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| Alaska Department of Health and Social Services |
Development of a Long Term Care Plan
HCBS Strategies took a three prong approach to developing the long term care plan. One, we conducted background research with other states, interviews with national experts, and meetings and focus groups with stakeholders. Two, we conducted a business process review of Alaska’s current long term care delivery systems. Three, we engaged in a collaborative process with the State and stakeholders to review and revise recommendations. These recommendations were translated into a three year implementation plan and a set of recommendations for reform after the initial three year period. To view the Client Project Page including the report: Click here
To view Client Project Page including the report: Click here
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DC Department of Mental Health
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Real Choice Systems Change Grants
HCBS Strategies assisted the DC Department of Mental Health (DMH) in the preparation of three Real Choice Systems Change grants and one Assets for Independence Grant. We worked with District staff and other key stakeholders to match their goals in improving the delivery of long term supports for individuals with disabilities to the requirements of the grant category that presented the greatest likelihood of success. As a result of these efforts, the District was awarded more than $2.3 million in grant funds.
HCBS Strategies worked with DMH and Georgetown University to implement the Real Choice Systems Change Portals from EPSDT to Adult Service grant. This effort will help identify children in foster care with mental health issues, and reform current Medicaid services and create a new Medicaid case management funding stream to assist them in transitioning to adulthood.
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Integrating Housing and Long Term Supports
HCBS Strategies assisted DMH in implementing the Districts Real Choice Systems Changing Integrating Long Term Supports with Housing grant. Under this project, we worked with DMH in matching individuals with mental health issues to housing and developing mechanisms to support home ownership.
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At Risk Youth Wraparound Development
HCBS Strategies is assisting DMH in designing a wraparound program that will help youth with serious mental illness avoid placement in Residential Treatment Centers (RTCs). HCBS Strategies is assisting identifying possible Medicaid funding streams, financial architectures for reimbursement, and the operational design of the program.
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DC 1915(c) Elderly/Physical Disability (EPD) Waiver
Dr. Lutzky oversaw the successful renewal and expansion of a Medicaid HCBS waiver serving the elderly. The renewal included both the addition of adults (18+) with physical disabilities to what was the “elderly” waiver and an increase in the enrollment cap. Assisted living and attendant care were also included as new Waiver services
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CMS approved a long-standing request to amend the District of Columbia’s Medicaid HCBS Waiver serving individuals with Mental Retardation and Developmental Disabilities in December 2001. This amendment increased the scope of funded services. Dr. Lutzky also oversaw the subsequent renewal that increased the number of people the Waiver can serve and added additional services
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DC HIV 1115/Ticket to Work
Dr. Lutzky oversaw the development, submission, and implementation of twin efforts to expand Medicaid eligibility for individuals who were HIV positive, but did not meet the Social Security Administration’s definition as being disabled because of AIDS. These efforts include the submission of an 1115 Medicaid demonstration that utilized savings from switching prescription drug financing from traditional Medicaid approaches to the Federal Supply Schedule to cover the additional eligibility group and the receipt of a $26 million dollar CMS grant under the Ticket to Work Demonstration to Support Employment and Independence effort.
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Hawaii Department of Health, Executive Office on Aging
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HCBS Strategies was hired to fulfill the role of the Systems Change Developer (SCD). The objective is to creatcreate a five year strategic plan that will guide the development of a streamlined operations infrastructure for Hawaii's ADRC, Community Living Program, and Person-Centered Hospital Discharge Planning efforts. The SCD effort will build an infrastructure that will streamline access to HCBS, help target scarce resources to individuals at greatest risk of institutionalization and Medicaid spend down, and provide a participant-directed option under the state-funded Kupuna Care program. While the main thrust of the effort will be to develop the five year plan, we will also be engaged in building infrastructure to develop and sustain collaboration among the stakeholders. Additionally, we will facilitate the two mandated conferences.
To view Client Project Page including the report: Click here
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Illinois Department of Healthcare and Family Services
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Illinois MFTD Waiver Assessment and Resource Allocation Development
HCBS Strategies is working with Health Systems of Illinois, HSI (now eqHealth) to assist the state of Illinois in building an assessment tool and resource allocation methodology for its 1915(c) waiver targeting medically fragile technology dependent (MFTD) children. The scope of this work also included developing a more objective and valid Level of Care Screening tool to determine eligibility for MFTD waiver services.
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Illinois Medicaid Waiver Quality Management Review
HCBS Strategies worked with Health Systems of Illinois, a Quality Improvement Organization (QIO) to assist Illinois in maintaining and improving their systems for managing quality in Medicaid funded home and community based services. We are working with the state to develop a strategy for building quality management systems across waivers that comply with CMS requirements and best practices.
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Illinois Department on Aging
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CMS Compliant 1915(c) Waiver Quality Management Strategy
HCBS Strategies is currently assisting the Illinois Department on Aging to build a quality management structure for the State of Illinois Community Care Program (CCP) that complies with CMS requirements for 1915(c) waiver is under application version 3.5. CCP is an entitlement program serving individuals needing long term supports, who are over age 60 and live in the community. Many of the people served are Medicaid eligible under the 1915(c) waiver that includes CCP services. The project includes an operational analysis of the existing quality management structure, comprehensive research of national practices, development of performance indicators, methodologies for discovery and remediation, and recommendations for operational implementation for the new quality management system (including technology tools). The project will provide the State with the information needed for their waiver renewal. It will also include the development and delivery of training to staff and providers on the requirements of the new system.
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Indiana Area Agency on Aging Technical Assistance
HCBS Strategies has an ongoing relationship with Generations, one of 16 Area Agencies on Aging in Indiana. HCBS Strategies wrote a presentation for Generations that discusses issues related to the structure of waiting lists for home and community-based services. This paper discussed the implications of various policy options on operations and the lives of individuals with disabilities. In addition, HCBS Strategies provided assistance in developing a response to a Request for Information (RFI) to the state.
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Maryland Department of Health and Mental Hygiene
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HCBS Waiver Quality Management Evaluation
HCBS Strategies collaborated with the Delmarva Foundation to assess strengths and weaknesses of three 1915(c) Home and Community-Based Waivers for the Maryland Department of Health and Mental Hygiene. The scope of work also included the provision of a roadmap for redesigning a quality improvement system and some initial quality management tools
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(ADRC) Liaison for the Money Follows the Person (MFP) Demonstration
HCBS Strategies has been contracted by the Maryland Department of Health and Mental Hygiene (DHMH) to assist them with integrating key parts of Maryland’s MFP effort into the ADRC effort, known as the Maryland Access Point (MAP) program. This will allow the state to maintain these initiatives when the MFP grant expires.
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Maryland Department on Aging
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NH Diversion Modernization Grant
HCBS Strategies is assisting MDoA to implement a NH Diversion grant it received from AoA. HCBS Strategies will be assisting in a variety of efforts, including developing targeting criteria of identifying individuals at high risk of institutional placement and developing reimbursement approaches.
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Options Counseling Grant Support
HCBS Strategies was awarded a contract with the Maryland Department of Aging (MDoA) to support the implementation of a grant from the Administration on Aging (AoA) to build Options Counseling infrastructure in Maryland’s ADRC program. Key tasks in this effort include the following:
- Establishing infrastructure to facilitate collaboration among the state and local ADRC sites
- Conducting background research and presenting proposed models for options counseling
- Developing options counseling protocols for the initial intake, assessment and care planning, and ongoing case management business operations
- Setting staff qualifications and training requirements
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Minnesota Department of Human Services (DHS)
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HCBS Strategies developed a Comprehensive Assessment tool and Individualized Service Plan for the Department of Human Services to address the needs of individuals throughout the lifespan, incorporating a strong person-centered component to the choice and planning process. This work involved working extensively with the Division on Aging to adapt the tool to reflect the needs of older adults. To view Client Project Page including the report: Click here
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State to County resource allocation methodology for the DD Medicaid Waiver program
HCBS Strategies played a lead role in a collaborative effort with Johnston, Villegas-Grubbs and Associates (JVGA) to design a new county budget allocation methodology for programs serving individuals with MR/RC. The collaboration also included The Lewin Group and AmeriChoice. The overall goal of the project was to design a mechanism that will allow the state to more equitably distribute the budget for individuals with MR/RC across the counties. HCBS Strategies surveyed all 87 counties and conducting more in-depth follow-up with a subgroup of counties to understand how they currently operate the MR/RC 1915(c) HCBS waiver. This information helped to determine which types of budget allocation methodologies are feasible and what infrastructure would need to be created to implement a new strategy.
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| Hennepin County, Minnesota |
The objective of the project was to review of Hennepin's programmatic operations that support individuals with developmental disabilities. This effort included an evaluation of key business processes, consumer and provider stakeholder focus groups, and developing recommendations for improving County operations. We also facilitated a one day stakeholder summit meeting. HCBS Strategies developed three reports: an operational review, a summary of stakeholder input, and a findings and recommendations report.
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Click here to contact HCBS Strategies for more information about our various projects and past experience.
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