nursing home diversion modernization grants linda velgouse oppd/aoa n4a/cash and counseling webinar...
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Nursing Home Diversion Modernization Grants
Linda Velgouse
OPPD/AoA
N4A/Cash and Counseling Webinar – 2-27-08
Key Messages
• These grants begin to implement the 3rd component of new LTC provisions in the OAA
• Provides broad national standards for an Aging Network “Nursing Home Diversion Program” with state flexibility
• Encourages State Units on Aging to transform existing OAA, ADDGS, and state revenue dollars into flexible funding options
• Gives states an additional tool for rebalancing
Key Parameters
•12 grants awarded at approximately $500,000 per grantee
• SUAs were only eligible applicant
• SUAs must work with AAAs, community providers, and state Medicaid office, among other stakeholders
• Funds can be used to transform existing $ or expand services
• States must meet certain minimum expectations by the end of the 18 month grant period
Nursing Home Diversion Standards
Service Elements
• Use Flexible Service Dollars• Target individuals at-risk of nursing home
placement• Give all clients the option of Cash & Counseling• Use funds to complement, not supplant,
resources of families and other programs• Target publicly supported services at individuals
at-risk of spending down to Medicaid
Targeting Criteria
• At Risk of Nursing Home Placement
– Functional Status– Health Status– Cognitive Status– Status of Informal Support System
• At Risk of Spend Down
– States May Consider Income and/or Assets
Nursing Home Diversion Standards
System Elements
• Use Single Entry Point to ensure streamlined access for consumers
• Infrastructure to support consumer directed services, including Cash & Counseling model
• Quality Assurance• Performance Measurement & Evaluation
Minimum Expectations
• Serving consumers with flexible service dollars
• Targeting individuals at risk of Nursing Home Placement and spenddown to Medicaid
• Using a Single Entry Point System
Use of Grant Funds
• Direct Services and Supports
• Case management and broker services
• Developing new targeting criteria/tools
• Developing new budget systems/tools
• Designing and implementing Evaluation systems/tools
FY2007 State Grantees
• Arkansas
• Connecticut
• Georgia
• Illinois
• Kentucky
• Maryland
• Michigan
• Minnesota
• New Hampshire
• New Jersey
• Vermont
• West Virginia
Consumer Direction in NHDM Programs
• Most grantees developing a cash and counseling model
• States using different funding sources
• Most using Title III E and III B funds
• Other funds include: state funds, ADDGS
• AR, IL, KY, MI, MN, NJ VT, MI, expand or replicate current C&C programs
State Examples
• Georgia
• Transform State Respite and Title IIIB funds and some grant funds for services
• Pilot through Atlanta Regional Commission (10 county) ADRC
• Anticipate 200 screened and 50 in program by end of grant
State Examples
Minnesota• Will transform Title III-B, Title III-E, and
ADDGS funds• 2 AAA sites: Arrowhead & Central MN• Will provide consumer-directed service
options to 50-75 consumers/caregivers (ADDGS funds will be used to serve 1/4 of target population with Alzheimer’s)
• Plan to identify 200-300 at risk older adults and 150-200 caregivers for future services
State Examples
Vermont• Will transform Title III-B, Title III-E, State
Revenue, and Local Revenue funds • Plan to provide options counseling,
training, or flexible services to 200 persons (ADDGS funds will be used to serve 1/3 of target population with Alzheimer’s)
• Selecting 5 AAA sites, eventually expand program statewide through AAAs
State Examples
West Virginia• Will transform Family Alzheimer's In-
Home Respite (FAIR) Plus Program funds • Upper Potomac AAA pilot site • Will provide consumer-directed service
options to 50 consumers/caregivers affected by Alzheimer’s by end of grant
• Plan to expand program to other parts of state in 2010-2011
State Examples
• Arkansas
• Implement C&C Model in 2 AAA pilot sites: Central AR and NW AR AAAs.
• Transform funds including Title IIIE and state general funds
• Develop and test Medicaid spenddown screening tool
• Expect to serve up to 150 consumers
More Information
Linda Velgouse
http://www.aoa.gov/prof/Nursing/nursing_grants.asp