Massachusetts

Main Contact: 
Ketly Jean-Louis: ketly[dot]jean-louis[at]state[dot]ma[dot]us
NWD/SEP System
Name of Operating Agency: 
Executive Office of Elder Affairs (EOEA)
Participating types of NWD/SEPs: 
ADRCs, CILs, AAAs, Aging Services Access Points
1-800 number: 
1-844-422-6277 (1-844-422-MASS)
Level I screen: 
Developed internally and available through the website and call center
Level II assessment: 
Completed by the appropriate assessing agency depending on service need.
Agency responsible for completing the financial assessment: 
MassHealth Enrollment Center
Coordination/automation of referrals between levels (i.e., Level I and Level II) : 
If the Level I screening results indicate a need for a Level II assessment, staff from the NWD entity or call center make the referral to the appropriate agency. Level I screening information is transmitted to that agency via secure email or phone.
Core Standardized Assessment
Elderly individuals (age 65 or older): 
Depends on service needs; Possible assessments include: MDS-HC; OASIS; Application Evaluation for PCA Services, Consumer Assessment
People with developmental disabilities: 
Depends on service needs; Possible assessments include: MASSCAP, Vineland II or ABAS II; OASIS; MDS-HC; Application Evaluation for PCA Services, Consumer Assessment
People with a serious mental illness or severe emotional disturbance: 
Depends on service needs; Possible assessments include: OASIS; MDS-HC; Application Evaluation for PCA Services, Consumer Assessment
People with physical disabilities: 
Depends on service needs; Possible assessments include: OASIS; MDS-HC; Application Evaluation for PCA Services, Consumer Assessment
Conflict-Free Case Management
Mitigation strategies in place/planned: 
Most of MA community LTSS are provided in a completely conflict-free environment. In addition, many strategies are in place to ensure consumer choice and satisfaction and the appropriate level of services.
Service data: 

Claims data

Quality measures: 

Medicaid Adult Health Care Quality Measures

For a set of the LTSS programs, Group Adult Foster Care (GAFC), Adult Foster Care (AFC), Personal Care Attendant (PCA) and Adult Day Health (ADH), MA currently contracts with the University of Massachusetts Medical School (UMMS) to conduct Non-Institutional Provider Reviews for LTSS. These site reviews and targeted chart reviews are conducted to assess quality metrics not readily available through claims data.

Outcomes data: 

MFP; Surveys from ASAPs; DDS National Core Indicator; Level II Assessment Tools 

Use of Enhanced FMAP: 

Funds are contributing to the following NWD System and Enrollment Process activities:

  • Enhance existing toll free numbers to include more community LTSS information and provide training for call center staff.
  • Establish a statewide NWD website that is informative and easy to navigate for anyone seeking information on community LTSS in the state.
  • Expand ADRCs’ onsite capacity for enhanced Options Counseling.
  • Ensure all NWD staff are knowledgeable about the full spectrum of community LTSS and trained on the coordination and completion of functional eligibility and financial eligibility for Medicaid.
  • Hire LTSS financial eligibility specialists who will work within the MassHealth Enrollment Center system and provide technical expertise for ADRC and state agency staff. 
  • Increase visibility of the NWD system among the general public through branding and a marketing campaign.

In addition, MA is increasing direct care worker wages and expanding community LTSS through more mental health community placements.