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Home & Community-Based Services: State-Only Funded Programs in Minnesota

States may be required to contribute match funding to some federally funded long-term care (LTC) programs and to different extents. In FY 2003 states spent 21.4% of total state expenditure on Medicaid (NASBO, 2004). Total expenditures for HCBS are increasing and totaled $16.4 billion in FY 2001, with states paying between 1.7% and 13.3% of total health care expenditures on HCBS in FY 2001 (Milbank 2003). Medicaid spending grew quickly in the early 2000s, forcing state legislatures and officials to investigate ways to contain Medicaid costs rather than expanding services (Coleman et al 2003).

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Program Name: Alternative Care³,⁴,²⁴

Administrative Agency: Dept of Human Services

Population Served: Elderly 65+

Annual Expenditure: $55,807,000 FY05

Funding Source: General revenue

Number of People Served: 7,557 FY05

Eligibility Criteria: Low income & assets, at risk of nursing home placement (nursing home level of care). Individuals who do not meet the financial eligibility requirements of Medicaid. Income & asset limit FY02 - combined income & assets are at/below $22,819 (income & assets would cover 6 mths/less of nursing home costs based on individual's level of need).

Further Information: Cost control: No cost caps. No service limits applied. Co-pay on sliding fee scale ($1,292/mth - 175% FPL pay 25%of cost of services, excluding case management). Quality control: site visit, random interviews. Consumer direction Can be consumer directed. Other information 2003 - eligibility criteria tightened, expansion of mthly fees which meant some beneficiaries dropped out of the program. This may be part of a larger program with an FY02 appropriation of $65 million.

Program Name: Non-waiver MA Home Care²⁴

Administrative Agency: Dept of Human Services

Population Served: Elderly

Annual Expenditure: $15,83,000 FY05

Funding Source: N/A

Number of People Served: 3,380 FY05

Eligibility Criteria: N/A

Further Information:

Program Name: Senior Nutrition⁴

Administrative Agency: Dept of Human Services

Population Served: Elderly (60+)

Annual Expenditure: $2,740,000 FY02 Appropriation

Funding Source: General Revenue

Number of People Served: 88,000 FY02

Eligibility Criteria: No income or asset limit

Further Information:

Program Name: Caregiver Support⁴

Administrative Agency: N/A

Population Served: Elderly (60+)

Annual Expenditure: $453,000 FY02 Appropriation

Funding Source: General Revenue

Number of People Served: 7,000 FY02

Eligibility Criteria: No income or asset limit

Further Information:

Abbreviations:

AAAs - Area Agencies on Aging.

ADL - Activities of Daily Living.

AT - Assistive Technology. Dept - Department.

FY - Financial Year.

HCBS - Home & Community-Based Services.

LTC - Long Term Care. Mth - month. Rehab - Rehabilitation.

Mth - month.

Rehab - Rehabilitation.

SCI - Spinal Cord Injury.

SSBG - Soical Services Block Grant.

TBI - Traumatic Brain Injury.

Wk - week.

Yr - year.

Footnotes:

(a) Note that some figures listed are the yearly appropriation, not expenditure.

(b) Sources of funding are listed in the language with which they are reported.

(c) The figures for number of participants are not necessarily figures for unduplicated participants.

Notes:

(1) The definitions of the services provided in programs may differ between states.

(2) Unless otherwise stated, programs are statewide.

(3) Programs where it is known that funding may come from a variety of sources, including non-state only funds (e.g. Older Americans Act) are indicated by the program name in italics.

(4) The table does not include Mental Health Services programs.

(5) All information is the most up-to-date found from secondary sources noted in the references.

(6) N/A means the information has not been found (not available).

(7) all programs primarily aim to support people to live in the community, therefore there may be additional state only funded programs but these are not directly to support HCBS.

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