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Nevada receives multi-million-dollar grant to strengthen service



CARSON CITY, Nev. — Nevada has been awarded nearly $10 million over a six-year grant period from the Centers for Medicare and Medicaid (CMS) for the 2011 Money Follows the Person Rebalancing Demonstration Grant. The goal for this grant is to transition individuals out of institutional long-term care settings, and into home or group-home settings with the least restrictive level of care.

The grant proposes to transfer 524 individuals over the grant term. To this end, the grant will help continue to develop and refine the supports necessary to allow persons to live outside of an institution; rebalancing services from institutional to community based care.

The major “gaps” or differences between the current level of rebalancing and more desirable levels include:

  • Strengthening the Facility Outreach and Community Integration Services (FOCIS) program, the state’s Olmstead-response institutional diversion and transition program;
  • Building administrative and budgeting mechanisms to use savings on nursing home expenditures to fund Home and Community-Based Services (HCBS);
  • Enhancing quality improvement systems that cross multiple programs and services;
  • Improving housing alternatives; and
  • Improving overall care coordination for Medicaid Long Term Care (LTC) recipients, including those dually eligible for Medicare.

The new grant’s funding:

Approximately $5.5 million is to help support the cost of current Medicaid home and community based services and provides an enhanced FMAP for these.

Approximately $1.9 million for demonstration services including Transition Navigation (a person to assist in the transition), Community Transition Services (help set up community living including rental, utility and phone deposits, preparing the household including cleaning or acquiring furniture etc.), and Environmental Accessibility Adaptations which are physical adaptations to the residence such as ramps or grab bars.

Approximately $2.3 million of the grant is for administrative functions including grant staff, to improve program administrative efficiency, quality and continuity of  care.  This activity will also encompass the consolidation of multiple home and community based quality systems (currently waiver and state agency specific) into one system. This system will be expanded to include:

  • 24-hour back-up system required for critical services, including monitoring of its use and effectiveness;
  • Risk assessment and mitigation process for all program participants, including monitoring; and
  • Incident management system used to monitor health and welfare of participants.

Nevada is proud of its institutional diversion and transition program. As one of Nevada’s responses to the U.S. Supreme Court’s Olmstead decision in 1999, the Division of Health Care Financing and Policy (DHCFP) Facility Outreach and Community Integration Services (FOCIS) program came into existence.  FOCIS began as a pilot program in northern Nevada in 2002, was expanded to southern Nevada in 2003, and became available throughout the state in 2004. FOCIS was initiated in response to the Task Force on Disability’s Strategic Plan for Persons with Disabilities, and was aided in 2003 by a CMS Money Follows the Person grant to promote community integration. In July 2006, a collaboration with Southern Nevada Center for Independent Living and FOCIS was established through the Funds for Healthy Nevada grant, Transition Housing Assistance Program.

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