DHCS Releases Draft Policy on Home and Community Based Services in the Duals Demo

The Department of Health Care Services has released for public comment draft policy on the inclusion of additional home- and community-based services in the duals demonstration.

Stakeholder Comments Submitted

First release of DHCS Policy on provision of additional HCBS in the Duals Demonstration
  • Draft HCBS Policy Paper (1/24/13) This document explains the department’s policy to expand the availability and use of additional HCBS by allowing demonstration plans to pay for these services out of the monthly payments they receive to provide care to their enrollees. This is the first release of this paper and we encourage stakeholder comments.
  • Draft HCBS Enrollment Flow Charts (1/24/13) This document contains a series of six flow charts to help promote a shared understanding of how these populations may receive certain HCBS under the CCI – either because beneficiaries are currently enrolled in a HCBS program or because they are seeking such services.  The options vary depending on a number of factors, including if the beneficiary participates in the Duals Demonstration.
Revised Documents
  • Updated Draft Care Coordination Standards (1/24/13) This document reflects significant stakeholder input received on the version released on November 26th, 2012. The Care Coordination standards continue to focus on the person-centered model of care, and have been streamlined from the previous version. Specific changes to this updated document include: 1) Defining the population subject to these standards; 2)Deleting of the references to National Quality Forum standards; 3) Expanding the risk stratification groups from three to four; 4) Changing the timing of the HRA assessment; 5) Clarifying who may conduct the HRA; and 6) Adding behavioral health and substance use elements.
  • Updated Draft Long-term Services and Supports Network Standards (1/24/12)  This version has gone through two iterations of public comment with previous versions being release on August 6th and November 26th, 2012. It describes the specific requirements that will be incorporated into the Health Plan Readiness Tool. Based on additional stakeholder feedback, the LTSS standards have undergone further revision and refinement.  The previous version of the LTSS standards required plans involvement and direct oversight of LTSS programs, which raised concerns that the State was somehow transferring its role as regulator to plans. There is also now a greater focus on service specific training for plan staff, in addition to, enhanced policies and procedures for communication between plans and providers, as well as beneficiaries and their representatives. These standards also will be required of health plans for the non-demonstration population receiving managed LTSS.

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