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Massachusetts: Transforming Long-Term Care to Meet the Needs of Elders and People with Disabilities in their Own Communities
When many people think of long-term care, they often think of nursing home care. This is especially true for individuals who have Medicaid (known as MassHealth in Massachusetts) as nursing home care is a service Medicaid is required to pay for while many community services are not covered.
Massachusetts has been working to address barriers to community living through a series of “Systems Change Grants” funded by the Centers for Medicare and Medicaid Services (CMS) in addition to other state and federally funded initiatives developed under a “Community First Policy”. Examples of projects include nursing home transition, self-directed community-based services, collaboration between aging network providers and independent living centers, Comprehensive Screening and Service Model (CSSM), Senior Care Organizations, and Programs of All Inclusive Care for the Elderly and a number of other innovations. Some of these projects are in a piloting phase, others identified best practices, and others are fully implemented across the Commonwealth to assure individuals have the option of community prior to nursing home care.
In 2005, the Commonwealth was awarded the most recent “Systems Change” grant commonly referred to as the “Systems Transformation” grant. The purpose of this grant is to bring all of the initiatives together into a strategic framework while stimulating further progress related to quality management, financing of community-based long-term support, and housing.
The award, $2.89 million over five years (2005-2010), was divided into two parts. First, 10% of the funds were provided to complete the strategic planning process for systems transformation between October 2005 and May 2006. With the approval of the strategic plan in June 2006, the remaining funds were awarded to implement the strategic plan.
The grant focuses on three key goals that will help lift remaining barriers:
The Community First Systems Transformation Grant graphic depicts the organizational structure and communication flow of grant activities. To read a description of the graphic please click here.
The grants' Abstract gives a brief overview of the background leading to the grant and of the grant goals.
To access the full narrative of the grant, please click here .
To view the Appendices of the grant, click here .
Strategic Planning Process
A Steering Committee made up of approximately 40 participants who represent the disability and elder community, providers, and state representatives was formed to drive the work of the grant in October 2005. To learn more about the Steering Committee click here . In order to share information and seek involvement in the formulation of the three goal-specific subcommittees two community forums were held in December 2005. A great deal of consumer, state and provider interest emerged from the forums and the three goal-specific subcommittees were formed in January 2006. The subcommittees worked through May 2006 and presented a final strategic plan to CMS in early June 2006. During this strategic planning process CMS allocated 10% of the grant funds. The strategic plan was approved in late June and the remaining 90% of funds will be released going into the implementation phase of the grant.
The general information for the strategic plan submitted to CMS gives an overview of the stakeholders involved in the process, the process and more information regarding the goals.
Click here to learn more about the Quality Subcommittee.
Click here to learn more about the Diversion Subcommittee.
Click here to learn more about the Housing Subcommittee.