May 30, 2013 Newsletter

Based on feedback received regarding the Money Follows the Person Program, HFS implemented an online process to streamline referrals for the Program. HFS developed an online referral process to ease the navigation of the referral process; improve the tracking of referrals; and ensure that timely follow-up occurs on all referrals received. The online referral system can be accessed at the MFP/Pathways to Community Living website. Due to this new online referrals system, HFS is requesting that all state and local agencies, including nursing facilities, utilize the online referral system for all referrals. Additionally, individuals and family members can utilize the online referral system. HFS has determined that referrals in which individuals have expressed an interest in transitioning to the community most often result in successful transitions.

Once HFS receives an online referral, we e-mail the referral to the Local Contact Agency with the expectation that contact is made with the individual within ten business days of receipt of the referral. The online referral system provides both ombudsman and nursing facility staff with a mechanism to inquire about the status of the referral if follow-up hasn't occurred in a timely fashion.

Referrals for individuals residing in non-Institution for Mental Disease (non-IMD) nursing homes in Cook County, covered under the Colbert Consent Decree, should also be directed to HFS via the online referral form on the website. Once received, HFS will direct these referrals to Aetna and IlliniCare for follow-up. (HFS has contracted with these Managed Care Organizations to provide care coordination for all Colbert class members.)

As of May 10, 2013, HFS has received a total of 697 referrals; 561 of which have been received thus far in 2013. The following is a breakdown of referrals by program category: 371 Colbert referrals, 32 Williams' referrals, and 288 general referrals for MFP.

Illinois recently submitted its application to Federal CMS to apply for funds through the Balancing Incentive Payment Program (BIP). The BIP, authorized under Section 10202 of the Affordable Care Act, offers a targeted increase in the Federal Medical Assistance Percentage (FMAP) to states that undertake structural reforms to increase access to non-institutional Long-Term Services and Supports (LTSS). The increased matching payments are tied to the percentage of a State's non-institutional LTSS spending, and Illinois is eligible for a 2% match. The BIP provides increased FMAP to states in return for their implementation of structural changes, including a No Wrong Door/Single Entry Point System (NWD/SEP), conflict-free case management services, and a core standardized assessment instrument. The goals of the three structural changes include ensuring that individuals have the same access to information and resources on LTSS regardless of their entry point into the system; individuals are assessed once for the entire range of LTSS for which they may be eligible; eligibility determination and enrollment processes are conducted in a streamlined manner, with the functional and financial components of eligibility coordinated; and the establishment of conflict of interest standards to ensure independent evaluation and assessment processes.

Illinois expects to receive a total of $90 million from the increase in FMAP through September 2015. The BIP requires these funds to be used for the enhancement and/or expansion of home and community based LTSS. BIP funds may not be used to cover funding gaps or budget holes for any agency or organization.

After submitting the initial BIP application on March 28, 2013, (once approved), Illinois must submit a final work plan by September 28, 2013 that describes in detail the plans for achieving the requirements of the BIP. While the draft work plan is due six months after submittal of the application, Illinois has until September 30, 2015 to implement the structural changes required by the BIPP.

On February 12, 2013, Governor Quinn, along with representatives from the U.S Department of Housing and Urban Development (HUD), announced that Illinois had been awarded an $11.98 million grant under the Section 811 Supportive Housing for Persons with Disabilities program. This sizeable award will strengthen Illinois' efforts to allow people with disabilities to live independently in the community of their choice. These funds will make up to 825 apartments affordable for people who have special needs, and are in financial need, across the state. HUD hosted a competitive application process for the Section 811 awards, and IHDA, the state's housing finance agency, received the third largest award in the country. IHDA will award the rental subsidy to owners of eligible properties via one or more competitive application rounds. Each rental subsidy awarded will have an initial term of five years with renewals for up to 20 years. The State Referral Network will link potential tenants to participating property owners. To qualify, potential tenants must be extremely low income, which is defined as making up to 30 percent of the median income for the area - or, $15,480 in the Chicago area, or $14.130 in Springfield, for a one-person household.

On Tuesday, April 30, 2013 IHDA began accepting program applications from landlords for a portion of up to $10 million in Long Term Operating Support (LTOS) Special Demonstration Program grant funding under the Rental Housing Support Program. Applications will be accepted until 3 p.m. on June 10, 2013, and all existing regulated housing developments are welcome to apply. For more information and to apply, please visit the Illinois Housing Authority website.

Additionally, IHDA has recently formed an Interagency Panel for the Statewide Referral Network, as called for in the Section 811 application and Statewide Referral Network Intergovernmental Agreement. IHDA, DHS, HFS, and IDoA have all appointed representatives, designated by their directors, to serve on the interagency panel. Lora McCurdy and Paul Bennett plan to represent HFS on the Interagency Panel. The Panel will assess the capacity of the Referral Network's ability to match housing units with the Target population. Outreach will also be provided to the Project Rental Assistance Demonstration Program Target Population in the State's MFP Demonstration and class members of the Olmstead Consent Decrees. As a part of this collaboration, HFS will link managed care providers under the State's Medicaid Program to the Referral Network.

HFS recently amended its MFP Operational Protocol, Version 2.0, which was approved by Federal CMS in February. The MFP Operational Protocol is a set of guidelines that defines the program's operating policies and procedures, as well as the organization and administration of the MFP-Pathways program.

Added to the Operational Protocol was the Colbert Consent Decree, which provides information regarding the Colbert lawsuit, the Colbert Implementation strategy and how it will coordinate with MFP, as well as the Colbert and MFP/Pathways Service Model. A new demonstration service known as "peer Support" was also added for Calendar Year 2013.

Supportive Living Facilities were also added to the OP as a qualified community residence under MFP for individuals with physical disabilities. Home and Community Based Service (HCBS) waivers for individuals with Traumatic Brain Injury (TBI) and AIDS, were also added as qualified waivers under MFP. Individuals receiving services through either of these waivers are now eligible to enroll in the MFP program.

The updated MFP OP can found on the MFP Additional Information webpage under the "Referral Form" link.

Beginning in mid-February 2013, representatives of the AgeOptions, Aging and Disability Resource Center (ADRC) for suburban Cook County began the provision of Outreach and Education to Colbert Class Members. This agency is currently working with nursing facility staff to facilitate access to Class Member residents and significant others and scheduling individual and small group meetings at the facility. It is anticipated that similar activities will begin soon in the City of Chicago with representatives of their Aging and Disability Network (ADRN).

Additionally, the process of Evaluation and Transition Planning for Class Members also began at that time. The Illinois Department of Healthcare and Family Services (HFS) has contracted with Aetna Better Health and IlliniCare Health Plan to provide care coordination services. These Health Plans are also responsible for the evaluation of Class Members to determine appropriateness for community transition as well as for planning for transition to the community. As part of these responsibilities, the Health Plans have been meeting with current nursing facility residents identified through targeted outreach, including persons who are current Integrated Care Program (ICP) enrollees; persons identified through the ADRC/ADRNs; referrals from staff of the Long Term Care Ombudsman Program (LTCOP), and with residents who self-refer.

Under the Consent Decree, HFS is required to transition 300 class members residing in a non-IMD nursing home by November 2013, and, we are on our way to reaching this goal. HFS expects approximately 90% of Colbert class members to be eligible for enrollment in MFP.

In light of the Ligas Consent Decree, as well as the upcoming closure of the Murray Developmental Center in Centralia, the MFP Transition goal established for the Division of Developmental Disabilities (DDD) was set at 140 for CY 2013. While the transition benchmark was set at 140, the total number of MFP transitions for DDD is expected to be significantly greater due to the impact of Ligas and the closure of Murray. Individuals transitioning out of Intermediate Care Facilities for Individuals with Developmental Disabilities (ICF/DDs) must move into four bed or fewer Community Integrated Living Arrangements (CILAs) in order to qualify for enrollment in MFP. (CILAs larger than four bed are not considered to be a "qualified community setting" under federal MFP guidelines.)

The State of Illinois has contracted with the Council on Quality Leadership to provide outreach and education to potential class members under the Ligas Consent Decree. To date, 253 individuals have already moved out of ICF/DDs and transitioned into 5-8 bed CILAs. Additionally, 1000 individuals have already been assessed and removed from the Prioritization of Unmet Needs (PUNS) waiting list, as a direct result of the progress being made under the Ligas Decree.

HFS, along with the University of Illinois at Chicago-College of Nursing, has scheduled upcoming MFP trainings for all Pre-Admission Screening or Individual Service and Support Advocacy (PAS/ISSA) provider agencies throughout the state. (PAS/ISSA provider agencies will be providing care coordination services for individuals transitioning out of Murray.) The trainings will be held on May 29, 2013 from 1 to 4 p.m. at Central Illinois Service Access in Lincoln, IL, and June 11, 2013 from 10 a.m. to 1 p.m. at Suburban Access, Inc. in Homewood, IL.

HFS is pleased to announce that Mental Health services for MFP participants have been expanded to DuPage County through a collaborative grant between the DuPage County Health Department and HFS. Rebalancing funds were used to extend mental health services to DuPage County. After the addition of DuPage County, there are now MFP Mental Health providers in three areas of the state: Springfield, Peoria, and DuPage County.

HFS, in collaboration with the University of Illinois at Springfield (UIS) technology department is in the process of producing a promotional outreach video about the MFP Pathways program. Thanks to funding awarded through a grant received from the Chicago Community Trust, HFS and UIS are nearing completion of an informational video outlining the Colbert Consent Decree, and is in the process of developing a video to market the MFP program. The MFP video will feature individuals enrolled in MFP who have successfully transitioned to the community. Filming is expected to begin in June.

As of May 16, 2013, the Pathways to Community Living partner agencies have successfully transitioned 868 individuals from institutional settings to Qualified Home and Community Based residences since the inception of MFP in 2009. In light of the projected Colbert transitions (300 class members must have transitioned by November 8, 2013), the MFP benchmark established for Calendar Year 2013 is 607 individuals. Thank you to all the transition coordinators and stakeholders for their continued efforts to successfully transition individuals to community-based services and supports.

MFP Trainings

Listed below is the schedule of various upcoming MFP Trainings available via webinar. Please e-mail Mindy Bristle if you are interesting in registering.

Future MFP Stakeholder Meetings:

The next stakeholder meeting is scheduled for July 10, from 10 a.m. to Noon.

We would like to encourage greater consumer participation in the committee meetings. If you would like to refer an individual or know someone who would like to participate, please let us know! You may e-mail that information to Pathways to Community Living Staff by selecting the "contact us" link on the program website - http://www.illinois.gov/hfs/MedicalPrograms/mfp/.

Sincerely,

Lora McCurdy

Pathways to Community Living/MFP Project Director

Illinois Department of Healthcare and Family Services