MSSP Transition Model of Care Workgroup Releases Recommendations for Public Comment

Under the Coordinated Care Initiative (CCI), MSSP will transition from a federal 1915(c) HCBS waiver to a fully integrated Medi-Cal managed care benefit in the CCI counties no sooner than January 1, 2020. In preparation for this transition, the Department of Health Care Services (DHCS) and the California Department of Aging (CDA) have convened a Model of Care Workgroup composed of Multipurpose Senior Services Program (MSSP) sites and managed care plans.

This Workgroup is tasked with developing recommendations for a model of care for the new Home and Community-Based Services Care Planning and Management (HCBS CPM) benefit that will take the place of the MSSP program in CCI Counties. The workgroup has met 13 times since January 2018 and will continue to meet and work through outlined areas of the program. The first set of recommendations have been completed.

DHCS and CDA are seeking public comment on this first set of Model of Care recommendations, which are available here. The public comment period will be open for the month of September, with comments being due by close of business on Monday, October 1 to info@calduals.org.

Model of Care Workgroup Recommendations
The first set of recommendations from the Model of Care Workgroup include:

  • Eligible Members: The Workgroup recommends gradually expanding eligibility for the HCBS CPM benefit to beneficiaries age 62 years and older, while maintaining the same level of care criteria.
  • Data Sharing: The Workgroup developed a series of recommendations on how plans and providers could work towards improved data sharing, including bidirectional data sharing, real-time data access, and eventually fully integrated care plans and member data.
  • Joint Care Planning: The Workgroup developed a joint care planning process for plans and HCBS CPM providers to coordinate care for both members in Cal MediConnect and in Medi-Cal managed care.

Background
CCI was designed to improve coordination and integration of care for dual beneficiaries (people who are enrolled in both Medicare and Medicaid). A significant component of CCI is to enhance coordination for long term services and supports (LTSS) benefits such as the Multipurpose Senior Services Program (MSSP). MSSP sites provide social and health care management for seniors who are 65 years of age or older who qualify to reside in a nursing home but wish to remain in the community. MSSP sites provide services such as housing assistance, meal services, transportation, and chore and personal care assistance.

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