plan Personal Care • Receive long-term services in community without institutionalization criteria applied

13. More Medicaid Considerations • Assisted living – community-based character? • Free technical assistance – state contacted CMS? • Managing budget crisis – Eligibility tightened? Staff reductions? Benefits reduced? Benefits reduced in institutional setting?

14. Aging Network • Partnership needed – parents of adult children with disabilities and persons with disabilities aging • Older Americans Act – requires modernization (maximizing independence) • Veterans-directed Home and Community-based Service Program (VD-HCBS) Indicators: Close partnership with AAA, conduct training on independent living movement, share capacity to support to Veterans, & how many VD-HCBS programs in state? Source: www.adrc-tae.org

15. Aging & Disability Resource Centers (ADRCs) • Collaboration between Administration on Aging & the Centers for Medicare & Medicaid • Streamlines long-term services • Empowers people to make informed decisions through information, assistance and access • 200 operationalized in 54 states • 13 states have statewide coverage • 30 states passed legislation • Additional $10 million each year through 2014

16. ADRCs Indicators: • State has received grant (s) • Reached fully functioning status • Build solid partnerships • Statewide access • State legislation protects • Sustainability plan Data Source: www.adrc-tae.org

17. Housing & Urban Development • Set aside vouchers for Money Follows the Person and persons with disabilities • Department of Health and Human Services and HUD • 2010 - $40 million over 12 month period, 5,300 housing vouchers to non-elderly • 10 MFP states have set asides Indicators: Does your state have a MFP set aside? Has your state applied for housing vouchers? Source: http://portal.hud.gov/hudportal/HUD?src=/press/press_releases_media_advisories/2011/HUDNo.11-003

18. Additional Considerations • Affordable Care Act • Advancing the availability and use of home and community services • Rebalancing (2% or 5% enhanced Federal Medicaid match) http://www.healthcare.gov/law/introduction/index.html • Behavioral Risk Factor Surveillance System • State specific data • Asks standard core questions about health risk behaviors • More than 300,000 adults interviewed http://www.cdc.gov/brfss/

19. Valuable Resources • http://www.aarp.org/health/health-care-reform/info-10-2010/health-panel-10201.html • http://www.statehealthfacts.org/profile.jsp • http://www.ancor.org/news/2010/09/thompson-releases-newest-medicaid-long-term-services-state-by-state-expenditure-data • http://apps.nccd.cdc.gov/brfss/display.asp?cat=DL&yr=2009&qkey=4001&state=UB • http://www.census.gov/hhes/www/disability/datacollection.html

20. Analysis • Decide what is important to you, your organization, and your constituency • Do your homework – know how your state measures-up • Strengths + weaknesses = opportunity • Compare with neighboring states – similar states • Understand the options • Position for Health Care Reform to consider new enhanced funding prospects

21. Questions and Answers

22. Wrap Up and Evaluation • Please complete the evaluation of this program by clicking here: https://vovici.com/wsb.dll/s/12291g48f5f

23. New Community Opportunities This webinar is presented by New Community Opportunities, a national training and technical assistance program of Independent Living Research Utilization. This webinar was organized and facilitated by the National Council on Independent Living (NCIL). Support for development of this presentation was provided by the U.S. Department of Education, Rehabilitation Services Administration under grant number H400B100003. No official endorsement of the Department of Education should be inferred. Permission is granted for duplication of any portion of this slide presentation, providing that the following credit is given to the project: Developed as part of the New Community Opportunities program at ILRU.