IDD SRAC Subcommittee Work Plan - 25Sept2018.v1

9/25/18 Page 1 Confidential

Recommendation Subcommittee Date 1. Deloitte / UT Health study results Transition to Managed Care Jan-19

TBD a. Review & disseminate via SRAC updatesb. Subcommittee role TBD?

2. Comprehensive impact evaluation for transition to managed care model Transition to Managed Care

Create an Assessment Workgroup

2019 (use results from Deloitte/UT Health study)

a. Needs of the individualb. Impact on provider’s health plans: costs, operations, outcomesc. Recommendations for transition optionsd. Outline reforms needed for current IDD systeme. Recommendations for setting appropriate standards & metricsf. Evaluate key metrics:

i. Average monthly cost per person for acute care & LTSSii. Utilization of community integration & prevention of institutionalizationiii. Average total Medicaid cost, by LON, in various residential settingsiv. Percentage of individuals employed in meaningful, integrated settingsv. Overall client satisfaction (expand as needed)

3. Expand system capacity for LTSS: 2018-2019 a. Adequate provider network

i. Standards & MetricsSystem Adequacy

1. Rider 51 performance metrics - update, Janet Fletcher, HHCS2. High medical needs (Susan Murphree)3. Education & training - Erin Lawler to send out draft curriculum statement Oct 9 2018 mtg

a. Cross train MCO/Providers?ii. Urban vs. Rural

1. Telemedicine2. Maintain smaller providers - collect size & location data, Jennie Costilow, HHSC Oct 9 2018 mtg 3. Comprehensive provider framework - TBD? Survey tool?

iii. Certification requirements1. National Provider Identifier (NPI No.) for all service providers, including personal care attendants?

b. Employmentc. Community integration -

i. Housing - System Adequacyii. Meaningful Day - Day Hab/Employment

d. Transportation

Day Hab/Employment

System Adequacy Day Hab/Employment Day Hab/Employment

IDD SRAC Subcommittee Work Plan: SRAC Recommendation Letter

AGENDA ITEM #7-1

DRAFT

IDD SRAC Subcommittee Work Plan - 25Sept2018.v1

9/25/18 Page 2 Confidential

4. HIPPA compliant provider reporting & billing system System Adequacy Transition to Mgd Care

2018-2019 a. CARE system for HCS & TxHmL - IT project update, Trish Burkett, HHCS b. Collaborate with eHealth Advisory Committee - Hope Morgan, HHSC

Dec 4 / 11 2018 Oct 9 2018 - SA Mtg

5. New IDD LTSS assessment tool: implement, test, validate Transition to Managed Care Create an Assessment

Workgroup

Sep-22 a. Determine the resource allocation method b. Test new allocation method before any final decisions

6. Implement electronic eligibility & systems management for CLASS & DBMD System Adequacy

Transition to Mgd Care 2018-2019

a. Automate current DOS-based system - IT project update, Trish Burkett, HHSC b. Collaborate with eHealth Advisory Committee - Hope Morgan, HHSC

Dec 4 / 11 2018 Oct 9 2018 - SA Mtg

7. Electronic Visit Verification (EVV) implementation System Adequacy

Transition to Mgd Care 2018-2019

a. IT project update, Trish Burkett, HHSC Dec 4 / 11 2018 b. Evaluate portability options

c. Collaborate with eHealth Advisory Committee & Texas Council on Consumer Directed (TCCD) - TBD, HHSC Oct 9 2018 - SA Mtg

8. Policy changes & appropriations for HCBS settings requirements by 2022 deadline 2022 a. Day Hab settings Day Hab/Employment

System Adequacy

b. Residential Settings update from Kate(?), HHSC Oct 9 2018 - SA mtg

9. Grandfathering protections: assess sustainable business model Transition to Managed Care Jun-19

10. Person-centered implementation plan for transitioning to managed care, including: Transition to Managed Care Jun-19 a. Timeframes b. All changes necessary for success c. Recommendations for regulatory oversight, including publicly available data, identifying the IDD population, & appropriate performance measures d. Provider accessibility e. Ease of use f. LTSS benefit structure focused on need, preferences, and person-centered methods g. Financial investment & actuarially sound decisions on appropriate capitation rates h. Innovations to increase flexibility, independent living, employment, housing & transportation, & other individualized meaningful engagement opportunities in the general community i. Checks & balances to ensure individuals receive all necessary services, including those recommended by their primary care physicians & specialists j. Reporting mechanisms to track quality of life, health, & wellness outcomes that are specific to outcomes that are important to & for the individuals

DRAFT

Agenda Item #7-2