This is the first annual review of the integration requirements for Medicare Advantage dual eligible special needs plans (D-SNPs), completed for the Maryland Department of Health. The goal of D-SNP integration, which became effective in calendar year (CY) 2021, is to improve coordination of care transitions for individuals who are dually eligible for Medicare and Medicaid. To meet this goal, D-SNPs are required to notify the state designees (e.g., supports planners) of Medicare hospital and skilled nursing facility (SNF) admissions when members receive long-term services and supports (LTSS) through a home and community-based services (HCBS) waiver or state plan program. This review describes key findings from the first year of implementation, focusing on aggregate trends.

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This chart book explores utilization and expenditures for Medicaid-funded long-term services and supports (LTSS) in Maryland for state fiscal year (FY) 2016 through FY 2020. The focus of this chart book is on Medicaid nursing facility services, with one chapter that illustrates Maryland’s efforts at providing home and community-based services (HCBS) to an increasing number of Medicaid recipients who may otherwise be served in nursing facilities.

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Policy Analyst Advanced Roberto Millar, PhD, Senior Programmer Erick Geil, and Director of Aging & Disability Studies Christin Diehl co-authored this article published in the Journal of Applied Gerontology.

In Maryland, residential service agencies deliver Medicaid home and community-based services (HCBS) to older adults with disabilities through direct care workers. Leveraging survey data from residential service agency administrators, this study describes agency characteristics and participant and family caregiver experiences by participant dementia status. Findings lay the foundation for future longitudinal and embedded interventions within Medicaid HCBS.

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The Community Supports Waiver provides community-based services and supports to individuals of all ages with developmental or intellectual disabilities. This infographic presents information for fiscal years (FYs) 2019 and 2020.

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The Family Supports Waiver provides community-based services and supports to individuals aged 21 years or younger with developmental or intellectual disabilities. This infographic presents information for fiscal years (FYs) 2019 and 2020.

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Autism Waiver services enable individuals who have autism spectrum disorder and who meet an institutional level of care to be supported in their own homes or community-based settings. Due to the high demand for Autism Waiver services and a defined capacity, individuals wishing to receive waiver services must have their name placed on the Autism Waiver Registry. This infographic presents data about the list and its registrants for FY 2018 to FY 2022.

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The Community Pathways Waiver provides community-based services and supports to individuals with developmental or intellectual disabilities. The waiver includes both self-directed and traditional service delivery models. This infographic presents information for fiscal year (FY) 2016 through FY 2020.

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The Model Waiver provides services to individuals with medically complex needs and a chronic hospital or nursing facility level of care to be supported in their own homes or community-based settings. A unique aspect of the Model Waiver is that, due to the medically complex needs of its participants, non-waiver expenditures typically far exceed waiver expenditures. This infographic provides information for fiscal years (FYs) 2016 through 2020.

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The Brain Injury (BI) Waiver provides services to individuals aged 22 or older with a brain injury diagnosis who require specialty hospital or nursing facility level of care to be supported in their own homes or community-based settings. Each year, the Maryland Department of Health strives to serve an additional ten participants through the BI Waiver. This infographic presents information for fiscal years (FYs) 2016 through 2020.

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Autism Waiver services enable individuals who have Autism Spectrum Disorder and who meet an institutional level of care to be supported in their own homes or community-based settings. This infographic provides information about Maryland Medicaid participants who received services through the Autism Waiver in fiscal years (FYs) 2016 through 2020.

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