NASHIA: AN INTRODUCTION TO THE MICHIGAN MONEY FOLLOWS THE PERSON PROGRAM. Gayle Haven Project Director, MFP Program October 9, 2013

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1 NASHIA: AN INTRODUCTION TO THE MICHIGAN MONEY FOLLOWS THE PERSON PROGRAM Gayle Haven Project Director, MFP Program October 9, 2013

2 Objectives The Money Follows the Person (MFP) Rebalancing Demonstration The MFP Program incorporated into the MI Medicaid System MFP Data, National, Michigan Questions Contact information 2

3 The Money Follows the Person Rebalancing Demonstration The Money Follows the Person (MFP) Rebalancing Demonstration Grant helps rebalance the Medicaid long-term care system. As of December, 2012, over 31,000 people with chronic conditions and disabilities have transitioned from institutions back into the community through MFP programs throughout the nation. The Affordable Care Act of 2010 expanded the MFP program through September 30, $450 million has been allocated for each FY Funding for Michigan s MFP demonstration totals $67.8 million. 3

4 Money Follows The Person Enacted by the Deficit Reduction Act of 2005, the MFP Rebalancing Demonstration is part of a strategy to assist states to make changes to long-term care support systems and reduce reliance upon institutional care while developing community-based, long term care opportunities enabling the elderly and people with disabilities to fully participate in their communities. In 2007, CMS awarded MFP Grants. Funding does not belong to nor follow an individual literally. The state receives matching funding for up to 365 days that an individual participates in the MFP program. Flexible financing for long-term services guarantees individuals receive qualifying services and supports in the environment of choice when, where, and how they want services delivered. Consumers help drive decisions as they move through the LTC system. 4

5 MFP Grant: Federal Requirements An MFP qualified transition candidate must: Have resided in an institution for at least 90 days. Note: institutionalization days for the sole purpose of receiving short-term rehabilitation services reimbursed by Medicare do not count toward this 90-day period. Have been receiving Medicaid for at least one month. Meet nursing facility level of care criteria. Transition to a qualified residence including: A home owned or leased by the individual or a family member An apartment with an individual lease, lockable access, and living, sleeping, bathing and cooking areas over which the individual has control. A community residence with no more than 4 unrelated residents 5

6 Michigan, the MI Choice Program and MFP... January 1, 2005: implementation of the Nursing Facility Transition Program In 2005, 35 participants transitioned to the community via the nursing facility transition program For the period 1/1/05 to 9/23/13, 5,889 MI Choice nursing facility program participants transitioned to the community (1,713 were MFP program participants.) 6

7 THE PLAYERS.... MI Department of Community Health The Nursing Facility Transition/MFP Program 20 Waiver Agencies (regional assignations) 14 Outreach Specialists (regional assignations) 20 Housing Coordinators (regional assignations) 427 Certified Nursing Facilities 43,788 Medicaid Beds 7

8 Medicaid *Data for Fiscal Year MI Home and Community Based Services, Bureau of Medicaid Financial Management & Administrative Services Nursing Facility Transition Program (Participants: 1,623, 55% of population served) MI Choice Waiver Program (Participants: 1,112, 69% of population served) Money Follows the Person Program (Participants: 388, 35% of population served) Non MI Home and Community Based Services Consumers Non Nursing Facility Transition Program Participants (participants: 1,310, 45% of population served) Non MI Choice Waiver Program Participants (Participants: 511, 31% of population served) Non Money Follows the Person Program Participants (Participants: 724, 65% of population served) Traumatic Brain Injury Program 8

9 Waiver Agency Service Areas 9

10 The Money.... Michigan funds the Nursing Facility Transition Program through several methods: Community Transition Services are included as a MI Choice waiver program service for those who transition and enroll in MI Choice MFP Administrative funding assists with the costs of persons who are seen, but do not transition Non-waiver transition services are funded through State General Fund $ s. 10

11 MI Choice Waiver/MFP Requirements & Features Medical Criteria: Must meet nursing facility level of care Financial Criteria: Income <$2130/mo Assets < $2000 Spousal Protections Apply Must need & receive two (supports coordination and one other) MI Choice Waiver Services on a continual basis Must meet MFP Requirements (qualified housing, enroll in MI Choice upon transition) 11

12 MI Choice Waiver/MFP Requirements & Features Adult Day Health Chore Services Community Living Supports Community Transition Services Counseling Environmental Accessibility Adaptations Fiscal Intermediary Goods & Services Home Delivered Meals MI Choice Nursing Non-Medical Transportation Personal Emergency Response Systems Private Duty Nursing Respite Specialized Medical Equipment & Supplies Supports Coordination Training 12

13 MFP Facts The February, 2013, Kaiser Report: Nationwide, 1,456 Medicaid beneficiaries transitioned to the community in 2012 with the help of MFP funding Michigan s cumulative MFP enrollment ranks the state fifth out of 46 MFP demonstrations nationally. MFP participants are roughly evenly split adults with physical disabilities and seniors. The average age of a Michigan MFP participant is 65.5 years old. Over the past year, Michigan s MFP enrollment increased by 400 individuals. On average, MFP participants took 46.5 days to transition home, which is below the national average of 105 days. 13

14 MFP Transitions- 320 Benchmark Goal: 450 (10/01/ /12/2013) 70 MFP Transitions Compared to Benchmarks MFP Trans Benchmark A&D AAAW M AAA1B AAANM DAAA HHS MORC NLCMH R2AAA R3BAA A R9AAA R4AAA R7AAA SR SS TIC TSA TCOA UPCAP VAAA MFP Trans Benchmark

15 Waiver Program Compared to Nursing Facility Data for Fiscal Year 2012 Agency Transitions Nursing Facility Beds Transitions/ Nursing Facility Beds Waiver Slots Public Service Area Transitions Note: HHS and R3BAAA were distributed into the PSA s based on MA Bed availability data. Nursing Facility Medicaid Beds , % , , % , % , , % , % , , % , % , , % , % , , % , % 1, , , % , % 1, , , % , % , , % , % ,784 1,066, % , % , , % , % , , % 1B 200 9, % 1, ,843 1,843, % 1A/1C 185 5, % 1, , , % Total 1,590 43, % 11,297 3,085,718 8,932, % 15

16 MI Choice Waiver Program/MFP Transitions by Fiscal Year. 16

17 MI Choice Waiver Program/MFP Transitions by Fiscal Year *Data by fiscal year 10/1 to 9/30 Fiscal Year MI Choice MFP , , , (partial) 1,

18 MI MFP Program Objectives Establish funding mechanisms that abide by the money follows the person principle. Fund the MI Choice waiver to serve all eligible clients. Establish reimbursement levels that realistically and appropriately reflect the acuity level and need for services and supports the participant needs, consistent with federal limitations. 18

19 Key Principles Supports can change as the participant s needs change. Participants should be fully included in community life and activities to the degree possible. Supports and services should be Community based Promote independence Promote community integration Promote participation in community life Continuously incorporate person centered planning and assessed medical needs in plan development and implementation 19

20 Questions?

21 Gayle Haven Project Director Nursing Facility Transition Program 400 S Pine Street Lansing, MI haveng@michigan.gov 21

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