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Our clients include Medicaid agencies, other state agencies that rely on Medicaid funds, the federal government and other key stakeholders affected by the Medicaid program, such as individuals with disabilities and their advocates and their providers.
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Centers for Medicare and Medicaid Services
State Agencies
Alaska Department of Health and Social Services Back to top
Develop a Long Term Care Plan for the State of Alaska
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Minnesota Department of Human Services (DHS) Back to top
The Comprehensive TheAssessment
Minnesota Department of Human Services (DHS) Back to top
The Comprehensive Assessment Effort for the State of Minnesota
- Status: In progress
- Objective: Simplify and streamline procedures used to gain access to services and to create a mechanism for assignment of services in order to maximize independence, recovery, and quality of life for all persons, regardless of age or disability.
- Method: HCBS Strategies conducted extensive research on other assessment tools and facilitated input from a Steering Committee and multiple workgroups. HCBS Strategies also worked with the State to develop and pilot an automated version of the tool.
- Result: Comprehensive assessment process that can be used to assess the needs of individuals with disabilities of all ages, including children and older adults. The project developed 17 modules, including an innovative person-centered interview that ensures that these principles drive the assessment process.
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Client Project Page: Click here
State to County resource allocation methodology for the DD Medicaid Waiver program
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Status: Completed
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Objective: to design a methodology for allocating state budget dollars to individual counties for the developmental disabilities (DD) waiver program (formerly known as the MR/RC waiver) that resulted in a more equitable distribution of funds.
- Method: HCBS Strategies collaborated with Johnston, Villegas-Grubbs and Associates (JVGA), The Lewin Group and AmeriChoice. HCBS Strategies role was to assess the counties' capability to implement proposed methodologies and provide input into the proposed approach. To complete this task, we surveyed all 87 counties and conducted a more in-depth survey with a subgroup of counties to understand how they currently operate the 1915(c) HCBS waiver targeting individuals with DD.
- Result: A summary report that assessed the feasibility of the proposed budget allocation methodology and recommended infrastructure needed to implement a new strategy.
- Final Report: Click here
Illinois Department of Healthcare and Family Services Back to top
Building a Quality Management Strategy the Complies with CMS 1915(c) Waiver Requirements
- Status: In progress
- Objective: To assist IDoA in developing a quality management strategy (QMS) that complies with CMS requirements for a 1915(c) Home and Community-Based Services Waiver.
- Method: HCBS Strategies scope of working includes the following tasks: (1) assisting IDoA in identifying performance indicators; (2) proposing changes to existing and the creation of new data collection tools to assess performance; (3) creating key management tools; (4) revising monitoring and remediation policies and procedures; and (5) incorporating these changes into IDoA’s waiver application.
- Result: A QMS and successful waiver renewal.
- Client Project Page: click here
Medically-Fragile, Technology Dependent (MFTD) Children's Waiver Assessment and Resource Allocation Development
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Status: Completed
- Objective: To develop a level of care (LOC) criteria and tool, an assessment and support planning tool, and a methodology for assigning resources to individual children.
- Method: Under a subcontract with Health Systems of Illinois (HSI), HCBS Strategies collected extensive information on work done by other states. We built upon the best practices identified and adapted tools to meet Illinois' specific needs. We used a backwards expert chaining approach to develop the resource allocation for which we obtained input from the individuals who worked most closely with these children regarding the factors that drove needs and assessed the validity of this input against available data.
- Result: A LOC tool and criteria, assessment and support planning tool, and a resource allocation methodology.
1915(c) Medicaid HCBS Waiver Quality Management Review
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Status: Completed
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Objective: Evaluate seven HCBS waivers to determine strengths and vulnerabilities in their quality management strategies and assess the ability to meet mandatory Centers for Medicare and Medicaid Services (CMS) quality assurances.
- Method: Under a subcontract with Health Systems of Illinois (HSI), HCBS Strategies reviewed the business processes related to assuring quality for each waiver. We developed a series of flowcharts and documents that identified how existing processes currently operate and assessed their ability to support data driven decisions.
- Result: We prepared reports on each waiver that summarized the key business processes and made recommendations for improvements. We also made recommendations regarding where and how quality management infrastructure could be built across waivers.
DC Department of Mental Health (DMH) Back to top
Preparation of Federal Grant Proposals
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Status: Completed
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Objective: Assist the DMH in the preparation of three CMS Real Choice Systems Change grants and one Assets for Independence grant.
- Method: 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 which presented the greatest likelihood of success.
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Result: The District was awarded more than $2.3 million in grant funds.
CMS Real Choice Systems Change Grant EPSDT Grant
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Status: Completed
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Objective: to implement the Real Choice Systems Change Portals from EPSDT to Adult Service grant. The purpose of this grant was to help identify children in foster care with serious mental health issues and ensure that they had a smooth transition into the service system that targeted adults.
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Method: HCBS Strategies collaborated with Georgetown University and District staff at DMH and the Children and Family Services Administration (CFSA) to evaluate current processes for identifying and transitioning foster youth with serious mental illness (SMI) who were aging out of the CFSA system. This review resulted in a series of recommendations and tools.
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Result: Tools for identifying and monitoring the transition of foster youth and a final report were created.
- Client Project Page: Click here
CMS Real Choice Systems Change Grant Housing Grant
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Status: In progress
- Objective: To implement the Districts Real Choice Systems Change Grant: Integrating Long Term Supports with Housing. The goal of this grant is to assist individuals from two populations, youth with SMI aging out of the foster care system and individuals with a dual DD and SMI diagnosis, transition to independent housing that they control.
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Method: HCBS Strategies is assisting DMH in matching individuals in the two populations with housing. We have conducted background research on programs in other states and developed policies and procedures for the program. We will be conducting an evaluation of the efficacy of the program.
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Result: The program has met its goal for the number of individuals to be transitioned.
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Client Project Page: Click here
At Risk Youth Wraparound Development
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Status: In progress
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Objective: To design a program using a "Wraparound" model that will help youth with serious mental illness avoid inpatient psychiatric hospital and Residential Treatment Center (RTC) placement.
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Method: HCBS Strategies researched Wraparound efforts in other states and assisted DMH in developing a Request for Proposals (RFP) for a vendor to operate a pilot program in DC. We are working extensively with the Wraparound Steering Committee and Wraparound Implementation Group in this effort. Our current efforts are focused on identifying and securing Medicaid funding for the program.
- Result: Thus far, the RFP has been issued and a vendor selected.
Maryland Department of Aging (MDoA) Back to top
Preparation of Federal Grant Proposal
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Status: Completed
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Objective: To complete proposals for an Administration on Aging (AoA) Aging and Disability Resource Center grant
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Method: HCBS Strategies worked with State staff and other key stakeholders to design the proposal
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Result: MDoA received the grant.
Nursing Home Diversion Modernization Grant
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Status: In progress
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Objective: 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 for identifying individuals at high risk of institutional placement and developing reimbursement approaches.
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Method: HCBS Strategies is working with State staff and representatives from the participating counties. We are conducting background research and developing key operational infrastructure.
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Result: Key committees have been developed and are meeting.
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Client Project Page: Click here
Maryland Department of Health and Mental Hygiene (DHMH) Back to top
1915(c) Medicaid HCBS Waiver Quality Management Review
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Status: Completed
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Objective: To evaluate three HCBS waivers to determine strengths and vulnerabilities in their quality management systems
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Method: Under a subcontract with the Delmarva Foundation, HCBS Strategies reviewed the business processes related to assuring quality for each waiver.
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Result: We provided a roadmap for redesigning a quality improvement system and some initial quality management tools.
Arizona Governor's Council on Developmental Disabilities Back to top
Employment Supports Evaluation
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Status: Completed
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Objective: To identify gaps and barriers to supporting competitive employment among individuals with developmental disabilities.
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Method: In collaboration with Johnston, Villegas-Grubbs and Associates (JVGA) and Virginia Commonwealth University, HCBS Strategies reviewed Arizona's methodologies for supporting employment. We reviewed programs funded using Vocational Rehabilitation and Medicaid. Our review included an analysis of how the programs were working at both the State and local levels.
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Result: This project resulted in a summary review of the current system and specific recommendations for improving the system.
Administration on Aging (AoA) Back to top
Aging and Disability Resource Center (ADRC) Technical Assistance
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Status: Ongoing
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Objective: To provide technical assistance to AoA and CMS grantees designing and implementing Aging and Disability Resource Centers. , under a consulting agreement with The Lewin Group
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Method: Under a consulting agreement with The Lewin Group, HCBS Strategies has provided technical assistance to Florida, Minnesota, Alaska, South Carolina, New Jersey, Indiana, New Hampshire, and Maryland
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Result: We have assisted numerous states in making crucial program design issues and determining when and how they can draw down Medicaid financial participation.
ADRC Business Plan Template
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Status: Completed
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Objective: To develop a template to assist states in designing their own ADRC
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Method: HCBS Strategies developed a business plan template that assists these grantees in identifying the size and scope of their potential market, developing their operations, and building a case for sustainability
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Result: The template.
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Business Plan template: Click here
White Paper on Redesigning HCBS information technology (IT) and business processes to support participant control, quality and cost-effectiveness
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Status: Completed
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Objective: AoA requested a white paper that would help states understand how they could use IT in reforming their HCBS delivery systems.
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Method: We conducted a review of practices in other states and developed a model of key business processes.
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Result: White paper developed- For copy click here.
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White Paper: Coming Soon
Centers for Medicare and Medicaid Services (CMS) Back to top
National Balancing Indicator Development
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Status: In progress
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Objective: To assist CMS in developing state-level indicators of the quality and effectiveness of states’ efforts to include a more appropriate balance of community-based and institutional supports in their long term care systems. The effort will result in a series of mandatory and voluntary indicators that states and the federal government will use to evaluate programs.
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Method: Steven Lutzky is a technical consultant to the National Balancing Indicator Contractor (NBIC) team that consists of IMPAQ and Abt Associates.
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Result: Thus far the team has developed a white paper to describe the potential vision for the effort.
Local Government Agencies Back to top
Hennepin County, Minnesota
DD System Evaluation
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Status: Completed
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Objective: To review of Hennepin's programmatic operations that support individuals with developmental disabilities.
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Method: 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.
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Result: HCBS Strategies developed three reports: an operational review, a summary of stakeholder input, and a findings and recommendations report.
Foundations and Advocacy Organizations Back to top
National Council on Aging
Reverse Mortgage Annuities Analysis
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Status: Completed
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Objective: To estimate the impact of increased use of reverse mortgage annuities (RMAs) on Medicaid expenditures.
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Method: In collaboration with The Lewin Group, we used the Long Term Care Financing Model, a micro-simulation model that can be used to evaluate the impact of a variety of long term care policy scenarios to evaluate the potential impact of policy changes that increased the use of RMAs.
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Result: We produced a chapter that went into an overall report.
Provider Organizations Back to top
Generations
Generations is one of 16 Area Agencies on Aging (AAAs) in Indiana
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Status: Ongoing
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Objective: To assist Generations in working with the State to reform the HCBS delivery system.
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Result:Thus far, we have written a white paper for them on restructuring waiting lists, assisted them in responding to a Request for Information (RFI) from the State, and to develop a proposal for restructuring services.
Abilities in Motion (AIM) Back to top
AIM is a Center for Independent Living located in Pennsylvania.
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Status: Completed
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Objective: To develop an operational manual for a Fiscal Intermediary Program.
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Result:HCBS Strategies developed a step by step manual that meets both State and Internal Revenue Service (IRS) requirements.
Click here to contact HCBS Strategies for more information about our various projects and past experience.
