July 22, 2015

Next Steps In Wolf’s Managed Long-Term Services And Supports Plan

The Departments of Human Services and Aging Wednesday announced the next steps to Gov. Wolf’s plan to improve care coordination and to move to Medicaid Managed Long-Term Services and Supports.
These updates are the result of overwhelming responses to the public comment period and critical stakeholder input.
“From traveling the Commonwealth, meeting with hundreds of Pennsylvanians and gathering comments from hundreds more, we heard repeatedly the need for consumer choice, consumer involvement and the desire to be served in the community,” said DHS Secretary Ted Dallas. “Thank you for your passion and for your willingness to participate in the process – the steps we are announcing today will help Pennsylvanians have more choices and make it easier to live in the community. While we still have a long way to go, these initiatives are a step in the right direction.”       
“The response to the Commonwealth’s invitation for stakeholders to provide comment on Gov. Wolf’s plan to improve care coordination and move to a Medicaid Managed Long-Term Services and Supports program has been tremendous,” said PDA Secretary Teresa Osborne. “The reaction thus far has deepened our commitment to ensure that ample opportunities for continuous stakeholder engagement occurs.”
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.
The Departments will take the following steps:
1. Doubling the number of staff who work on Nursing Home Transition
-- 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.
2.  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 is 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. These webinars will be available at www.dhs.state.pa.us;  
-- 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; and
-- Encourage open communications. Questions can be submitted to RA-MLTSS@pa.gov.
3. 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 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.
Gov. Wolf’s person-centered initiative will result in a more strategic care delivery system and improve health outcomes for seniors and individuals with disabilities. MLTSS will create a capitated model that will improve care coordination and better health outcomes while allowing more individuals to live in their community.
The departments will host the first of several webinar updates Wednesday at 2:30 p.m. and will continue to meet with recipients, caregivers, advocates, providers and other stakeholders throughout the entire process.
For more information and to view the discussion document, visit the DHS Managed Long-Term Services and Supports webpage.