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Maryland’s Money Follows the Person Demonstration: Support Transitions Through Enhanced Services and Technology

Introduction
  1. Money Follows the Individual Act is codified in the Annotated Code of Maryland, Health General §15–137; the Maryland Department of Health and Mental Hygiene may not deny an individual access to a home- and community-based services waiver due to a lack of funding for waiver services if: (1) The individual is living in a nursing facility at the time of the application for waiver services;(2) At least 30 consecutive days of the individual’s nursing facility stay are eligible to be paid for by the Program;(3) The individual meets all of the eligibility criteria for participation in the home- and community-based services waiver; and(4) The home- and community-based services provided to the individual would qualify for federal matching funds.

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  2. Molly O’Malley Watts, Money Follows the Person: A 2013 Survey of Transitions, Services, and Costs, Kaiser Family Foundation’s Kaiser Commission on Medicaid and the Uninsured, April 2014, available at: https://www.kff.org/other/report/money-follows-the-person-a-2013-survey-of-transitions-services-and-costs.

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Issue Brief
  1. The Minimum Data Set (MDS) 3.0 is an assessment tool that is used with residents in all Medicare-licensed nursing facilities.  Section Q of the MDS relates to the resident’s desire to return to receive services in the community.

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  2. Effective January 6, 2014, applicants and participants have freedom of choice among available enrolled providers.

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  3. Department of Health and Mental Hygiene, State of Maryland, Money Follows the Person Operational Protocol, 2011, available at: https://mmcp.dhmh.maryland.gov/docs/MFP-Operational-Protocol-v%201-1.pdf.

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  4. Molly O’Malley Watts, Money Follows the Person: A 2013 Survey of Transitions, Services, and Costs, Kaiser Family Foundation’s Kaiser Commission on Medicaid and the Uninsured, April 2014, available at: https://www.kff.org/other/report/money-follows-the-person-a-2013-survey-of-transitions-services-and-costs.

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  5. The Bridge Subsidy program links individuals in nursing homes and institutions to temporary housing subsidies until permanent support can be located.

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  6. The Governor’s budget has provided annual funding of $250,000 since 2006. In 2013, Senate Bill 83 codified in state statute the Maryland Access Point (MAP) program and the agencies responsible for administering, supervising, and coordinating the program.  The MAP program has strengthened partnerships between state executive staff and legislators. Executive staff of the state’s Departments of Health and Mental Hygiene (Maryland’s Medicaid Agency), Disabilities, Human Resources, Housing and Community Development, Education, Veterans Affairs, and Aging are active on the State MAP Advisory Board and in the workgroups.

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  7. To ensure that people can access the same information, the state Medicaid agency is working to create a toll-free hotline that connects directly to the caller’s local MAP; the hotline is expected to be available in 2014.  MAP site staff will complete a brief telephone screen that triages a person into LTSS, focusing on person-centered planning and providing direct referrals to functional and financial assessments when appropriate.

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  8. The Hilltop Institute, presentation by Ian Stockwell and Rebekah Natanov to the Maryland Department of Health and Mental Hygiene, Medicaid Long-Term Services and Supports in Maryland: Money Follows the Person Metrics, June 4, 2013, available at: https://mmcp.dhmh.maryland.gov/longtermcare/SitePages/Maryland%20Money%20Follows%20the%20Person.aspx, See Hilltop presentation on MFP Metrics, Part 2.

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  9. Molly O’Malley Watts, Money Follows the Person: A 2013 Survey of Transitions, Services, and Costs, Kaiser Family Foundation’s Kaiser Commission on Medicaid and the Uninsured, April 2014, available at: https://www.kff.org/other/report/money-follows-the-person-a-2013-survey-of-transitions-services-and-costs.

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  10. Code of Maryland Regulations 10.07.14.02B(10). As defined in state law, assisted living facilities are qualified residential settings that may serve small groups of unrelated individuals.  Code of Maryland Regulations 10.07.14.02B(10)

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  11. Molly O’Malley Watts, Money Follows the Person: A 2013 Survey of Transitions, Services, and Costs, Kaiser Family Foundation’s Kaiser Commission on Medicaid and the Uninsured, April 2014, available at: https://www.kff.org/other/report/money-follows-the-person-a-2013-survey-of-transitions-services-and-costs.

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  12. Maryland Department of Health and Mental Hygiene, https://mmcp.dhmh.maryland.gov/longtermcare/SiteAssets/SitePages/Community%20First%20Choice/General%20CFC%20Provider%20Memo.pdf

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  13. Maryland Department of Health and Mental Hygiene, Balancing Incentive Program Application, February 2012, available at: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Long-Term-Services-and-Supports/Balancing/Downloads/Maryland-Submission.pdf.

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  14. A summary of these initiatives is available at: https://mmcp.dhmh.maryland.gov/docs/MFP-Operational-Protocol-v%201-1.pdf

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  15. “Medicaid Program; State Plan Home and Community-Based Services, 5-Year Period for Waivers, Provider Payment Reassignment, and Home and Community-Based Setting Requirements for Community First Choice and Home and Community-Based Services (HCBS) Waivers,” 79 Federal Register 2947 (16 January 2014), pp. 2947-3039, available at: https://www.federalregister.gov/articles/2014/01/16/2014-00487/medicaid-program-state-plan-home-and-community-based-services-5-year-period-for-waivers-provider.

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