Medicaid Long Term Care Task Force: Where Are We Now

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Medicaid Long Term Care Task Force Where Are We
Now?

• Michigans 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

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Eager vs. Engler/Granholm lawsuit
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Eager vs. Engler/Granholm lawsuit
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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

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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

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Medicaid Long Term Care Task Force

• The task force shall include representatives
  of
• state agencies,
• providers,
• legislators or their representatives,
• advocates and consumers.

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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.

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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 persons needs or preferences change.

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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.

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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

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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.

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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.

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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

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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.

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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.

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The Vision

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

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What Has Happened

• July 9, 2005 Rally
• Governors Executive Order
• At least 3 SPE pilots
• Office of Long-Term Care and Supports
• Long-Term Care Commission
• SPE RFP issued November 2005

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Whats Happening

• Office of LTC position - interviews
• Commission appointed 17 members
• Nursing Facility Transition policies
• MIChoice waiver dollars
• Use of CMP funds for transition services

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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

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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.

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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.

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Medicaid Long Term Care Task Force

• http//www/ihcs.msu.edu/LTC/