maryland department of health and mental hygiene 1 thursday, november 5, 2015
TRANSCRIPT
Maryland Department of Health and Mental
Hygiene
1
Thursday, November 5, 2015
Agenda
Introduction
Goal of PilotTier PilotingActivity to PilotRole of DHMH in the pilot
Standards and Technologies Under Consideration
Logistics
Ecosystem
Defining Success
Resources/References
Introduction: Pilot Team
Name Role Email
Kale Sweeney Co-Project Lead [email protected]
David Wertheimer Co-Project Lead [email protected]
Whitney Moyer Chief, ISAS Division
Lorraine Nawara Deputy Director, Community Integration Programs (Long Term Care)
Christin Whitaker Chief, COA Division (Long Term Care)
Introduction: Organization
• Maryland Department of Health and Mental Hygiene (DHMH), aka Maryland Medicaid
• We are the state Medicaid agency for the State of Maryland and one of the main payers for Maryland beneficiaries
• The state plan for Maryland Medicaid includes providing Long Term Supports and Services for Maryland beneficiaries
• Maryland launched its electronic LTSS system (LTSSMaryland) using funds from the Balancing Incentive Program (BIP). LTSS currently includes the beneficiary groups of Community Options Waiver, Money Follows the Person, Community First Choice (State Plan), Community Personal Assistance Services (State Plan), Increased Community Services, and Brain Injury, with Community Pathways (DD Waiver) and Medical Day Care planned for the future. We also have the In-home Supports Assurance System (ISAS) to ensure that service providers are in the beneficiaries homes caring for them when they say they are.
Pilot Introduction: Business Drivers
• Long Term Care (CFC, CO Waiver Programs, Brain Injury Waiver)
• Business use case: A platform where service plan information can be stored and service providers can be tracked. Use case is provider-based.
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Goal of the PilotUser Story 2
Pilot Workflow
• The current workflow is all user-initiated• The desired workflow is that we want to have
the users to–View their plan– Trigger specific events where a supports
planner would be able to assist them in the modification of their plan
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Which Tier are you piloting?
• Round 1: Tier 1• Round 2: Tier 2
What are you intending to pilot?
• Pick which one(s) apply• Access, View, Review Plan
• Have you identified a Service provider with which to work, if so who?• In Progress
• Do you know if they have an electronic system?• To Be Determined
• Do you know which sub-domains from the FR document will you pilot: – Work, Community, Choice & Decision Making, Relationships, Self-Direction, Demographics,
Person-Centered Profile, Medication, ADLs/IADLs, Safety, Behavioral Needs, Restrictions, Service, Financial/Payer Information, Service Information, Family Information, Community Connections, Access & Support Delivery, Information & Planning, and Health
What role do you play in the pilot?
• Beneficiary System• LTSS/Case Management Information• LTSS/Service Provider System• Payer• Please describe the role you intend to play in the pilot: – Identify population– Give access to plan– Monitoring compliance, user behavior, user feedback
Standards Under Consideration:
• Tier 1–Non Electronic – paper documents
• Tier 2– Electronic – .pdf or export files such as CCDs
• Tier 3 (future phase) – Secure exchange methods (HIE)
Pilot Logistics:
• Timeline – (April 2016 is end date for round one pilots)• Kick off: November 2015• Identify Partners/Providers/Beneficiary Pilot Population – December 2015• Complete Partner Data Use/Sharing Agreements – January 2016• Develop methods for producing and sharing eLTSS data – February 2016• Exchange eLTSS data via paper, fax, or other secure method – Early to Mid
March 2016• Receive Pilot Population Feedback – Mid to Late March 2016• Complete Pilot: April 2016
• Challenges:• Beneficiary access to technology• Beneficiary education and training• Setting baselines to monitor performance standards and improvement• Building incentives for beneficiary participation, both for pilot and beyond • Assessing business needs and modification of workflow within DHMH
Pilot Ecosystem
• Current or Potential Partners/Providers: – DHMH Long term care staff, supports planners,
agency providers, beneficiaries and their guardians/caretakers
• What electronic systems/what vendor(s) do they use to support their work:– Maryland LTSS/ISAS
• What electronic systems/what vendor(s) do you use to support your work:– Maryland LTSS/ISAS
How do you define success?
• Tier 1– Whether or not we can get beneficiary/participant
buy-in– User behavior and engagement with their
supports planners should be higher– Beneficiary Survey (before and after pilot)?
• Tier 2– System-level metrics– User behavior within client profile and/or service
plan
Helpful References
• Maryland Medical Assistance Programs: https://mmcp.dhmh.maryland.gov/SitePages/Home.aspx
• Maryland Money Follows the Person (MFP): https://mmcp.dhmh.maryland.gov/longtermcare/SitePages/Maryland%20Money%20Follows%20the%20Person.aspx
• Maryland Home and Community-Based Services (HCBS): https://mmcp.dhmh.maryland.gov/waiverprograms/SitePages/Home.aspx