MFP Update

ABSTRACT:  MFP rebalancing activities in full swing.

 Several rebalancing initiatives funded by the Money Follows the Person (MFP) initiative are operating in the state, many of which touch the lives of our members somehow.  NYAHSA participated in a recent meeting in which we obtained important updates on these efforts and the MFP program in general.

 Changes to MFP Demonstration
 The Patient Protection and Affordable Care Act (PPACA) extended the MFP program, originally planned to end in September 2011, into September 2016.  Additional changes liberalized eligibility criteria.  Through the MFP program, the states receive an enhanced federal contribution for any individual transitioned from a nursing home into the community, given certain criteria are met.  In turn, the state must commit to using these funds to initiate rebalancing activities. One of the requirements was a six-month consecutive stay in a nursing home to trigger the enhanced federal contribution; however, the law has reduced this to three consecutive months, excluding Medicare-covered rehabilitative stays (not Medicare-covered nursing days).  In addition, an individual must have been Medicaid eligible for 30 days; this has been reduced to one day. 

Another important change that happened earlier this year is the inclusion of the Traumatic Brain Injury (TBI) waiver as a vehicle by which someone could transition to the community and trigger an enhanced contribution.  Previously, the nursing home transition and diversion (NHTD) waiver had been the only program eligible. NYAHSA had advocated for the inclusion of other programs as well, and DOH evaluated these possibilities but determined that there would need to be fundamental changes to the program to meet the reporting requirements.  Data regarding the status of the NHTD waiver, including the number of participants and providers per service and region, are provided as an attachment to this memo.

 Lastly, NYAHSA advocated for a change in the definition of “qualified residence” as it relates to count toward the community transitions for the purpose of an enhanced federal contribution, to include adult care facilities and assisted living.  Unfortunately, this is federally defined and while several states have raised this as an issue, the Centers for Medicare and Medicaid Services (CMS) has been unwilling to change it.

Online Housing/Assisted Living Search
 Representatives from Homes and Community Renewal (HCR) reported on their online housing locator, www.NYhousingsearch.gov.  The site has listings about units that cost no more than 130 percent of the fair market value, and all HCR funded projects are listed.  The site also has a separate Adult Care Facility (ACF)/Assisted Living directory, and listings are not subject to the fair market limitations. 

The site can identify vacant units, so that the searcher does not have to waste time looking at units that are taken.  Consumers can also access wait lists and lotteries for New York City area units.  At the time of this writing, 80,000 units are listed, and 2,371 are available.  The highest number of vacancies are in Niagara Falls, Far Rockaway and Poughkeepsie.  HCR is working to help New Yorkers learn about this site, so members are encouraged to use the service and spread the word.  The service also has a call center, which can help people with housing searches over the phone.  Clearly, this is a valuable service whether you are trying to help someone find housing in the community or are a housing or ACF/Assisted living provider yourself.  Click here to list your property -- it’s free marketing!  

 Statewide Housing Education and Outreach
 The New York Association for Independent Living (NYAIL) has conducted statewide training to help educate and address the affordable, accessible housing needs in the state.  Education has focused on topics such as universal design, Fair Housing, the Consolidated Plan and affordable housing.  NYAIL will continue its efforts into September of 2011. 

TRAID Program Helps More People Stay at Home
 The Technology Related Assistance for Individuals with Disabilities (TRAID) program is a federal program, and $400,000 of MFP dollars have helped to support the program for the purpose of helping people transition back to the community from a nursing home setting.  TRAID offers short-term assistive technology or durable medical equipment loans for any reason to any New Yorker free of charge.  Above and beyond TRAID’s typical services in a given year, MFP funding has helped to purchase 1,200 additional pieces of equipment, enabled 970 device demonstrations and provided 1,500 loans to people to meet MFP rebalancing goals. Click here for more information about the TRAID program.

Outreach to Nursing Home Residents
Another rebalancing activity under the MFP program is outreach to nursing home residents.  DOH has contracted with entities to conduct peer-based outreach activities to nursing home residents to provide them with education regarding their options for community services.  NYAHSA provided DOH with a variety of recommendations regarding these efforts to help ensure a smooth and logical process for residents, their loved ones and for our members.  According to their report, the outreach agents are following these recommendations, and it is reportedly going well. 

The contractors began their work in the spring by developing relationships with nursing homes, community-based agencies, regional resource development centers, etc.  Resource materials have been developed in each community to inform consumers of the array of home- and community-based services available (including non-medical services such as EISEP, home-delivered meals, etc.). 

 A Dear Administrator letter was issued to nursing homes regarding this effort, and the contracted entities met with social workers and administrators to describe the project and review the list of residents with whom they should meet, per MDS data.  If a resident does want to move back into the community, the contractor can work with the nursing home discharge planner to facilitate the discharge, though the contractor would not perform duties that the discharge planner typically does, such as a referral to home care.  The revised MDS Section Q referrals are the contractor’s first priority, but they will meet with other interested residents and those who have low RUG scores.  DOH provided a presentation entitled “Protocols for MDS 3.0 Section Q Implementation” as a resource. 

A list of contacts by region for the MFP Outreach Project are provided as an attachment to this memo, as well as data on outreach contacts thus far, statewide. 

Next steps
DOH is evaluating if any changes should be made to the MFP current rebalancing activities.  The group indicated a need to continue funding the current initiatives, which were reportedly successful but in need of ongoing support.  If you have ideas of other rebalancing initiatives that you would like to have considered for this demonstration, let me know.  It should be noted that while the federal government has issued another RFP for new MFP demonstrations, New York is not eligible to apply for a second grant;  rather, this MFP demonstration will be administered until 2016. 

If you have any questions about the contents of this memo, contact Diane Darbyshire at 518-449-2707, ext. 162, or ddarbyshire@nyahsa.org.

 

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