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.
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