In a proactive response to the changing managed care environment, Alameda Alliance has created a new LTSS unit that will be primarily responsible for the Long-Term Supports and Services that are moving under managed care when the Coordinated Care Initiative launches. At the January 31st SSC Panel Discussion, Alameda Alliance’s Director of Outreach and Education for LTSS, Elizabeth Edwards, outlined five guiding principles which the Alliance is operating from as they prepare for the Coordinated Care Initiative:
1. Honor consumers’ existing relationships with medical and LTSS providers.
2. Supplement medical care through a robust assessment process and by developing plan based and community based care coordination activities.
3. Engage CBOs that provide significant services to the Duals Demonstration population.
4. Enhance scarce resources but not supplant existing funding sources.
5. Define and measure success as no disruption in care.
To realize these principles, the Alliance will be connecting with medical providers, supportive services providers over the next several months and beyond:
● Medical Providers – The Alliance’s work will include determining which medical providers are significant to consumers, and reaching out to these providers to create contracts and continue information sharing. (Community based organizations can assist in this process by sharing medical provider contact lists with the Alliance.)
● LTSS Providers – The Alliance will contract with the MediCal LTSS providers (IHSS, MSSP, SNFs) much like they are currently contracted with CBAS/ADHC providers. These contractual relationships will allow the providers to share any recent in depth assessments of consumers upon enrollment in Alliance, allowing Alliance to be better informed about new members’ status and service needs. Elizabeth described the assessment as key to ensuring that Alliance is able to “get folks into care that need it and find the people who are not getting the services that they actually need and make that transition easy for them.”
From the CBAS transition, the Alliance learned that the expertise currently existing within the community is an incredible asset. The Alliance wants to “make it possible for those community providers to… do what they’ve been doing.” Yet Elizabeth acknowledges that resources are scarce in the county and waiting lists abound, and that the Alliance cannot provide funding to fill all these gaps.
To return to the Changing Landscape page, click here.
For a report on the entire January 31st SSC Panel Discussion, click here.