April 20, 2017

3rd

Thursday

Webinar

Jennifer BurnettDeputy Secretary

Office of Long-term LivingDepartment of Human Services

Welcome to the Third Thursday MLTSS Webinar

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Communications/Outreach for

Community HealthChoices

April 20, 2017

54/21/2017

4/21/2017

Communications Goals

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• Educate participants, providers, family members,

and stakeholders on changes coming.

• Eliminate confusion regarding transition plans.

• Align HealthChoices with Community HealthChoices

events and communications whenever appropriate

and possible.

4/21/2017

Timeline

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• We heard from advocates, consumers, and providers

concerning the CHC and HealthChoices implementation

timeframe.

• Adjusted the timeline accordingly and included a

phased-in approach:

4/21/2017

4/21/2017

Communications Activity

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• Current

– Strategy meetings to discuss interconnectivity of programs

– Website redesign

– Creation of deliverables

– Outreach event planning

• 20 events in the SW for CHC

• Mid-summer provider education session in the SW

– Provider and staff training development

• Ongoing

– Social media

– Third Thursday webinars

4/21/2017

CHC Outreach & Deliverables

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Aging Well will:

• host public education sessions to assist participants in

understanding CHC, what it means for their services, and

what steps they need to take to ensure they have access to

providers of their choice; and

• train providers on CHC.

Communication Development is underway:

Updated Fact Sheet

Glossary/Acronym Guide

Updated Timeline

4/21/2017

CHC Website

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4/21/2017

CHC Provider Webpage

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4/21/2017

Provider Communications

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MARCH 2017

• General email sent update providers on CHC-MCOs and basic CHC information

• Behavioral health-specific provider message on CHC to go out

APRIL 2017

• Provider-specific docs to be uploaded to CHC page

• OBRA letters will go in advance of the participant letters to SCs, AAAs, and waiver providers

• CHC provider bi-weekly updates begins

MAY 2017

• Notification to COMMCARE providers sent

4/21/2017

Participant Communications

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CHC Zone 1 CHC Zones 2 – 5

MAY 2017

• Letter mailed to OBRA participants regarding their Level of Care Determination (LCD) assessment

JUNE 2017

• Letter mailed to OBRA participants who were NOT found to be NFCE telling them that they will stay in OBRA

JULY 2017

• Initial mailer sent to CHC participants to give them initial information

• Outreach events are held for healthy duals

• Nursing facilities begin CHC communications with their residents

• Service coordinators begin CHC communications with their participants

• COMMCare participants notified that they will move to Independence

4/21/2017

Participant Communications

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AUGUST 2017

• Outreach continues

• Attendant Care and Independence participants ages 18 to 20 notified that

they will move to OBRA

SEPTEMBER 2017

• Outreach continues

• Transition notice mailed to participants

• Information on the MCOs mailed by the IEB

4/21/2017

Participant Communications

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CHC Zone 1 CHC Zones 2 – 5

OCTOBER 2017

• Transition notices mailed to new participants who were not captured in September

• IEB continues to follow up with calls and mailer to assist with plan selection

• Letter mailed to OBRA participants in Zone 2 regarding their LCD assessment

NOVEMBER 2017

• Transition notices mailed to new participants who were not captured previously

• IEB continues to follow up with calls and mailer to assist with plan selection

• Letter mailed to OBRA participants in Zone 2 who were NOT found to be NFCE telling them that they will stay in OBRA

CHC Protests and Appeals

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• Selected offerors were announced: August 30, 2016.

• Protests were filed by unsuccessful bidders

– Protests filed with DHS

– Appeals filed with Commonwealth Court

– Status of Injunction

CHC Today

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• Greenlight – What does that mean?

– Established e-mail communication with MCOs

– MCO Kick-Off Meetings:

• March 30, 2017 Rate and Contract Agreement

• April 6, 2017 Readiness Review

• April 12, 2017 MCO/DHS Information Systems

• Upcoming—May 4, 2017 Performance Measures,

Provider Files, Enrollment, and Credentialing

– Meeting on Contract Agreement and Rates on April

17, 2017:

• AmeriHealth Caritas – Patty Wright

• Pennsylvania Health and Wellness – Joshua Sloop

• UPMC for You – Ray Prushnok

Rate and CHC Agreement Status

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• March 30, 2017 met with the Three (3) plans to

discuss:

• CHC Timeline Overview

• Communications

• CHC Rate Setting Methodology

• Data and IT

• LIFE Program and CHC

• Program Evaluation

• CMS Waiver Authority Requirements

• Related Procurement Activity

• Readiness Review Process

• CHC Draft Agreement Noted Changes

LIFE Continues with CHC Implementation

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• Known nationally as the Program of All-inclusive Care of the

Elderly (PACE)

– Integrated managed care program for individuals age 55 and over,

needing the level of care provided in a nursing facility

– Provides long-term care, acute care and behavioral health services

to its older citizens through an interdisciplinary approach

• Currently LIFE programs are available in 39 counties across the

commonwealth

• The LIFE Program will continue to operate as an option for

eligible individuals in geographic areas in which LIFE is

available

• Here is a link for more information about the LIFE Program:

PA DHS - LIFE (Living Independence for the Elderly)

Kickoff Meeting held on April 6, 2017 with CHC-MCOs

• Each MCO had approximately ten (10) staff in attendance.

• Reviewed the RR Process and Timelines.

• Work to Obtain System Access and Business Partner Agreements.

• Schedule Weekly Calls

• Ongoing Coordination with Multiple DHS program offices that will

occur during the RR process for All Zones.

• Technical Assistance Session with CHC-MCOs scheduled for May

4, 2017 to review quality, provider files, enrollment, and

credentialing.

• OLTL and Department of Health (DOH) are currently engaging

Stakeholder input on a monthly basis to develop LTSS Network

Standards for CHC.

CHC Readiness Review (RR) Update

Functional Eligibility Determination (FED) Tool

• New FED tool beginning late fall 2017 as part of the

participant eligibility determination for LTSS

• Stakeholder Webinar held on March 20, 2017—over 45

individuals were in attendance.

• New FED tool will be more consistent and less subjective,

and provide for a more valid gateway to Medicaid-funded

services.

• Upcoming Assessors Training on April 26, 2017 to test and

validated the tool.

• In May of 2017, the FED tool will be tested with participants

entering into the program in selected counties.

• Implementation scheduled for late summer of 2017

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IEB Update

OLTL is working weekly with Maximus to address

Customer Service improvement.

• Staff have been trained to use an escalation process

and we have received very few complaints on this

issue since January.

• Significant improvements in Customer Service of the

Call Center staff.

• Referrals are now being made by the Call Center to the

ADRC and information is provided on all denial letters

from the IEB.

• New Request for Proposals (RFP) was released on

April 7, 2017 for re-procurement of the IEB.

• Link to the RFP: PA - eMarketplace

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DHHS Unification

• On January 30, 2017, Governor Wolf announced his

plan to create a Department of Health and Human

Services (HHS) in his 2017-2018 budget in order to

promote more effective collaboration and service

delivery, enhance program effectiveness, and eliminate

duplicative processes.

• Several Hearings held with Senate and House Members

in the past several months, and meetings are continuing.

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