Under the Coordinated Care Initiative (CCI), the Multipurpose Senior Services Programs (MSSP) will transition from a federal 1915(c) Home and Community-Based Services (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 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 20 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 second set of Model of Care recommendations, which are available here . The public comment period will be open from now until close of business on Friday, February 8 to firstname.lastname@example.org.
Model of Care Workgroup Recommendations
The second set of recommendations from the Model of Care Workgroup includes a detailed process to determine appropriate use of purchased services at MSSP sites. These include:
- Assessment and Development of the Care Plan: The Workgroup recommends that providers determine a service or item as necessary to prevent elevation to a higher level of care.
- Emergency Care Plan: The Workgroup recommends that the provider create an Emergency Care Plan in the event that the specified services or items will be purchased.
- Informal and Formal Resources: Before purchasing items or services, the provider should determine if the service can be provided by the beneficiary’s support network, Medi-Cal, and/or a local organization.
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.