Event ID: 1516239
Event Started: 3/25/2010 2:50:29 PM ET

Please standby for real time captioned text.

It seems like a few people just joined us. Hello?

This is the 13.

Caroline and Liz? Did you say Annette?


What state?

North Carolina. I am sitting in to Dave for Tammy.


Did anyone else join that I missed?


This is Lauren from the state of Nebraska.

How you doing?


How are you.


Can you hear me okay?

We can hear you just fine did someone else just joined us?

This is Marty.

How are you doing?


We will wage of a few more minutes. I am sure there are more people joining us.

Does anybody have any special plans for this weekend?

Not really just trying to get outside if I can get some yard work going.

Did someone else just joined us?

This is Dan Clark from California.

How are you, Dan?


I am not representing our AT program. I have been watching Money Follows the Person in California.

Great. Glad you could join us. We will give it a few more minutes.

Lauren, you have joined us.

Lori, are you on the line?

I am here.

How are you doing?


This is Rob with RSA. I does wanted to let you know I join the call.

Hi, Rob.

Rob, this is Dan Clark. How are you?

I was asking about you the other day. I have been around but doing other things.

Clearly, I met with some people from California at the Western AT symposium in felt Lake City. Tim was there.

I had dinner with Kim.


How are the kids doing?

The little one is about two and a half now, it is good.

Last time I talk to you he was 6 months old.

Time flies.

Especially when you are on the West Coast, right?


It is Good to hear that Lori is on the call from Oregon, right?

I am.

Good to hear your voice.

We will give it about another two minutes and we will get started.

Is everyone there?

Yeah. I am here.

I accidently hit a button and thought I lost every one. I will step away and start the recording and we will go ahead and get started.


Good afternoon, everyone. This is Lisa and I have Rick and Nancy. Before we get started I am going to ask everyone to say your name and state you are calling from.

Eileen from Connecticut.

Laurie from Oregon.

Lori from Nebraska.


Michael from Portland, Maine.

Caroline and Liz in Georgia.


Dan Clark, California.

Kathy Adams, Maine.

Anyone else?

Andy from Mexico.

Rob from RSA in D.C..

Thank you for joining us today on Collaborations with Money Follows the Person. We have Arlene, the program director with the Connecticut project as well as Lori, executive director of Oregon's AT program, Bill, the brand manager from the division of Medicaid and long-term care in Nebraska and Lauren from the assistive technology partnership in Nebraska. They will share information on the collaboration's they have going on with the Money Follows the Person initiative. Just a quick side note, if you can mute your phone, that is *6 and to take it off of mute, that would be #6 the car will turn it over to review, Arlene.

This is , the program director from Connecticut and Lisa asked me to take them few minutes to talk about the collaboration that my program is doing with the Connecticut program. I will first it a brief overview of MSP, mostly from the Connecticut perspective. Essentially, Money Follows the Person is a Federal Administration grant from the Centers for Medicare and Medicaid, intended to rebalance the long term care system so that individuals have the maximum independence and freedom of choice regarding where they live and where they receive care and services. The program builds on current progress by enhance community services and support to those having resided in nursing facilities for at least six months the good in Connecticut deaf Federal support isn't an incentive to reduce the cost of more costly care. It is more cost-effective for taxpayers and expected to improve the quality of life for elders and people with mental illness and physical disabilities.

Options to go back into the community and and click the personnel own home, apartment or elderly housing speak team that Connecticut our goals are to reduce reliance on institutional care and increase efficiency and effectiveness on your system. Our goal is to increase dollars for, and the percentage of people receiving long-term services within the community, decrease the number of hospital discharges to nursing facilities for those that require care after discharge, increase the probability of those returning to the community after six months and transition at least 700 individuals out of institutions back into the community. We have transition coordinator is located at [ indiscernible ] and centers for Independent Living that provide assistance with community support, system navigation, access and Resources and living arrangements. It is important to mention that with the Connecticut MSP, New Jersey five is available to help people be as independent as possible within the community and is written into our demonstration grant. Basically, the person that oversees the Money Follows the Person program in Connecticut, Don Lambert was the director briefly. He was in charge of the grant for the program as well as other brands [ indiscernible ] and made it possible for me to move into this position, which I did not care for. She has done strong belief that assistive technology can help people increase their independence and make sure to write it into the MSP grant. Basically, the Connecticut act partners with MSP. They have a person by the name of Paul that could not be here today. I was hoping he could join us. He does training for MSP. Recently, Paul and I have a training around assistive technology and increasing independence as well as decreasing reliance on case support, reducing-has the ability to reduce people's time by using assistive technology, environmental controls and other devices to help the individual transition into the community of. We developed a training and families of the Powerpoint. I am not sure if that was distributed as of yet, but if it has not, I am sure we can get it out to everyone. Paul went on tour of the state and trained about 350 professionals throughout the state. He used inventory from the Connecticut Tax Act product demonstration center and was able to use my inventory to do the training and while he was out there that he made sure to market the project programs and services that could benefit consumers that are on MSP. We developed long-term computer programs for individuals on Medicaid in Connecticut and through the partnership, it essentially, if a person is interested in seven a Computer in the Home or school, they can apply as long as they can show verification they are on a waiver fico we thought this was helpful for get people on MSP as they transition home they may not be able to go out and do shopping easily and might not be able to stay in contact to visit family and friends and thought that giving them access to the community through online, the Internet with the a great to keep them engaged and reaching out and having contact with others. Through the program, it essentially, the transition coordinator let their consumers know this is available. If interested they can apply and we help them get the computers they need, for they need an any devices they might need to be able to use the computer to reach out to family and friends using that I cannot think of the name of the program, where they register and have the groceries delivered to them and things like that. Like I said earlier, Paul did training to approximately 350 professionals throughout the state including the Money Follows the Person transition corn acres, the Independent Living Centers, area agencies and agents, elder care Weaver planners, social workers for the brain injury waiver, Connecticut Community Care Center staff, Department of developmental disabilities and Department of Mental health Service waiver personnel's because he reached out to the Department of Economic and Community Development Staff and might be one of the areas that the transition coordinators' might be tackling, the Connecticut Center on aging and Board of Education Services for the blind, as well as. It essentially we developed the first round of training and reached out to all of the individuals and now that the program is up and running, transitions are happening, individuals are getting assistive technology evaluations and the devices--he and I est. in touch and I get calls all the time for resources, information, programs and services they might be able to benefit from and work on a second level of training, more in death assistive technology training to ensure that everyone working on MSP has an in depth training and reduce the time with the individual, allowing them to be independent and in the home, possibly without that person, companion staff or so on.

At as point, that is pretty much what we are doing with MSP. We have a close relationship. We stay in touch. If there is anything that pomades or I need, we work together to try to make sure that we are helping each other out. As I said earlier, MSP transition cornetists the in contact with me so that we can sure that their consumers are receiving the AT they need to be independent from the home wherethrough their transition. That is, essentially, all I have. Does anyone have any questions about that?

This is Arlene North Carolina. My question-you are saying that the individuals get to evaluations and also receive the AT they need. Our special funds set aside for the assistive technology devices?

Basically, what happens is if someone is eligible for a Connecticut waiver, a brain injury waiver, they will get the funds from those programs to do the assessment and purchase the equipment. In some cases they have caps or might have had AT. They might not have other types of assistive technology. That Money Follows the Person program will pay for assistive technology evaluations and a device and training so that the consumer is able to use the device.

Fell, there is separate money set aside within Money Follows the Person for assistive technology?


Is that set up separately with Connecticut?

As the grant was set up, that was made sure to be included in our system, policies and procedures.

Thank you.

No problem.

We help connect them to the appropriate personnel to do the assessment. It might be that one of our partner agencies. And might be a PT, depending on the scenario. The Tech Act is not providing the evaluation or training for consumers directly on how to use there AT devices. We have provided the overall training to the professionals working under MSP so they have a in step technology on increasing independence and ensuring they know what the procedures are to follow to help their consumers get evaluated, get the device and training they need. The Tech Act is not reimbursed by MSP because we are not providing that service. I hope that answers the question. Any other questions?

The last thing I would say is the Powerpoint is available. Lisa will be able to distribute that or put it somewhere where you can access it and if there are any questions, please feel free to e-mail me at anytime.

I send that out yesterday and was attached to the reminder. If anyone did not receive it, let me know and I will get it out to you. Thank you. Did someone have a question?

I am not sure I got your e-mail from yesterday's. This is Dan Clark. Is your e-mail in the invitation?

Yes. I have your e-mail, Dan. I have made a note to follow up with you.

I appreciate that. I'd like to look at the Powerpoint and get back to you, if necessary. We will see what we can do to tap into this.

All right. I think we will move on over to you, Lori.

In Oregon, our program is called [ indiscernible ]. It is very similar to the description you just heard in these sense that the AT part of our program works closely with providing demonstrations to centers, coordinator. However with the Oregon program, On the Move in Oregon asked us under our nonprofit umbrella to provide the actual assessment for the individuals. So, we provide daily living assessments not done through the Tech Act dollars, down through our nonprofit dollars. As we set up the program in early 2008, the individuals with the On the Move in Oregon did not one a face to face assessment or the consumers. They want to save money is because they wanted the assessment to be conducted over the phone. So, in doing so, we were, primarily, with the transition coordinators'. I was asked to let you know some of the difficulties and challenges we have experienced and some of the positive outcomes we have seen. One waiver started doing the daily living assessment, like any new project there is a learning curve of. We did not anticipate that the transition coordinators were not familiar with disabilities. We thought that they probably had a general knowledge of disabilities and thought they might be somewhat familiar with assistive technology, Environmental Control Unit, computer access, that kind of stuff. We also thought they probably had a general understanding of medical equipment as well as accessibility issues that the person would face when they were moving into their home or wherever they were going to be living. It was an eye opening experience to know they did not have any of this basic understanding. So, let me share with you how the assessment takes place. Unless there is unusual circumstances, we do not meet the person. Knowing that we cannot meet that individual bays to face, we cannot make a definite recommendation for a Product. If a person is moving from a nursing-home and need a power wheelchair, we can tell them that they need a power wheelchair and the report we provide will give examples that could be necessary based on the individual's needs. We also have to say they need an sufficient assessment. Sometimes we might have a dozen people on the phone call. We might have several transition coordinator is because the person is moving from one transition toward nature after region into another. We could have nurses on the phone. We could have an individual. It is a difficult assessment is because the more people you have involved, the more conflicting information you are going to have. The best way for us to conduct the assessment is we request pictures of the home that the individual is going to. We request measurements of the hallways and doorways, everything we need to make good decisions for them so that the person can receive the [ indiscernible ] and assistive technology they need. During the call, it is our job to discuss all areas of the individual's daily activities to learn what [ indiscernible ] they currently have and what is successful team the nursing home and what might or might not belong to them as well as what type of assistance the individual requires route the day to accomplish their task. Are they independent with their transfer? How many people transfer a system when they are transferring? We discussed their physical and cognitive abilities. Do we need to learn who would be assisting the client? Is it a family member? Do they have outside cared pay for providers coming in? Again, we have to know if they are living independently or if they are going to live in adult foster homes, that type of thing.

The challenges we have had, we did an assessment where we have received the pictures ahead of time. Sometimes it is difficult but we rely on the transition coordinator to provide the pictures of the home as well as the measurements prior to the assessment. We have got one particular instance where the pictures came the day of the assessment and did not have time to talk with the coordinator ahead of time. Sometimes we have a private conversation before the conference call. This particular case we did not. As we walk them through the assessment and were talking about accessibility of the home and identify the home has two doorways, that is great. The individual will be using a power wheelchair and talking about accessibility into and out of the home, the transition coordinator was very adamant that the home is wheelchair accessible but when you look that the picture you can see a dog that is having to stretch to reach the threshold of the doorway is because you have to have a conversations that if the dog cannot easily walk into the house, there is no way the person will be able to take the wheelchair into the home. They did not really understand what accessibility in the Home consisted of.

We have had other cases where the core nature might have decided that the person is going to receive a computer, they will be able to stay in Contact with their family across the state. We have helped them to identify the assistive technology they would need. Then, they made the purchase and the individual has become bedridden and the Zepa that was discussed as they have to start over. [ indiscernible ] like what they were going to do. They have part of the accommodations and not everything is because that is what we see in our Tech Act program all the time in. On the other side of it, they can pick and choose what they needed. They had a learning curve. We did hear that in Oregon since late 2008, Oregon has transitioned 300 individuals with the Money Follows the Person program and have provided, approximately, that one-third of those individuals with assessments to help identify the technology. As I mentioned, the transition coordinator is beginning to have made clear understanding of the technology. We can see a huge difference. Now the transition or neighbors are calling us more for information. We can just do a quick consultation on the phone instead of doing a full-blown assessment. We are seeing fewer and fewer assessments. They have hired a new person in or again that can address the needs for purchasing the equipment as well as the assistive technology. This person is very key in Oregon's program with making sure the person receives the right Technology. Before, the transition coordinator thought they just ordered a wheelchair. They did not know that the brand-the patients lived is what we were asking about and they did not know that. There our number lot of changes we have seen in Oregon. We have seen the growth. We could have done the same thing if they contacted with the Tech Act piece to do professional training for the core natures? Yes, we think they could have, but that is not what they wanted. They came about it a different way but we think we have the skills and knowledge to move forward and make sure the people are transitioning successfully. We have been really excited to be a part of it, regardless of what side of our program they access to get there. In Oregon we do know that On the Move in Oregon is great for purchasing computers and accommodations to allow the individual to [ indiscernible ] as well as environmental control units. Maybe the fact that they accessed the from our non-profit side we do assessments with them allowed us to see, first hand, that they were really receiving these technologies. They came from that side to train the individual on the new technology in. So, that is how we do that here. Any questions?

This is Dan Clark. I am curious you make the point that people cannot [ indiscernible ] accessibility issues. That is a process that they would have a better understanding of access issues that you are finding a picture-there is a threshold, a stepped up. We were shocked. The people that go into the home is the transition coordinator. In Ore., when we started, they were not sharing any of this information within their agency, much less with the other team members that were assisting individual who was transitioning.

What were the job qualifications to be paid?

I would like to have seen.


Carolyn Phillips says: In Georgia we have worked with MFP. As you experienced, there seems to be some misunderstandings on how AT can assist and how much it cost. Many folks think it cost too much and is not helpful. Any advice for AT Act Programs to educate more folks involved with MFP on AT? Advice on creating stronger connections with MFP programs? Thank you, Carolyn Phillips

Well, I think that is why we had a harder time to know the AT side of our programs because we wanted to talk assistive technology before we wanted to talk durable middle equipment and wanted to emphasize that piece of it. I do not know, again-I suppose you want these skill level of our transition coordinator when we started and do not know if they get it. Now they do. They come to us for Information on the assistive technology and under the AT side of the program, we do not have to know assistive technology. We do not have to be spending the money, we can be a Resource. We see them coming to us for computers. We see them coming to us because it is easier and faster. That is what the person needs. We are seeing them coming around more for the assistive technology. It seems like it came around the wrong direction, backwards. Any other questions?

We are going to move now to Nebraska with Bill and Lauren.

This is Lauren and I am a Resource--[ Audio/Speaker not clear] so, he can discuss how we manage MSP here and the things they are doing.

You will notice that she said that I get to speak briefly is because she must a too well. I am Bill, the gram Manager in Nebraska and we developed our program to use our existing waivers. Our individuals are assessed by the transition coordinator. They are sing all facilities in the state. Use a minimum data sets that is an assessment care and dental use to map long-term care and we have access to that. Got one of the questions on that is, do you have a desire to return to the community in. Currently, in Nebraska we have now made thousand people that have indicated they want to go to another environment other than long-term care. We are going to meet with each and every got one of these individuals and sharing information with them about Money Follows the Person [ indiscernible ] and in addition to that, we have a and list of resources that we connect our individuals to.

[Audio interference].

I am not sure what that is.

When I wrote the protocol, we concluded ATP and have had them and Bob in our advisory panel and Lauren and I and people with the ATP staff have worked on a number of projects together to coordinate services when we make a referral. We make the referral as a MSP recipients a notice connected with the MSP program. We have been able to keep good coordination [ indiscernible ]. Accessible and affordable housing is a real challenge. We are working with our Tech Act Nebraska and working on the housing website and doing some things and will let Lauren talk more about that. Here is some recent use that came out today that I will share. The conditions of MSP the sorry for at least six months. We received notice today that in the healthcare proposal bill that went through and looks like it will now be dropped down to 3 month. We are extremely happy about that. The second is there is a push with HUD and CMS to specify a voucher specifically to individuals that are transitioning from an institutional setting and is another great thing that has happened with MSP. That is on the grass that is doing things and we are happy to work with ATP and working with our concern as to get them the needed services. I will let Lauren talk about the other side and our collaboration's and then take whatever questions you might have.

All right. I am an advisory committee for the helping portion of Money Follows the Person and also at the beginning we met with all of the transition coordinators' about the it services the assistive technology partnership provides and the resources with it. When we get a referral from MSP [ indiscernible ]. That referral goes to our technology specialist and we have offices, and four offices in Nebraska depending on the region where the prison is transitioning into, an indefinite living situation is because they are evaluated and as is by it their technology needs and home situation [ indiscernible ]. For some reason if there needs can be met [ indiscernible ] we work with other programs and have other resources we can use to get them the assistive technology or the home modifications they need to transition into an independent living situation. One of the biggest barriers beside the physical barriers are trying to find [ indiscernible ] accessibility modifications is finding available housing. The accessibility and affordable housing is not easy to come by, especially in more World areas of Nebraska. --Especially in more rural areas of Nebraska. The assistive technology we were able to provide is our housing database. That is housing.ne.gov. It began in 2006 and is a free, online, real-time housing database that individuals can access throughout the state to find housing that meets their needs--[ indiscernible ] you can search forhousing, grocery stores and then the accessibility search. Individuals can search for available housing throughout the state that has grab bars or rolling showers. There is an extensive list that individuals can search for. They go into the nursing home and are identifying people that want to transition out. They can help them search for that housing in the area that meets their needs. For example if they want to be close to the doctor's office in a certain area they can search within a couple miles of that doctors' office. If any public transportation they considered for that also. It is housing that is available and can pull it up online and go and go to that apartment and see if it meets their needs. For individuals that do not have access we have a 800 number. It is a bilingual call Center and is translated into Spanish and also accessible for anyone that has visual or hearing disabilities. One of the great partnerships is they can use that and Money Follows the Person helps us promote that [ indiscernible ] we are getting the word about this program and how they can help people with disabilities in Nebraska. That was pretty fast. I am nervous and was talking fast. If anyone has questions, I would be happy to answer them.

This is Dan from California. I like the feature of real-time databases. How has that been promoted to get people to do this? I know people who have put on a ramp and so forth, but if they go to rent the house, how do they know where to give this information? How is it advertised?

Through the public service announcements and the advertisements we have done through them, that has been promoted through housing development. We have a lot of grassroots [ indiscernible ]. The other thing is when ATP goes in and modifies the an apartment or house that has been modified we ask on our forums that if this should ever come up for again, please list it on our housing.ne. gov site. If you put a ramp on a house or do some bad for modifications, the landlord has an outlet [ indiscernible ].

That is great. How long has this been up and running?

Since 2006. Or regionally, we were going to develop housing specifically for people with disabilities. We realize it could help the entire state. Economic development really likes this [ indiscernible ] they can look that the housing available in the community they need for the goods is really good for identifying the gaps that exist in housing with their state.

What is the website?

It is housing.ne.gov.

Great. Thank you.

I encourage everyone to look that it. We continue to improve and develop it. Any individual that might be transitioning from Mom and dad's house or college or transitioning into the state, they can use this. I want to point out that we develop this team that conjunction with a service called Socialservice.com and they are the ones that we contacted with us because they develop and maintain it is because they help us with marketing.

I have a questions because this is Annette in North Carolina. When you have someone who is transitioning out of a nursing home, is the first of [ indiscernible ] that they apply for or which one of those waivers that they would qualify for that? Are those waivers set up [ indiscernible ] have you seen those waivers expand their types of devicessism are you using that money from Money Follows the Person for the assistive technology?

First off, when we meet someone in a long-term care facility, the first thing is that they indicate that they want to leave. We try to interpret the conversation as to what that means and what they perceive or hope that they need for them? We do an assessment when we first meet them. That assessment helps us decide which waiver they might be best served by. There might be someone that has a Development disability, but the developmental disability needs are small and might bring them into the [ indiscernible ] waiver. We select the waiver and make the referral based on the information we have gathered from the information from the [ indiscernible ]. In regards to what they need when they come out of the facility, obviously, we are using ATP. There are many things out there that there are not funds necessarily associated to. That makes it more difficult. In Nebraska we just approved [ indiscernible ]. The Home again bonds provides to the individual transitioning to upgrade $1,600. That money can be used for a variety of things. It cannot pay rent but can pay deposits, furniture, computer, phone, a particular phone. That would be available to them through that restores. I am sure many other spaces. We have quite a few connections with nonprofits and local organizations that when we have a particular situation we can reach out and find people who are willing to support those needs that those individuals have.

Was that state money that was specifically designated with the 55 participantses?

No ma'am. It was built in and approved by CMS as part of our waiver.

Under the waiver, we can pay for modifications [ indiscernible ] so, if the two individual is requiring something that funds are not available for, [ indiscernible ] can be made through the assistive technology partnership. Our Service and device application of a multiple AT form that we use and partner with a number of different agencies and individuals can submit a requests through the Service and device application and based on the information we provide to sorry or that the other local agencies have in ordered to find the individual's needs.

Thank you.

You're welcome. Thank you for the question.

Any other questions? Does anyone else have anything to share on what their state is doing?

Carolyn Phillips says: Do you find AT being used in all of these folks served in Money Follows the Person?

We see it with individuals that we work with. All of the individuals referred have needs that we need to address [ indiscernible ].

This is Arlene. Can you hear me?


I would say in Connecticut that we have a large majority of transitioning individuals using AT and have individuals with very significant disabilities that have been in facilities and wanting to get out. Now they have an opportunity with housing and assistive technology and other assistance that will help them be successful in the community in. We have a large majority using AT. I do not have the numbers but could give something for you, if you really wanted it. We have made strong push in Connecticut for AT by consumers.

I would say the same in or again given the specific people we work with, the degree of disabilities that necessitated [ indiscernible ] that require assistive technology. I think it will lead to On the Move in Oregon to allow us to do the professional AT training to do this. Transition coordinator and will have a better understanding.

Carolyn Phillips says: Thank you

If anyone is on mute, it is #6 to go off of mute.

Can anyone describe their reimbursement arrangements for AT assessments to the AT providers?

In Oregon we contract-we wanted to do an annual contract and On the Move in Oregon wanted to do per person so they could track the money, specifically, with the client.

In Connecticut I would have to get back to you on that answer. I do not know the specifics. I know they contract with other entities to provide evaluation's. I cannot tell you about the reimbursement but would be happy to find that out and send an e-mail to you.

This is Lauren. I believe we have a contract with the Department of Health and Human Services and there is a per assessment charge and would go to HHS.

Carolyn Phillips says: How much are you charging per person for eval?

I believe it is his $8.50 per assessment. That is drawing up plans and getting quotes on projects when needed.

In or again we start at a lower rate with the expectation that if the a learning process for everyone. They kicked and screamed when we went to increase the rate. We are still at about $3.75 and to provide a very detailed report is because some can be 10 or 12 pages long.

Anyone else?

This is Rick in Virginia.

Are any of the assessments available [ indiscernible ].

In Oregon it is not because it belongs to the agency that contracts with us.

I think is the same way in Nebraska.


Again, I would have to check with Paul but would say probably it is not.

I appreciate that.

I will ask.

This is North Carolina. Is any of the reimbursement paid for by state money [ indiscernible ]?

No, not for Nebraska.

What about the other states.

Can you repeat your question?

Is there an assessment or service provided by the AT program? Is any of the reimbursement done by specific $8.50 funds or all done by waivers services or other programs the person is a part.

It is offered by the non-profit program.

Is that non-profit reimbursed?


Who reimburses them?

We are paid. We do a per person agreement for any of these services. We send out a quote.

That is for que?

MSP this thing that for you?


The Tech Act is probably not during the assessment, but MSP is for the evaluation ofism under another waiver program.

Thank you.

--Thank you to all the presenters. I really appreciate it. You give us some great informations the good of a note to everyone on the call, if you can fill out the evaluation I sent yesterday when I send out the reminder, and send them back to me, we would like your feedback in providing any information on additional teleconferences on other topics you might be interested in. If you have any questions, you can follow up with me and I can get you the information. If there are no other questions, have made great afternoon.

Thank you. Goodbye, everyone.


[Event concluded ]