Governor released his 2017-18 budget proposal which continues Cal MediConnect and MLTSS.
The State and DHCS are committed to increasing and improving the coordination of care for dual-eligible individuals. The budget reflects the Administration’s commitment to the principles of the CCI and making the necessary changes in order to make the Cal MediConnect program stronger.
When created, the Coordinated Care Initiative (CCI) contained a provision requiring the Department of Finance to determine if the CCI program is cost effective each January, and if not, the entire program would be discontinued the following year.
The Budget estimates that CCI will not be cost effective, thereby triggering a process that ceases all statutory provisions related to CCI as of January 1, 2018. Until then, DHCS is taking this opportunity to restructure parts of the program to make it cost effective.
Based on the lessons learned from CCI, the Budget proposes to extend the Cal MediConnect program, continue mandatory enrollment of dual-eligibles, and continue to integrate long-term services and supports (except IHSS) into managed care for two years. Some of the pieces of the CCI were found to be cost-effective and have the potential to improve the quality of care for those enrolled, and help keep individuals in their homes and communities, thereby leading to likely long term cost reductions.
Other changes under the Budget include:
- IHSS would no longer be included as a health plan benefit, but would continue to be available to eligible beneficiaries as a fee-for-service benefit, just as it was before implementation of the CCI
- Funding changes implemented under the CCI would end, and funding for IHSS would no longer be included in the capitation rates for plans
- Plans and counties would be encouraged to collaborate on care coordination
- DHCS, in conjunction with the Department of Aging (CDA), is proposing to delay for two years the transition of the Multipurpose Senior Services Program from a fee-for-service benefit to a benefit fully supported under the managed care plans
- Considering the budget proposal, the State does not plan to proceed with the Universal Assessment Tool. However, the State recognizes that a number of the proposed items developed through this process cover important topics that could be useful if addressed during the IHSS in-home assessment, and plans to assess if and how they may be leveraged by the IHSS program.
DHCS has been open about the challenges that have come with trying to integrate two very different health care systems in a way that provides improved and better coordinated care. We will continue to work closely with our plan, provider, and stakeholder communities as any changes to the program are rolled out.
To listen to a recording of the stakeholder call on 1-12-17 which discusses the budget announcement, click here.