Home and Community-Based Care
Medicaid funds institutional and community based benefits for persons needing long term services and supports. Increasing the proportion of Medicaid expenditures made for community services responds to consumer preferences and in most instances is less expensive.
*Milestone details:
*Full name: Develop a strategy to increase the proportion of total Medicaid long term care services and supports spending devoted to home and community-based care.
*Relevance to the ACA:
Several provisions of the ACA provide policy direction to shift the balance of Medicaid long term services and supports expenditures towards community living.
§ 2402 - Requires the Secretary to issue regulations on home and community services to ensure that states develop systems designed to allocate resources to respond to the needs and preferences of persons receiving long term services and supports financed through Medicaid and other sources.
§ 2403 - Provides states enhanced matching payments for Medicaid home and community based supports provided to persons transitioning from institutional living to the community.
§10202 - Provides states with increased FMAP for Medicaid home and community based supports if they adopt service delivery systems reforms aimed at shifting the balance of Medicaid financing to community supports.
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California
The University Medical Center of Southern Nevada issued an RFP for a Medicaid 1115 Waiver Project. The purpose of the RFP will be to identify a consultant with knowledge and experience in Medicaid 1115 waivers to assist in the implementation of a Medicaid waiver in Nevada. Consultants will also lay the ground work through the post implementation of the waiver. University Medical Center of Southern Nevada, located in Las Vegas, Nevada, is a county-owned, acute-care hospital, organized under Nevada Revised Statute Chapter 450, with over 500 beds, a Level 1 Trauma Center, a Level 2 Pediatric Trauma Center and 10 urgent care clinics. The RFP was released on February 12, 2012 and responses are due by March 6, 2012.
District of Columbia
State Refor(u)m user Mark Larson of the Department of Vermont Health Access has shared the attached presentation entitled, "Choices for Care: Vermont's Home and Community Based Care Waiver." He presented this PowerPoint at a National Association of Medicaid Directors (NAMD) meeting in November 2011.