ACL Touts the Benefits of No Wrong Doors Systems
We’ve seen game show logic puzzles portraying three doors, pointing out that there is a prize behind one of the doors but nothing behind the others. If you select the first door, the puzzle then asks whether you want to continue selecting that door or switch to the second door, as you are then shown that the prize is not behind the third door. How do you choose? The Department of Health and Human Services Administration for Community Living (ACL), in its own way, is doing what it can to to help states provide services to limit elderly citizens from dealing with the “wrong door” conundrum when attempting to gain access to Medicaid.
ACL recently issued a resource for state Medicaid programs detailing the benefits of leveraging Medicaid administration claiming for No Wrong Door (NWD) Systems functions. NWD Systems is an initiative launched by ACL and the Centers for Medicare & Medicaid Services (CMS), and their federal partners and advanced by states, that coordinates the networks of state and local agencies that provide information on and streamlined access to public and private long-term services and supports.
ACL notes that older adults and people with disabilities often face barriers and challenges when accessing long-term services and supports. Inefficiencies in the process to gain access to services can be costly if people don’t get timely and accurate information about helpful community supports. They may enter nursing facilities prematurely, costing the state money as Medicaid is the primary payer of long-term nursing facility care. Due to the complexity of Medicaid eligibility determinations, and the increasing aging and disability populations, the volume of Medicaid applications and re-certifications may place a heavy burden on the Medicaid enrollment and eligibility workforce. This demand leads to eligibility workers needing to focus on eligibility determinations and may not allow time for staff to provide additional support to individuals that are applying for Medicaid and/or needing home and community-based services.
To address this, state NWD Systems address access inefficiencies through a coordinated network of key partners and stakeholders, making it easier for people to learn about their options through established access points and person-centered approaches. ACL’s new resource details how state and community-based partners can obtain federal reimbursement for activities performed in support of Medicaid, such as application assistance, outreach and program planning.
The resource notes that federal reimbursement is available at a rate of 50/50 federal/state funding for activities such as facilitating applications for Medicaid, education and intake, as well as for time spent on Medicaid-related training and program planning. Activities that support the administration of preadmission screening and resident review, which is a federal requirement to help ensure that individuals are not inappropriately placed in nursing homes for long term care, as included in an approved cost allocation plan are eligible for 75/25 federal/state funding. States also can obtain 90/10 federal/state funding for costs to enhance a state’s Medicaid Management Information System to support the state’s NWD Systems building eligibility and enrollment systems, and 75/25 federal/state funding to operate and maintain the systems.
Perhaps the NWD Systems is the prize.
Join us for our following Thompson Grants event:
Nonprofit Legal, Finance, & Grants Conference | Oct. 1-2, 2024 | Arlington, Va.
Federal Grants Forum: Navigating the 2024 Uniform Guidance Changes | Oct. 29-30, 2024 | Virtual Event
