Arkansas Department of Human Services - AFMC€¦ · • In 2015, the Governor’s Health Care...
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Arkansas Department of Human Services DDS CES Waiver Provider and PASSE Care Coordinator Training April 20, 2018
Transcript of Arkansas Department of Human Services - AFMC€¦ · • In 2015, the Governor’s Health Care...
Arkansas Department of Human Services
DDS CES Waiver Provider and PASSE Care Coordinator Training
April 20, 2018
Agenda
• Purpose of training• Introduction to the PASSE• PASSE care coordination• Q&A session
PURPOSE OF THE TRAINING
INTRODUCTION TO THE PASSE
PASSE CARE COORDINATIONWHAT IS IT AND HOW CAN IT HELP OUR CLIENTS?
Melissa StoneDirector, Division of Developmental Disabilities Services
Background of PASSE• In 2015, the Governor’s Health Care Reform Task Force
brought in the Stephens Group to review and make recommendations for Medicaid reform
• The Stephens Group made several recommendations, including managed care and increased care coordination across divisions
• In response, the legislature passed Act 775, creating the Arkansas Provider-Led Organized Care system
• The goal of this system is to lower costs by increasing care coordination to eliminate gaps in care, not by cutting services
Timeline of ImplementationFeb. 1, 2018—Dec. 31, 2018: Phase I• During Phase I, the PASSE is only responsible for providing
Care Coordination• The purpose of this Phase is to allow the PASSE to lay a solid
foundation for continued care coordination while not having the risk of providing all services
Jan. 1, 2019, and forward: Phase II• During Phase II, the PASSE will be responsible for providing
ALL services a beneficiary needs• Care coordination must continue in Phase II
Definition of Care Coordination• Must work with providers to
ensure continuity of care across services
• Must promote activities focused on the health of the patient andtheir community
• Responsible for the total plan of care
• Responsible for obtaining copies of all treatment and service plans and coordinating services between them
PASSE Provider Manual, Section II, effective 10-1-17
Care Coordination
Total Plan of Care
Health Services
Medication Management
Medical-Health Services
Preventative Services
Circle of Support
The PASSE care coordinator will be responsible for coordinating the care of assigned beneficiaries across these multiple systems
Minimum Requirements of Care Coordination
• Making at least one face-to-face contact per month, with the first being in person
• Gathering all treatment and service plans for the beneficiary• Assisting the beneficiary in remaining in the most appropriate
and least restrictive setting for that beneficiary• Assuring 24/7 access to care coordination services• Coordination with other health care providers to ensure
continuity of care
DDS Patient PopulationThe PASSE will be expected to provide care coordination to DDS beneficiaries in these settings:• A private intermediate care facility (ICF)• In the community
– Those receiving waiver services– Those on the waitlist for waiver services
What if the Client is in an ICF?The care coordinator should:1) Reach out to the client and the family or primary caregiver2) Find out the long-term goals of the client and the caregiver3) Assist the facility in coordinating all services, especially those
that are not provided onsite4) Provide health coaching and education to the client when
needed
How could a care coordinator be beneficial to your clients? To you?
Care Coordination for CES Waiver Beneficiaries
• The PASSE care coordination is the equivalent of Waiver Case Management
• The care coordinator does not take the place of the primary caregiver, but supports them
• The PASSE must follow the conflict-free case management rules
• Until Jan. 1, 2019, CES Waiver Provider is responsible for the person-centered service plan
How could a care coordinator be beneficial to your clients?
To you?
Attribution of Waiver Clients• Will start on July 1• Want to work with providers to ensure smooth transition• Plan is to give Optum the name of the CES Waiver Provider
and the DDTCS, when applicable• First, DDS wants your input on this plan
PASSE Contacts
Robbie Nix, Assistant Director, DMS
501-686-9871
Melissa Stone, DDS Director
501-682-8662
Questions?
