1. Marylands Home and Community-Based Services Waivers Medicaid Advisory Committee – July 2007 Marylands Home and Community-Based Services Waivers Medicaid Advisory Committee July 2007

2. Marylands Home and Community-Based Services Waivers Medicaid Advisory Committee – July 2007 Overview Review of Marylands Waivers Waiver Services Registry Money Follows the Person Demonstration 2

3. Marylands Home and Community-Based Services Waivers Medicaid Advisory Committee – July 2007 Review of Marylands Waivers Maryland has seven home and community-based services (HCBS) waivers. HCBS waivers provide support services in community settings to individuals traditionally served in long term care facilities paid for by Medicaid. There is a high demand for waiver services. In FY08, Maryland will serve more than 16,670 individuals in waivers. Many waivers are out of slots and not accepting new community applicants. 3

4. Marylands Home and Community-Based Services Waivers Medicaid Advisory Committee – July 2007 Review of Marylands Waivers: Funded Waiver Slots – FY08 Waiver Funded Waiver Slots - FY08 Older Adults Waiver Living at Home Waiver Waiver for Children with Autism Spectrum Disorder Waiver for Individuals with Developmental Disabilities Model Waiver for Medically Fragile Children Waiver for Individuals with Traumatic Brain Injury 3,750 500 900 10,988 200 35 New Directions Waiver (Developmental Disabilities)300 4

5. Marylands Home and Community-Based Services Waivers Medicaid Advisory Committee – July 2007 Waiver Services Registry The Older Adults, Living at Home, Autism, Model and TBI Waivers are closed to community applicants. DHMH developed a Waiver Services Registry for people who are interested in receiving waiver services. Individuals may place themselves on the Registry by calling a toll-free number (OAW, LAH, AUT) or calling the Department or its designee (Model, TBI). Individuals can find out their place (or number) on the Registry by calling the Registry and providing their SSN. 5

6. Marylands Home and Community-Based Services Waivers Medicaid Advisory Committee – July 2007 Waiver Services Registry As of June 2007, the Waiver Services Registry has: –8,700 individuals interested in OAW –1,600 individuals interested in LAH –2,000 individuals interested in AUT – 86 individuals interested in Model Waiver – 2 individuals interested in TBI Waiver 6

7. Marylands Home and Community-Based Services Waivers Medicaid Advisory Committee – July 2007 Money Follows the Person (MFP) Demonstration Created as part of the Deficit Reduction Act (2005) Maryland was among 31 states approved in 2007 for this five year demonstration Intended to help states rebalance their long-term care systems –Serve more people in the community and fewer people in institutions Enhanced match (75% Federal / 25% State) must be used towards demonstration goals and rebalancing –Stakeholders will be involved in developing priorities through workgroups 7

8. Marylands Home and Community-Based Services Waivers Medicaid Advisory Committee – July 2007 The MFP Program Offers 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 residence

9. Marylands Home and Community-Based Services Waivers Medicaid Advisory Committee – July 2007 Current Activities Working to complete the required operational protocol that will lay out the details of the demonstration The State will soon hire a full-time project director The State formed the MFP Stakeholder Advisory Group to provide direct input and technical expertise into the operational protocol –Consumers, advocates, and providers for MFP target populations are represented –UMBC is writing the protocol

10. Marylands Home and Community-Based Services Waivers Medicaid Advisory Committee – July 2007 MFP Advisory Groups The general Stakeholder Advisory Group meets twice monthly –Ad-hoc groups with State support meet more frequently to focus on specific topics –Current topics of discussion Enhanced services/transition support Peer mentoring / Outreach / Identification The MFP Interagency Advisory Group meets twice monthly to coordinate activities and discuss issues affecting State agencies

11. Marylands Home and Community-Based Services Waivers Medicaid Advisory Committee – July 2007 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