1. STAKEHOLDER ADVISORY COUNCIL Community Choice Partnership Money Follows the Person Grant December 17, 2015 1

2. Montana will create a sustainable system that supports community options as a first choice for individuals needing long term care services. MFP Vision 2

3. The Starfish Story A young man is walking along the ocean and sees a beach on which thousands and thousands of starfish have washed ashore. Further along he sees an old man, walking slowly and stooping often, picking up one starfish after another and tossing each one gently into the ocean. “Why are you throwing starfish into the ocean?,” he asks. “Because the sun is up and the tide is going out and if I don’t throw them further in they will die.” “But, old man, don’t you realize there are miles and miles of beach and starfish all along it! You can’t possibly save them all, you can’t even save one-tenth of them. In fact, even if you work all day, your efforts won’t make any difference at all.” The old man listened calmly and then bent down to pick up another starfish and threw it into the sea. “It made a difference to that one.” 3

4. MFP might be small numbers, but the successes are big! 4

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7. Transitions – Proposed vs. Actual Year Big Sky ED Big Sky PD ID/DD Mentally Ill Adults SED Youth Total CY2012000000 CY2013000000 CY201423331223 2014 Actuals 2361315 CY2015510532447 2015 Actuals 19 38049 CY201613157123077 CY201715225123488 Total35502030100235 7

8. 0208 Waiver Transition from MDC to group home. Success Stories 8

9. Big Sky Waiver Physically Disabled Nursing home to home Elderly Hospital to nursing home to assisted living Success Stories 9

10. SDMI Waiver Nursing home to subsidized apartment Success Stories 10

11.  Started with 2 pilot transitions in May 2014  August 2014 marked the beginning of transitions Transitions 11

12. 2014 Referrals 2015 Referrals 2016 Referrals 2017 Referrals 2018 Referrals Total Referrals DD Total188 + 2 from MSH 26 +2 from MSH MDC 020893 12 PRTF 020860 6 PRTF 1915(i)12 3 NH23 5 SDMI1422 36 Elderly947 56 Physically disabled 2458 82 Unknown01 (MC) 1 Total65138 203 Program Referrals 12

13. PopulationRe- Institutionalized Passed AwayLeft by choice Total DSD 1 MDC 02081 PRTF 0208 PRTF 1915(i) SDMI Elderly5218 Physically disabled 313 7 Total per category: 93416 Transitioned But No Longer In Service 13

14. Case ManagementProgramReasonAdministrative Cost Lewis & ClarkSDMI Physical decline$1,000 Lewis & ClarkBig Sky -- ED Decided to stay in NH$4,000 Lewis & ClarkBig Sky -- PD Left NH AMA$4,000 Spectrum Great FallsBig Sky -- PD Returned to family, declined waiver services $1,000 Spectrum Great FallsBig Sky -- PD Unable to find enough direct care staff $4,000 Helena Industries Anaconda PRTF -- 0208 Chose housing that didn’t meet MFP qualifications $4,000 Spectrum KalispellBig Sky -- PD No Section 8 Voucher$4,000 Spectrum Great FallsBig Sky -- PD Did not meet eligibility for Medicaid $2,000 Total $24,000 Failed to Make Moving Day 14

15. Population Completed 365 DSD 8 MDC 02085 PRTF 02083 PRTF 1915(i) SDMI1 Elderly Physically disabled1 Total Complete Transitions: 10 Completed 365 Days 15

16.  These numbers are based on actual claims paid as of 9/30/15: Demonstration Services Demonstration ServiceNumber of Participant s Total Paid MFP Transition Services27$96,166 MFP Regional Transition Coordinator 31$150,000 MFP Information Technology 2$533.81 MFP Peer Support Services MFP Companion Services MFP Overnight Supports MFP Modify Existing Vehicle MFP Substance Use Disorder* 16

17.  Claims data reflects actual costs as of 9/30/15 and is very limited at this early stage  2014 – 15 participants with claims -- $239,057  2015 – 44 participants with claims -- $750, 021 Claims Data 17

18. Housing Placements Category MDC 0208 PRTF 0208 PRTF 1915(i) SDMIElderlyPhysically Disabled Total Group Home (4 bed or less) 22 4 Assisted Living 411722 Apartment5 661027 Home21 3511 Total by Category 93 10202264 18

19. Housing by Population Project Based Section 8 Housing Choice Voucher Public Housing Housing Bridge LIHTCHUD 811Total DSD MDC 0208 1 1 2 PRTF 0208 PRTF 1915(i) SDMI3 1 1 5 Elderly31 4 Physically disabled 23212 110 Total by population 94323 21 Subsidized Housing Breakdown 19

20.  HUD 811 PRA progress and updates  ALF Guidance  Housing Development Finance Professional Certification Program (HD 410; Home Ownership Finance)  Housing Workshop for MFP Housing Specialists Housing Updates 20

21.  Education/Outreach/Training  Continue Monthly Webinars  Annual Training (spring) – 5 locations statewide  Demonstration Services; Claims; Billing  Partner with AMDD staff to offer Mental Health 101  Governor’s Conference on Aging  Mental Health First Aid  Housing (Toolkit)  Transition, transition, transition!  Pilot transitions from MSH  Continue to build community partnerships to assist with complex referrals  Find a pathway to serve PRTF youth  Work with OPA – give update of successes  Improve processes  Focus on contractual budget items:  IT/Systems analysis  Self direction education  Person centered planning – in collaboration with partners 2016 Efforts 21

22.  Department update  Therapeutic Foster Care  Partnership with Children’s Mental Health Bureau and  Child and Family Services  Divisions are working on rules  Develop a process map for CMS review/approval  If approved, would use MFP grant for funding services  Summer/Fall 2016 SED Youth from PRTF 22

23.  Contact:  Madeline Boehm, Apprenticeship Specialist  Phone: 406-431-8708  mboehm2@mt.gov mboehm2@mt.gov 23 Department of Labor Healthcare Apprenticeship Program

24. Question And Answer 24

25. This PowerPoint presentation is created as part of the Community Choice Partnership Money Follows the Person Demonstration Grant awarded to the Montana Department of Public Health and Human Services 25