Maryland’s Money Follows the Person Rebalancing Demonstration

Maryland Medicaid Advisory Committee

Stacey Davis

March 26, 2007

MFP Overview

Created as part of the Deficit Reduction Act (2005)

Maryland was among 17 states awarded funding in 2007 for this five year demonstration

Intended to help states “rebalance” their long-term care systemsServe more people in the community and fewer

people in institutions

Demonstration Goals

1. Rebalancing– Increase the use of home and community-based, rather than

institutional, long-term care services

2. Flexible funding– Eliminate barriers to the flexible use of Medicaid funds to

provide eligible individuals support for long-term services in the setting of their choice

3. Sustainability– Ensure that long-term care services provided in a community

setting are sustainable

4. Quality– Implement quality assurance and continuous quality

improvement procedures for persons receiving home and community-based long-term care services

Maryland’s Proposed Transitions

** Only approximately 80 individuals are currently eligible to participate in the Demonstration, as the remainder have fewer than six months continuous residency.

Total Proposed Demonstration Transitions: 3091

(Will change based on the approved Operational Protocol)

Target Population

Current Population

Demonstration Transitions

NF 24,531 2,741

ICF/MR 368 250

Hospital 1,036** 25

IMD 80 75

Funding

Initial award of $1 million for calendar year 2007 Projected 5 year award: $67,155,856 Enhanced match (75% Federal / 25% State)

must be used towards demonstration goals and rebalancing State will prioritize the use of funding during the

development of the operational protocol Stakeholders will be involved in developing priorities

through workgroups

The MFP Program

Creates a new program to offer enhanced services to individuals who transition from an institution to the community

Eligibility for MFP Six months in an institution, at least one month of Medicaid

eligibility Participants must transition from a qualified institution to

a qualified community residence Maximum of four unrelated individuals in a single

residence

Timeline for ParticipantsDay of Discharge

6 months 365 days day 366 - ?

Mechanism Medicaid Money Follows the Person Demonstration

Existing or modified 1915(c)

waiver

Services Institutional Care

Qualified Home and Community Based Services (HCBS) Package PLUS Demonstration Only Supplemental Services

Qualified Home and Community Based Services (HCBS) Package

Funding 50% MA / 50% FMAP

25% MA / 75% FMAP [HCBS]

50% MA / 50% FMAP [Admin]

100% MA [Supplemental]

50% MA / 50% FMAP

After 365 days in demonstration, the qualified HCBS package

must continue through a waiver or State Plan Amendment

Participating State Agencies

Mental Health Administration Office of Health Care Quality Developmental Disabilities Administration Department of Aging Department of Disabilities Department of Human Resources Department of Housing and Community

Development

Other Information

UMBC will assist in the development of the operational protocol

The State is required to hire a full-time project director

The State will create a process for stakeholder participation in the development of the operational protocol