Author: wendyp

August 15, 2014 – Last week, California’s Department of Health Care Services announced they will postpone the Alameda County and Orange County launch of the Coordinated Care Initiative until July 2015.

The Alameda County launch has been postponed half-a-dozen times since we received CCI and Duals Demonstration status in 2012. This final postponement, however, is the last, at least for the Duals Demonstration (now known as Cal MediConnect). After July 2015 the demonstration window closes and no new counties can enter until, presumably, California takes the next step, post-demonstration, in the planned CCI roll-out.

The state cited “plan readiness” (or lack thereof) as the reason for postponing the launch in both counties. In Alameda County, Alameda Alliance has been under state conservatorship since May, an action the state Department of Managed Care Services took citing Alliance’s low cash reserves and a claims backlog that was the consequence of a failed transition to a new IT system. While we haven’t seen the conservator’s 90 day report, we can presume that the schedule for Alliance’s return to fiscal stability is the reason for the state’s decision about plan readiness.

The Alliance’s conservatorship status was confirmed by a superior court judge on July 25 after hearing arguments against the takeover from the Alliance’s Board of Governors. The judge put a time constraint on the conservatorship: one year starting from the takeover date of May 5, 2014. It is the sincere hope of the aging services community that the Alliance will be returned to local control with its collaborative spirit and commitment to the community intact.

One question that the CCI postponement has left open is the status of Alliance’s Complete Care (its Special Needs Plan for Duals, or D-SNP). The Alliance had planned to close Complete Care and “cross-walk” its members into the new Cal MediConnect plan in January, and federal permission to do so is already in the works. With the announcement of the list of 2015 D-SNPs and other Medicare Plans just around the corner, a back-up plan will have to be adopted soon.

Timing, if the launch goes forward: A July launch date means that the first consumers to be subject to passive enrollment will receive letters in April, and packets with plan options and enrollment information in May.

Look for new training announcements and other resources from SSC in the first quarter of 2015. In the meantime, the new CCI Technical Advisor for Alameda County, Katharine Hsiao, and her colleague from Harbage Consulting, Shelly Grimaldi, will be reaching out to providers, CBOs and other community groups to ensure that these trusted sources are equipped to inform and assist seniors and people with disabilities, both this Fall and into 2015. If you haven’t heard from them, contact Shelly at shelly@harbageconsulting.com.

For those who want to track CCI implementation already underway in six CCI counties, NSCLC offers a biweekly CCI Advocates Alert (to subscribe click here).

 

To return to the CCI Policy Developments page, click here.

July 11, 2014 – On June 27, the Alameda County Board of Supervisors approved its 2014/15 Budget, including a directive to Social Services Agency Director Lori Cox and Health Care Services Agency Director Alex Briscoe to earmark emergency funding for senior services and to develop an integrated plan for providing long term, health and supportive services to seniors in Alameda County. Click here to read the memo that is now part of the County Budget.

The recommendation was advanced by Supervisors Nate Miley and Wilma Chan. Please take time to thank them, and to thank your own Supervisor for supporting the recommendation. Click here to go to SSC’s advocacy resources page for Supervisors’ contact information.

Will the funding be adequate? The recommendation does not state a dollar amount or a percentage increase. Instead, it directs the two Agency Directors to bring to the July 28, 2014 Social Services Committee Meeting “a strategy to earmark one-time only emergency stabilization funds” for community-based organizations that contract with the Area Agency on Aging for Older Americans Act and Senior Injury Prevention services.

These CBOs have been struggling to provide services to more seniors with increasingly complex needs in spite of historically inadequate funding. We hope that with oversight of the Board of Supervisors via the Committee and continued engagement on the part of stakeholders, the stabilization funding will make a meaningful difference for these resource-strapped programs.

Will a comprehensive plan deliver resources and build a more effective system? At the June 2013 hearing on the status of seniors, SSC urged the county to move forward to develop a comprehensive plan that will address its rapidly aging population and the increasing demand for senior services that are already straining the healthcare and aging services network. The new budget recommendation directs Social Services and Health Care Services Agencies to collaborate on an “integrated long term sustainable plan of service delivery to older adults” and bring that plan to a joint meeting of the health and social service committees in fiscal 14/15. If both agencies truly collaborate, avoid falling back into their silos, and tap into the knowledge of the aging services community, then we stand a chance of developing a plan that accurately identifies the needs, innovates the service network, and engages new financing strategies.

Last but not least…Also included in the Social Services Agency Budget for the new fiscal year is approximately $140,000 to backfill this year’s federal sequestration cuts. This funding means that units of service won’t be lost for Older Americans Act programs, but CBOs will face another year of complicated budget reports resulting from the staggered funding process.

Thank you to everyone who joined us in communicating the urgent need for County action to Supervisors and Agency leadership. We were heard!