Roadmap to Medicaid Reform: Long-Term Care

This document issues guidance to states as they move toward choice and "money follows the person" policies for long-term-care services to expand coverage for individuals with disabilities. Guidance is issued about how to promote community-based care and increase access to community supports.

To increase access to community supports, states can:

• Offer home and community-based services without waivers. Beginning January 1, 2007, states can amend their state plans to offer home and community-based services as a state plan optional benefit.
  
   
• Apply for grants to ?rebalance? their long-term support system. The Money Follows the Person (MFP) Rebalancing Demonstration supports state efforts to ?rebalance? their long-term care support systems by offering $1.75 billion in competitive grants to states over 5 years. With this critical assistance, states will be able to make targeted reforms in their state to shore up the community-based infrastructure so that individuals have a choice of where they live and receive services.
  
   
• Apply for Real Choice System Change (RCSC) Grants for Community Living.
  
   
• Apply for demonstration projects to offer home and community-based alternatives to psychiatric residential treatment facilities for children.

To promote personal responsibility, independence and choice, States can:

• Offer a state plan benefit for self-directed personal care services without a waiver. Individual-controlled budgets provide for the transparency and informed choice believed to be vital to improve quality and value.
  
   
• Opt to participate in the State Long-term Care Partnership Program.