1. Nursing Home Diversion Modernization Grants Linda Velgouse OPPD/AoA N4A/Cash and Counseling Webinar – 2-27-08

2. Key Messages These grants begin to implement the 3 rd 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. FY2007 State Grantees Arkansas Connecticut Georgia Illinois Kentucky Maryland Michigan Minnesota New Hampshire New Jersey Vermont West Virginia

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. More Information Linda Velgouse linda.velgouse@aoa.hhs.gov http://www.aoa.gov/prof/Nursing/nursing_grants.asp