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Money Follows the Person Tribal Initiative

Learn about the Federal Demonstration grant for State Medicaid programs and Tribal partners, supporting State-Tribal partnerships in developing Medicaid-funded, sustainable Long Term Services and Supports options in Native communities.

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Money Follows the Person Tribal Initiative

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  1. Money Follows the PersonTribal Initiative

  2. Money Follows the PersonTribal Initiative : What is it? • Federal Demonstration grant for State Medicaid programs and Tribal partners • Allows State grantees to assign certain Medicaid authorities to participating Tribes • Meant to develop best practices for Long Term Services and Supports (LTSS) in Indian Country • Assigned funding through fiscal year 2020 to support State – Tribal partnerships in building Medicaid billable, self-sustaining LTSS options in Native communities • Awarded to 5 States (Minnesota, North Dakota, Oklahoma, Washington and Wisconsin)

  3. Demonstration Goals Enable and support Tribes in the design and operations of Medicaid funded programs that address the individual and unique cultural needs of aging and disabled Tribal members Aid Tribes in creating the necessary infrastructure to transition individuals from nursing homes and other institutional settings back to their homes and communities*

  4. Government-to Government Relationship Ensure MaximumTribal Reimbursements from all Fiscal Resources Identify & Address Disparities Partnership Program Values Recognition of Unique Needs and Cultural Identity thru Program Design Increase Access to LTSS Enhance Tribal Services & Infrastructure

  5. Increase Tribal participation in home and community based services (HCBS) and reduce nursing home and other institutional placement Program Goals Identify and Eliminate barriers in state law, state Medicaid plans, and state budgets which have reduced or prohibited Tribal use of Medicaid programs, specifically those related to long-term care support in all settings Strengthen the ability of Medicaid program to provide HCBS to Tribal people who choose to transition out of institutions Provide quality assurance and improvement of HCBS in Tribal communities and to Tribal peoples

  6. Barriers and Disparities

  7. Lack of basic housing in urban areas and issues of safety and accessibility in rural locals • Higher rates of unemployment impacted by transportation and other unmet needs Housing & Employment Challenges Across States • Both State and Tribal elections can bring administration changes that affect program building and progress on issues Leadership Changes • State and Tribal efforts have been focused on management of opioid issues. This has complicated LTSS efforts for programs and patients Opioid Epidemic IMAGE: Tent City Winter 2019 Minneapolis, MN

  8. Structural Barriers • The Medicaid system was developed without taking into account the role Tribal Governments should fill in the administration or delivery of services within the States • State and Federal staff often lacked relevant and accurate knowledge about the unique sovereign status of Tribal Nations and the special provisions for Tribal program participants

  9. MFP Tribal Initiative – Opportunities and Future

  10. {Hidden} • Technical Assistance • Data and Information Respect Dignity Sovereignty Culture • Funding & Investment • Listening and Facilitation

  11. Medicaid Enrollment • Increase Tribal participation • Outreach and Information on special provisions Tribal Opportunities:Maximizing Medicaid LTSS Services • Expand Tribally provided services • Ensure access to all resources/services

  12. Tribal Program Development Experiences of Tribal Participants

  13. Minnesota - John Anderson john.a.anderson@state.mn.us MFPTI State Program Contacts North Dakota - Melissa Reardon melissa.reardon@ndsu.edu Oklahoma - Russ Coker russell.coker@okhca.org Washington – Ann Dahl DahlA@dshs.wa.gov Wisconsin – Al Matano Alfred2.Matano@dhs.wisconsin.gov

  14. Chi-Miigwech

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