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LTSS Roadmap - Models

Guidance for the LTSS roadmap planning model, providing examples of other models.

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: August 03, 2016

The AI/AN Money Follows the Person (MFP) Initiative incorporates two programs in one: it transitions eligible participants from nursing facilities into community and it increases use of home- and community-based care.

Overview of MFP from Medicaid.gov

Purpose

To reduce reliance on institutionally based care, enable people with disabilities to be more integrated into community life, increase community-based LTSS opportunities, and create a more balanced approach to LTSS.

New AI/AN Initiative

  • Supplemental funding awarded to State Medicaid Agencies (SMAs) in cooperation with eligible Tribes and tribal organizations operating health programs under the Indian Self-Determination and Education Assistance Act to develop LTSS initiatives using one or more HCBS Medicaid authorities.
  • Used to support a structure that allows Tribes and tribal organizations to design a package of LTSS HCBS and to administer the process on behalf of the SMAs.
  • SMAs have oversight over program implementation.
  • Overview and invitation to apply
  • The MFP Tribal Initiative was announced by CMS in 2013. It offers funding for states currently involved in the MFP program to develop community-based LTSS specifically for Indian Country.

Eligibility

Older persons or persons with disabilities

Restrictions

MFP is a demonstration program, which means funding for it is limited. In addition, since health care reform was passed in 2010, only tribes that had MFP programs before reform can continue to apply for funding under the MFP tribal initiative.

Financing

100% Federal Medical Assistance Percentage (FMAP)

Benefits and Challenges of the MFP Model

Benefits

  • Reduce reliance on institutional care
  • Tribal members in community, with greater ability to participate in cultural and spiritual activities
  • Enhanced community-based LTSS options
  • Ability to provide for multiple funded services (e.g., intake, service coordination, management of program, designing and operating a variety of HCBS)
  • Can directly enroll eligible tribal members into the program
  • Oversee performance of service providers
 

Challenges

  • Must continue to work through State Medicaid Agencies (SMAs)
  • Limited availability of affordable, accessible, integrated housing
  • Need access to diverse professional and paraprofessional providers
  • Need for specialized services (independent living counselors, occupational therapy, community guides, etc.)

 

 

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