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San Diego Long Term Care Integration Project

San Diego Long Term Care Integration Project. LTCIP Planning Committee August 9, 2006. Ideal System. In-Home Services. Primary Care. Acute Hospital. Meals Service. MRS. C. Day Health Care. Transit. Medical Specialty. Skilled Nursing Facility. Mrs. C & Care Manager.

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San Diego Long Term Care Integration Project

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  1. San Diego Long Term Care Integration Project LTCIP Planning Committee August 9, 2006

  2. Ideal System In-HomeServices PrimaryCare AcuteHospital MealsService MRS. C. DayHealthCare Transit Medical Specialty SkilledNursingFacility Mrs. C & Care Manager Journal of the American Geriatrics Society, Feb. 1997

  3. San Diego Stakeholder LTCIP Vision for Elderly & Disabled • Develop “system” that: • provides continuum of health, social and support services that “wrap around consumer” w/prevention & early intervention focus • pools associated (categorical) funding • is consumer driven and responsive • expands access to/options for care • Utilizes existing providers

  4. Stakeholder Vision (continued) • Fairly compensates all providers w/rate structure developed locally • Engages MD as pivotal team member • Decreases fragmentation/duplication w/single point of entry, single plan of care • Improves quality & is budget neutral • Implements Olmstead Decision locally • Maximizes federal and state funding

  5. Strategies Developed to Support “Vision” • Aging & Disability Resource Center • Physician Strategy • Healthy San Diego Plus

  6. Long Term Care Integration Project Organizational Chart & Decision Tree San Diego County Board of Supervisors & State Office of Long Term Care Jean Shepard,Director County of San Diego, Health & Human Services Agency, (HHSA) • Internet • Facilitates communication • Provides broad public education Pamela B. Smith, Project Director Evalyn Greb, Project Manager Aging & Independence Services Lead County Agency Advisory Group: Goal: Make final decisions and recommendations for inclusion in the plan. Planning Committee: Goal: Guide the LTCIP planning process. Suspended Workgroups pending need for further action/decision-making Health Plan Partners Workgroup Finance/Data Workgroup Options Workgroup Personal Care Services Workgroup Community Education Workgroup LTCI Strategies: 1) Network of Care 2) Physician Strategy 3) Healthy San Diego Plus Workgroups: Care Management, Provider Networks, Cultural Responsiveness Explore use of public health education models that promote improved chronic care management for LTCIP Determine the financial feasibility of the proposed LTCIP for San Diego County. Make recommendation to Planning Committee on how to best integrate PCS into the fully integrated model. Explore use of the Healthy San Diego model for potential Service delivery system for LTCIP. Governance -Mental Health & Substance Abuse -Info/Technology -Quality Assurance -Scope of Services -Workforce Issues -Developmental Disabilities -Community Network Development www.sdltcip.org

  7. Aging & Disability Resource Center (ADRC)/Network of Care • Beta testing with • consumers and caregivers • community based organizations • MDs, other providers, Call Center staff • To develop “continuous quality improvement” program • Measure behavior changes of providers and consumers • Funding: Federal Aging & Disability Resource Center grant application

  8. ADRC Update • Revised Year 3 Work Plan • Supplemental funding request to strengthen partnership with disability community

  9. Physician Strategy • Partner w/physician “champions” • Develop interest/incentive for support of “after office” services (HCBC) • Identify care management resources to link physicians/office staff to patients • Train on healthy aging, geriatric/chronic care management, pharmacy, HCBC supports

  10. Physician Strategy Update • CA Endowment request to fund Implementation Plan: • Finalize/deliver community care management/team training for health and social service providers • Develop, evaluate outcome measures • Enhance IT infrastructure, decision support tools, resources, etc

  11. Healthy San Diego Plus (HSD+) • Builds on San Diego’s geographic managed care model for Medi-Cal • Medi-Cal Aged, Blind, and Disabled (ABD) offered voluntary enrollment • Service delivery model that provides full continuum of health and social services • Pooled Medi-Cal & Medicare $$ • Care manager and member in “hub”

  12. HSD+ Update • Governor’s proposal/AB 2979 • “Medicare HMO Wraparound pilot” • For dual eligible ABDs only • Rates to include skilled nursing facility (SNF) & adult day health care (ADHC) • Supported by Medicare Modernization Act (SNPs) and Budget Deficit Reduction Act

  13. www.sdltcip.org • Get on LTCIP mailing list for updates • Attend Planning Committee meetings • Log onto website for background & info • Call or e-mail input/ideas: 858-495-5428 or evalyn.greb@sdcounty.ca.gov or 858-694-3252 or sara.barnett@sdcounty.ca.gov

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