On July 22, the Departments of Human Services and Aging announced the next steps in Governor Wolf’s plan to improve care coordination and move to Medicaid Managed Long-Term Services and Supports (MLTSS). These updates are a result of overwhelming response to the public comment period and stakeholder input.
Along with feedback on how MLTSS should be implemented in the Commonwealth, the departments heard feedback on changes that can be made today to improve the current system. They will take the following steps:
Doubling the number of staff who work on Nursing Home Transition (NHT)
PDA and DHS recognize that current processes to move individuals who are able to be better served in the community from institutional settings are lengthy and complicated. To address this, the departments will:
- Increase the number of staff assigned to NHT from 5 to 10;
- Identify and implement strategies intended to
- improve the process
- enhance program outcomes
- advance the opportunities for individuals to either avoid premature placement and/or transition back into the community;
- Evaluate and redesign the entire NHT process; and
- Increase training for all current NHT staff and providers.
Creating an advisory committee with at least 50 percent representation by participants and caregivers and conducting monthly webinars
Throughout the MLTSS public input sessions, participants, advocates, and providers made it clear that more education, involvement, and communication are necessary as the Commonwealth moves to MLTSS. In order to accomplish this, the departments will:
- Host monthly webinars on the third Thursday of every month.
- Create an MLTSS Advisory Committee that will meet under the federally mandated purview of the Medical Assistance Advisory Committee (MAAC).
- MLTSS program participants will comprise half of the membership, with the remaining half representing provider communities
- Opportunities for participation via telephone for increased accessibility and convenience
- This committee will meet bi-weekly
- Encourage open communications; questions can be submitted via email.
Restructuring existing contracts to provide more choice for participants
Issue a procurement for a home modification quality improvement program in August 2015: In some cases, the transition from a nursing home to living in the community can be accomplished through a simple home modification such as the installation of a ramp for wheelchair access. The new procurement will streamline the current process to make this easier to complete these modifications, while at the same time ensuring that only high-quality contractors complete the work. The contracts will include two providers in each part of the state to provide choices in completing the work.
Issue a financial management services procurement in November 2015: There is currently one statewide vendor that acts on behalf of the consumer to make payroll, withhold and report taxes, and pay bills for individuals in home- and community-based waiver programs. Moving forward, multiple vendors will be awarded the contracts to ensure choice, and they will be required to maintain a regional presence throughout the state.
Award New Contracts for Independent Enrollment Broker (IEB) Services in November 2015: One of the most significant barriers to serving individuals in the community is the length of time it takes to enroll someone in home- and community-based services. The new contracts will be awarded in four regional lots and include new, strong performance standards, to ensure that the vendors are held accountable and participants are not stuck waiting for services.