Quarterly Stakeholder Meeting

June 25, 2013

Money Follows the Person

Agenda

Welcome MFP Staff Update MFP Data MFP Housing Update MFP Waivers

2

33

Demonstration Benchmark Data

3

4

MFP Demonstration Data

4

MFP participants in the community by population

As of 5/31/2013

202

29

80

13

0

50

100

150

200

Elder ID/DD Physically Disabled Mental Illness

5

MFP Demonstration Data

5

Number of transitions by type of community residence

As of 5/31/2013

60

118

1

84

61

0

20

40

60

80

100

120

140

Home owned byparticipant

Home owned by familymember

Apt leased byparticipant

Participant in assistedliving

Group Home of 4persons or less

6

MFP Demonstration Data

6

Number of MFP participants in the community by qualified facility

As of 5/31/2013

285

16 23

0

50

100

150

200

250

300

Nursing Facilities ICF/MR Chronic or Rehab Hospital

MFP Housing Strategies

888

MFP Participants’ Housing Needs

MFP Enrollees will transition to the community into MFP qualified residences – either by:

Returning to existing homes/housing;

Moving into a group home or other supported residential setting; OR

Seeking new housing – the topic of this presentation

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MFP Qualified Residences

In the MFP Demonstration, a Qualified Residence is:

a home owned or leased to the individual or family member;

an apartment with the individual holding the lease with a lockable entrance and control and domain over living, sleeping, bathing and cooking areas; cannot require acceptance of services as a condition of tenancy; or

a community based residence with no more that 4 unrelated individuals.

Focus of this presentation will be on those choosing the option to live in an apartment setting.

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MFP Demonstration Support for Housing Goals

MFP Strategic Housing Partnership Coordinator

5 Regional Housing Coordinators within Regional Housing Network Entities

Housing Search Entities

Adaptive Services Coordinator

One time set up expenses such as: furniture, bedding, security deposit, service installation

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MFP Strategic Housing Partnership Coordinator

Individual at the state level responsible to develop ideas, strategies and partnerships that support the development of new housing opportunities for MFP Participants with input from the Regional Housing Coordinators.

Oversee the implementation of the 811 Project Rental Assistance grant for EOHHS.

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Regional Housing Coordinators

A contracted position working within the Regional Housing

Network whose primary responsibilities will be to:

develop affordable, accessible housing opportunities for MFP participants in their designated region;

track and report the number of these units in the region to meet MFP goals;

ensure, confirm and track that such identified units meet the MFP definition of qualified residences;

engage and establish on-going relationships with local and regional entities that administer/manage affordable housing opportunities; and

coordinate 811 program referrals at the regional level.

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Massachusetts Regional Housing Network

For 30 years, nine regionally based non-profit member agencies of this network have championed the value of working on a regional level to address the needs of their constituents. They:

engage policy makers, landlords, community leaders, and investors to protect and to create affordable housing;

are efficient innovators, committed to restoring housing choice, and returning every Massachusetts family home;

consistently identify regional issues and work collaboratively with one another, as well as local government officials, local housing authorities, private landlords, private housing developments and other agencies working on housing concerns to find regional solutions to those issues;

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Regional Housing Network (continued)

cover the Commonwealth and available to all 351 cities and towns for assistance with housing development, management, and policy setting. All of this is in addition to their core work of implementing and managing innovative and traditional housing programs designed to assist people of all income levels;

manage over 19,000 Housing Choice Vouchers which allows low income families and individuals to live in decent, safe and sanitary housing;

work housing homeless families on behalf of the Commonwealth; and will administer the 811 Project Rental Assistance vouchers on behalf of

DHCD.

An RFR process will be utilized to select 5 of these entities to work on behalf of the MFP Demonstration to develop and monitor housing options regionally.

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Housing Search Entities

An MRC-qualified person or organization that specializes in securing affordable homes or apartments for MFP eligible participants.

Currently 6 organizations have been qualified to provide housing search activities. Two additional organizations are in the process of being qualified, and two more proposals are under review. Contracts for qualified HSEs are in process.

Open, rolling procurement on Comm-PASS.

Payment of $1000 with $400 for initial tasks and $600 at placement.

Contact Nina Rosenberg at MRC at (617) 204-3827 for more information.

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HSE Qualified Entities

Must have successful experience assisting elders and/or individuals with disabilities to secure affordable & accessible housing.

Must demonstrate knowledge of: Local public and private housing resources State & federal housing programs.

Must work closely with MFP participants, transition coordinators & case managers to ensure complete and timely housing applications.

Will coordinate with Regional Housing Coordinators on housing options developed through the regional networks.

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Qualified Housing Search Entities

Advocates – Greater Boston, Central, Southeast Regions

AIDS Action Committee – Greater Boston Region

Hearth, Inc. – Greater Boston Region

Housing Assistance Corporation – Greater Boston Region

Metropolitan Boston Housing Partnership – Greater Boston

South Middlesex Opportunity Council – Central Region

This RFQ is open for interested applicants – additional HSEs will be qualified on an on-going basis.

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Relationship of Transition Coordination Entities, Housing Search Entities and Regional Housing Coordinators

The Transition Coordinator (TC) will assist the MFP participant to select a Housing Search Entity (HSE) from the qualified pool when the individual identifies an apartment or rental unit as their choice of “qualified residence.”

The TC completes and sends a simple referral form to the selected HSE and a copy to the Regional Housing Coordinator.

If the referral is accepted by the HSE, then they will complete a more comprehensive Housing Needs and Preferences assessment to identify needs and any barriers to securing housing.

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Relationship of Transition Coordination Entities, Housing Search Entities and Regional Housing Coordinators (continued)

TC assists the participant in completing required forms and gathering documentation as part of the Housing Search process.

The HSEs and RHCs will regularly share all housing options that have been or are under development within the region for MFP participants.

The HSE will work with the TC and participant to follow up on recommended options.

TC, HSE and RHC will be in regular communication until the individual is successfully housed in the community.

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MFP Participant, with Transition

Coordinator

Housing Search Entity

Regional Housing Coordinator

Transition Coordinator

Shares Info about housing availability/leads in region

Copy referral

Works with MFP participant to find housing to meet their needs and preferences

Identifies need for apartment in community; chooses HSE

assists participant to complete applications/

forms, etc.

Housing Search Process

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Adaptive Services Coordinator

Staff of Mass. Rehab Commission’s Waiver Unit.

Manages all major home accessibility modification projects for MFP participants.

Coordinates projects with MFP participants, their transition coordinators and case managers and all other involved parties.

MFP home modifications may be available only for MFP qualified residences, but not including staffed residential programs.

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Housing Tools

MFP Housing Needs and Preference Tool

MFP Housing Search Entity Manual

UMASS On-line Training Resources

MassAccess Housing Registry

MassHousing Directory

Training will be available for TCs and HSEs

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Housing Strategies

Use of Existing State and Local Housing Targeted Resources Community Based Housing Facilities Consolidated Fund (DDS and DMH) Non elder Vouchers through Lynn Housing Authority Mass Housing Set aside (DDS and DMH) Home Modification Loan Program Supported Housing Program (EOEA) Assisted Living (those that meet MFP criteria)

New Resources Section 811 Project Rental Assistance MFP funds for access modification & one time setup costs

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Projecting Need

Using data from Mathematica 2011 Annual Report for all MFP States

Using MA MFP target of transitioning 2,192 individuals: 1,358 elders 510 with physical disabilities 182 with mental illness 142 with intellectual disabilities

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Applying Mathematica Averages*

Qualified Residence

Overall Elders Physical Dis.

Intellect.Dis.

Other Unknown

Home 28.7% 44.3% 31.2% 3.7% 31.9% 15.8%

Apartment 30.4% 23.9% 43.5% 15.1% 10.6% 28.1%

Assisted Living

9% 13.6% 8.1% 5.4% 5.9% 6.3%

Group Home

19.9% 7.3% 7.4% 71.4% 12.3% 16.4%

Unknown 11.9% 10.9% 9.8% 4.5% 39.3% 33.4%

*Based on data gathered nationally by Mathematica of all MFP projects through 2011

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Applying Mathematica Averages to Massachusetts MFP

Projections

Elderly

1358

Physically Disabled510

Intellectual Disability142

Mental Illness/Other182

Total 2192

Home 601 159 5 58 823

Apartment 324 221 21 19 585

Assisted Living

176 41 7 10 234

Group Home 99 37 101 22 259

Unknown 148 49 6 71 274

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Next Steps

Finalize and release RHC RFR - target for July 15th

Finalize HSE Training Manual – target for July 12th

Outreach to entities to respond to HSE RFR - quarterly, most recent one done in May

Qualify new responses to HSE RFR-on-going

Orientation for new MFP Strategic Housing Partnership Coordinator – target by August 15th

Update of all prior housing related materials to correct for new transition coordination model- August 30th

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Next Steps (continued)

Gather housing needs data from enrollees-monthly Collaborate with DHCD on the roll out of the 811 PRA funded units once

Cooperative Agreement signed between DHCD and HUD-meetings every 2 weeks

Provide training to Transition Coordination, HSE and Regional Housing Coordination entities-, target by October 30th

Provide training to entities making referrals to 811 program- TBD

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Discussion

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MFP Waivers

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MFP Waivers Implementation - Topics

Outline initial approach to implementing MFP waivers

Describe the MFP waivers and the waiver services offered

Provide Information on how to access the MFP waivers

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MFP Waivers- Implementation

Short term approach:

■ Conduct eligibility determinations and case management using the UMass Waiver Unit

■ Build on existing ABI waiver service providers■ Ramp up over the next 6 months

Longer term:

■ MRC and DDS will do case management – based on the Hutchinson settlement agreement

■ Will clarify timing of these changes as we go forward

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Money Follows the Person Waivers

MassHealth has two new 1915(c) HCBS waivers.

MFP Community Living (MFP-CL) Waiver

For participants who do not need 24 hour supports or supervision

Provides access to a variety of community-based waiver services

MFP Residential Supports (MFP-RS) Waiver

Participants who require supervision and staffing 24/7 and receive services in provider-operated and staffed settings

Residential habilitation in a group home serving no more than 4 individuals

Assisted living services

Shared living

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MFP Waiver Eligibility

Applicants must:

Be living in a nursing home or long-stay hospital for at least 90 consecutive days, excluding Medicare rehabilitation days;

Be 18 years old or older and have a disability, or be age 65 or older;

Meet the requirements for participation in the MFP Demonstration, including transitioning to an a MFP qualified residence in the community;

Be able to be safely served in the community within the terms of the waiver.

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MFP Community Living Waiver Services

■ Adult Companion

■ Chore Service

■ Community Family Training

■ Day Services

■ Home Accessibility Adaptations

■ Home Health Aide

■ Homemaker

■ Independent Living Supports

■ Individual Support and Community Habilitation

■ Occupational Therapy

■ Peer Support

■ Personal Care

■ Physical Therapy

■ Prevocational Services

■ Respite

■ Shared Home Supports

■ Skilled Nursing

■ Specialized Medical Equipment

■ Speech Therapy

■ Supported Employment

■ Supportive Home Care Aide

■ Transportation

■ Vehicle Modification

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MFP Community Living Waiver

The MFP-CL Waiver is for participants who do not need 24 hour supports or supervision

Service Limit of 12-hours per day on the following services, separately, or in combination: Homemaker Home Health Aide Personal Care Adult Companion Individual Support and Community Habilitation Supportive Home Care Aide

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MFP Residential Supports Waiver Services

■ Residential Habilitation (group home)

■ Shared Living – 24 Hour Supports

■ Assisted Living Services■ Day Services■ Home Accessibility Adaptations■ Individual Support and

Community Habilitation ■ Occupational Therapy

■ Peer Support ■ Physical Therapy ■ Prevocational Services■ Residential Family Training ■ Skilled Nursing■ Specialized Medical Equipment■ Speech Therapy■ Supported Employment■ Transportation

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MFP Residential Supports Waiver

The MFP-RS Waiver is for participants who need 24 hour supervision and staffing

The Participant must be assessed to need a residential support service within the terms of the MFP-RS Waiver

Provides access to 3 types of residential supports:

1. Group Home (up to 4 people)

2. Shared Living – 24 Hour Supports

3. MFP Qualified Assisted Living

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The MFP Waivers will allow participant to self-direct certain waiver services Employer Authority, similar to PCA program Allows the participant to select, train, schedule and supervise their own

worker Fiscal Intermediary will process payroll including handling withholdings

and tax paperwork

Participant Direction in MFP Waivers

Self-Directed Services with Employer Authority MFP-CL Waiver MFP-RS Waiver

Adult Companion Y NA

Chore Services Y NA

Homemaker Y NA

Individual Support and Community Habilitation Y Y

Peer Support Y Y

Waiver Personal Care Y NA

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All waiver participants will work with a case manager

As part of their person-centered planning process, each waiver participant will have a risk assessment

The case manager will develop a 24-hour back-up plan for each MFP Participant

Case manager can engage support broker for the participants as necessary

Case Management in the MFP Waivers

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■ Members participating in either the MFP-CL or MFP-RS waiver will be enrolled into the managed behavioral health plan through the Massachusetts Behavioral Health Partnership (MBHP)

■ Access to managed behavioral health services will help to address the significant role that behavioral health issues play in causing institutional placement and undermining community stability

■ The MFP-BH Waiver provides access to the full range of community, outpatient, and inpatient services through MBHP for all such participants.

1915(b) MFP Behavioral Health Managed Care (MFP-BH) Waiver

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Visit the MassHealth website for MFP Member Enrollment Process information and find: MassHealth Waiver applications MFP Brochures

Send completed MFP Waiver applications to: UMass MFP Waiver Unit333 South StreetShrewsbury, MA

For more information contact UMass Waiver Unit at 855-499-5109 or TTY 800-596-1746

Email: MFPinfo@umassmed.edu

Waiver Applications for Members

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Mass Rehab Commission contracts with some providers, such as home/vehicle mod providers, and residential service providers MRC maintains open RFRs for certain waiver services

Providers of many MFP waiver services enroll directly as MassHealth Providers

Provider Contracting and Enrollment

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Provider Enrollment

■ MassHealth has engaged UMass to manage provider enrollment and credentialing activities for enrolled waiver providers.

■ Monthly Technical Assistance Sessions offer support for interested providers.

UMass meets with individual providers upon request.

■ If you already enrolled as an ABI waiver provider you will only need to submit information to become qualified for additional waiver services.

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For More Information About Enrolling as a Provider

Later this week, the MassHealth website will have links for the MFP Demonstration and the home and community based waivers. Both links will have information on:

■ MassHealth MFP Demonstration Assistive Technology Provider Application MassHealth ABI and MFP Waiver Provider Applications and other forms Links to the MassHealth Provider Regulations, MRC Provider Services Standards and Provider Rates Contact information for providers about any enrollment questions or assistance with the enrollment process