OLTL Updates LTSS Sub-MAAC Meeting Summary
In the October 8, 2019 Sub-MAAC meeting, updates were provided on enrollment, hard-to-place cases, and procurement of enrollment services. The session highlighted key issues addressed by commenters, such as conflict-free enrollment, training for case managers, technology integration, and stakeholder engagement. The presentation also included data on consumers eligible for OLTL services by program.
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OLTL Updates LTSS Sub-MAAC Meeting October 8, 2019 9/14/2024 1
Agenda Enrollment Updates Hard to Place Cases 2
Enrollment Updates 9/14/2024 3
Enrollment Services Procurement Enrollment Services Procurement Concept Paper Released for Public Comment Released March 22, 2019 for a 30 day comment period. Draft RFA Released for Public Comment Released June 28, 2019 for a 30 day comment period RFA Publication 45 day response period 4
Enrollment Services Procurement Enrollment Services Procurement Total Commenters: 38 Total Comments: 495 Comments addressed: Conflict-free enrollment and choice counseling Adequate training and reasonable caseloads for enrollment case managers In-home visit process Consolidation of clinical eligibility functions and the physician certification process Improved County Assistance Office (CAO) communication The need for an expedited application process for individuals with special or immediate needs Support for individuals with Limited English Proficiency The Beneficiary Support System (BSS) Process and impacts for nursing facility residents Use of technology to improve the application and enrollment process and provide more communication options Inclusion of specific performance standards in the IEB contract Public reporting of Independent Enrollment Broker (IEB) data Ongoing stakeholder input and leveraging the expertise of existing community-based organizations 5
Consumers Eligible for OLTL Services Monthly OLTL Participants by Program FFS Waiver/Act 150/LIFE Program Act 150 Aging Attendant Care Independence LIFE OBRA LTC Total FFS Waiver/ACT 150/LIFE Consumers 18-Jul 18-Aug 18-Sep 18-Oct 18-Nov 1,437 36,660 16,661 14,807 6,727 1,215 41,455 18-Dec 1,429 36,745 16,718 14,844 6,775 1,222 40,591 19-Jan 1,408 10,740 2,574 6,229 6,821 19-Feb 1,402 10,805 2,564 6,265 6,825 19-Mar 1,394 10,856 2,563 6,287 6,838 19-Apr 1,389 11,067 2,580 6,355 6,871 19-May 1,379 11,181 2,493 6,366 6,890 19-Jun 1,377 11,193 2,486 6,384 6,636 19-Jul 1,366 11,445 2,506 6,494 7,023 19-Aug 1,362 11,541 2,508 6,549 7,067 1,457 35,269 16,213 14,378 6,489 1,127 41,358 116,291 1,449 35,740 16,328 14,494 6,520 1,138 41,209 116,878 1,444 35,506 16,374 14,398 6,222 1,127 41,123 116,194 1,436 36,321 16,522 14,705 6,665 1,195 41,500 118,344 118,962 118,324 819 821 822 844 843 849 880 912 27,010 55,601 26,828 55,510 26,596 55,356 27,044 56,150 26,721 55,873 27,069 55,994 26,953 56,667 26,545 56,484 Managed Care (Community Health Choices) CHC-HCBS Duals CHC-HCBS Non Duals CHC-LTC Duals CHC-LTC Non Duals CHC-NFI Total Managed Care Consumers 18-Jul 18-Aug 18-Sep 18-Oct 18-Nov 9,142 3,152 10,353 18-Dec 9,286 3,201 10,479 19-Jan 43,619 18,849 22,087 2,326 19-Feb 43,774 19,093 21,958 2,342 19-Mar 44,247 19,401 21,977 2,349 19-Apr 44,431 19,602 21,801 2,354 19-May 44,717 19,847 21,869 2,331 19-Jun 45,238 20,131 21,862 2,335 19-Jul 45,638 20,399 21,870 2,324 19-Aug 45,874 20,637 21,850 2,349 8,750 2,960 10,265 883 57,060 79,918 8,889 3,019 10,335 904 57,749 80,896 8,972 3,049 10,325 901 57,629 80,876 9,076 3,109 10,334 909 57,695 81,123 894 917 57,530 81,071 57,600 126,759 126,159 126,045 125,764 125,623 125,342 125,290 124,873 81,483 213,640 213,326 214,019 213,952 214,387 214,908 215,521 215,583 NOTES: The data source for both Fee For Service and Managed Care data is CIS. Consumers eligible for services count if active at any time during the period. The most recent activity date determines what record to choose if more than one activity occurs within the month. Consumers counted only in CHC if they appear in both FFS and Managed Care during the month. Approximately 5% of the LIFE count includes those participants in both LIFE and a long-term care facility. 6
Waiver Consumers Eligible for Services Monthly HCBS Total Enrollment by Month 100,000 90,000 80,000 70,000 60,000 50,000 40,000 30,000 20,000 10,000 - FFS Aging FFS Non-Aging CHC 60 and over CHC Under 60 FFS Non-Aging includes: Attendant Care, Independence, and OBRA waivers Data Source: eDW Monthly Standard Reports 7
Current IEB Report All Waivers 2018QTR2 2018QTR4 2019QTR1 2019QTR2 All Applications 2018QTR3 25464 Grand Total 25505 24283 25320 26335 15842 Complete 15795 14703 15607 16277 12252 Complete in 90 Days Complete > 90 Days With Excuse 12833 12186 12068 14343 351 350 400 344 435 Compliance Percentage 80% 83% 86% 80% 91% Average Days To Complete 59 56 52 60 52 1. 2. 3. 4. All unduplicated applications in process this quarter Total unduplicated applications completed this quarter Total unduplicated applications completed during the quarter in 90 days Total unduplicated applications completed during the quarter and over 90 days, but with excuse of a delayed enrollment Using the above fields = (row 3 + row 4)/ row 2 Average to complete excluding excused applications Note: Reapplications removed 5. 6. Data Source: Maximus IEB 8
Current IEB Report Over 60 Grand Total Complete Complete in 90 Days Complete > 90 Days With Excuse Compliance Percentage Average Days To Complete 2018QTR2 2018QTR3 2018QTR4 2019QTR1 2019QTR2 14948 9303 7246 15072 9442 7604 14140 8586 7063 14937 9323 7312 15771 9885 8804 234 80% 57 231 83% 56 275 85% 52 221 81% 58 272 92% 50 All unduplicated applications in process this quarter Total unduplicated applications completed this quarter Total unduplicated applications completed during the quarter in 90 days Total unduplicated applications completed during the quarter and over 90 days, but with excuse of a delayed enrollment Using the above fields = (row 3 + row 4)/ row 2 Average to complete excluding excused applications Note: Reapplications removed 1. 2. 3. 4. 5. 6. Data Source: Maximus IEB 9
Current IEB Report Under 60 Grand Total Complete Complete in 90 Days Complete > 90 Days With Excuse Compliance Percentage Average Days To Complete 2018QTR2 2018QTR3 2018QTR4 2019QTR1 2019QTR2 10516 6539 5006 10433 6353 5229 10143 6114 4948 10383 6279 4751 10565 6392 5539 117 83% 62 119 78% 55 130 84% 70 123 84% 63 163 89% 55 All unduplicated applications in process this quarter Total unduplicated applications completed this quarter Total unduplicated applications completed during the quarter in 90 days Total unduplicated applications completed during the quarter and over 90 days, but with excuse of a delayed enrollment Using the above fields = (row 3 + row 4)/ row 2 Average to complete excluding excused applications Note: Reapplications removed 1. 2. 3. 4. 5. 6. Data Source: Maximus IEB 10
Hard to Place Cases 11 9/14/2024
Hard To Place Cases In August 2019, DHS issued an RFI on Complex Case Placement to learn more about how the department along with the departments of Corrections, Aging, Health, and Military and Veterans Affairs could better serve complex case populations that are eligible for commonwealth services and supports. The Complex Case population for the purposes of this RFI have been defined as individuals whose clinical or behavioral conditions, or personal history create challenges in securing housing and services. DHS is particularly interested in feedback related to serving these populations under a no reject, no eject policy in the following settings; Long-Term Care Facilities Community Placement with intensive integrated services The LIFE program Other known models of care 12 9/14/2024
