Division of Medical Assistance Grant Opportunities

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NC Money Follows the Person Demonstration Project: NC Transition Bridging Team Project 2017-DMA-001

Division Issuing Notice: Division of Medical Assistance

Date of Notice: Aug. 9, 2016

Purpose: Money Follows the Person (MFP) is a Medicaid Demonstration Project that assists eligible individuals in transitioning from qualified long-term care facilities into their homes and communities with appropriate support. As a demonstration project, MFP also examines and works to improve functions, processes and expectations related to quality transition practices. More information on North Carolina’s Money Follows the Person Demonstration Project (NC MFP) is available at http://dma.ncdhhs.gov/providers/programs-services/long-term-care/money-follows-theperson.

As described in the Background section, NC MFP is sponsoring this RFA to address the lack of coordination at the time of transition for behaviorally complex individuals with developmental disabilities.

In an effort to better address the needs of targeted, transitioning individuals, the Department shall pilot a Transition Bridging Team concept to implement and evaluate the efficacy of certain transition-related interventions.

Managed by selected LME-MCOs, the Transition Bridging Teams will support identified individuals who experience a dual diagnosis of intellectual and developmental disabilities (I/DD) and serious behavioral challenges and are transitioning out of a PRTF or the state’s Development Center Specialty Programs and into community settings consistent with the Home and Community-Based Services Final Rule. While the level of Bridging Team involvement may vary, the Team will provide intensive, “hands on,” time-limited oversight and technical assistance to community-based support networks. Essential functions of the Bridging Team are outlined in Appendix C, while applicable timeframes are outlined in Appendix D.

Description: For the past several years, NC MFP has supported behaviorally complex individuals with I/DD to transition out of NC’s State Developmental Centers and PRTFs. As a result, NC MFP directly experiences the challenges in ensuring true continuity and linkage to integrated community-based options for this population. Advised by its partners within the Local LME-MCOs, Division of Medical Assistance (DMA), Division of Mental Health (DMH) and Division of State Operated Health Facilities (DSOHF), MFP has identified particular issues in ensuring:

  1. Adequate and continuous access to community-based behavioral health supports, including pre-transition planning and post-transition technical assistance;
  2. Effective community-based staff training on behavioral health support needs and strategies;
  3. Effective collaboration with local school systems (as relevant) to ensure behavioral support strategies are applicable and effectively applied within the school;
  4. Individuals who experience I/DD and behavioral health support needs have meaningful opportunities to become engaged, contributing members to their communities.

To better ensure continuity of care during times of transition, MFP also recognizes transition planning requires deliberate overlap, with community-based resources actively engaging in pre-transition training and planning. However, despite increased attention to this approach, community-based services cannot always comply with this preferred practice, resulting in spotty and inadequate staff training and gaps in service continuity. NC MFP’s transition experience also reveals the need for a more intensive “hands on” period for clinical and staffing consultation and assistance immediately following the transition.

Eligibility: Transition Bridging Team funding is available to approved LME-MCOs. Bridging Team services shall be available in the selected LME-MCO’s catchment area. All LME-MCOs, including those currently participating in the System of Care pilot initiative, are eligible to apply. 

How to Apply: Please see Request for Application 2017-MFP-001 Section 11: Application Content and Instructions

Deadline for Submission: Questions: Aug. 15, 2016

Submission: Extended to Sept. 14, 2016

How to Obtain Further Information: Please see Request for Application 2017-MFP-001 or email dma.bridging@dhhs.nc.gov

Documents

Request for Application (RFA) 
​RFA Questions and Answers

 

NC Money Follows the Person Demonstration Project: NC Transition Coordination Partnership 2017-DMA-002

Division Issuing Notice

Division of Medical Assistance

Date of Notice

Aug. 9, 2016

Purpose

The purpose of this Request for Application is to pilot transition concepts that are intended to expedite and streamline the transition of individuals from qualified long-term care facilities into their homes and communities with appropriate support.

Description

Medicaid beneficiaries transitioning out of long-term care facilities frequently require an interdisciplinary approach to ensure their community-based support needs are adequately addressed. However, the traditional service models in NC have “siloed” physical health, behavioral health and long-term care services, resulting in fragmented transition planning and unnecessary lag in the transition process. This RFA intends to promote more cohesive transition practices by:

1. Streamlining transition coordination and case management functions, and
2. Incenting partnership with other entities in order to fully address the support needs of transitioning individuals.

The Department will select no more than four applicants to serve as North Carolina's Money Follows the Person Demonstration Grant (NC MFP) lead transition agencies in four of the five defined regions to accomplish the following program objectives:

  • To pilot transition concepts that are intended to expedite and streamline the transition process;
  • To prepare for key elements of Long-Term Services and Supports (LTSS) Medicaid Reform including expedited waiver assessments to minimize institutional stays and improved coordination of care with other responsible entities;
  • To better meet the transition population demand in identified catchment areas;
  • To test the theory that if case management and transition coordination are housed within the same entity, long-range transition timelines and outcomes will improve;
    • Selected contractors will participate in DMA-sponsored evaluation of the transition process;
  • To strengthen essential cross-entity collaboration among partnering entities including but not limited to:
    • Enrolled programs utilized by the NC MFP Participants, including Community Alternatives Program for Disabled Adults (CAP/DA), Program of All-Inclusive Care for the Elderly (PACE) and Division of Vocational Rehabilitation Services - Independent Living Services (DVR-IL);
    • Community Care of North Carolina;
    • Behavioral Health Managed Care Organization/Local Management Entity (MCO/LME);
    • DVR-Independent Living Services;
    • Centers for Independent Living;
    • Area Agencies on Aging;
    • Regional medical centers/hospitals/acute care facilities.
  • To assist the State in examining the integration of concepts and services that build service capacity for transitioning individuals with high support needs:
    • Examination of tele-support technology where appropriate; and
    • Examination of alternative living options for NC MFP individuals.

Contractor is not expected to pursue these options for NC MFP Participants but rather to participate in exploration and discussion that will inform the future direction of the CAP/DA waiver and its authorized living arrangements.

  • ​To partner with other selected applicants to examine and make recommendations on topics and concepts identified as Transition Quality Improvement initiatives.

Eligibility

Eligible Applicants must currently serve as the Community Alternatives Program for Disabled Adults (CAP/DA) Lead Agency in one of the catchment areas listed below, or have a contractual relationship with one or more CAP/DA Lead Agencies in the selected catchment area, or demonstrate ability to establish such contractual relationships by September 9, 2016, by submitting letters of partnership from identified CAP/DA Lead Agencies in the application submission.

Each eligible Applicant shall be a community–based, public or private nonprofit, tax-exempt organization (including faith-based), school system, tribal government or local government agency that is duly incorporated and registered under North Carolina Statutes.

How to Apply

Please see Request for Application 2017-MFP-002 Section 12: Application Content and Instructions

Deadlines

Questions: Aug. 15, 2016
Submission: Aug. 31, 2016

How to Obtain Further Information

Please see Request for Application 2017-MFP-002 or email Diane Upshaw.

Documents

Request for Application
​RFA Questions and Answers

 

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