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Long Term Care Services and Supports in Michigan Single Points of Entry SPE Legislation . Jan Christensen JD, MSW . Medicaid Long Term Care Task Force . The Vision:
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Long Term Care Services and Supports in Michigan Single Points of EntrySPE Legislation Jan Christensen JD, MSW
Medicaid Long Term Care Task Force • The Vision: • Michigan will achieve over the next ten years a high quality, easily accessible, publicly and privately funded system of long term care supports and services. • The arrangement and type of care and supports for each person will be determined by “person centered planning.”
“For the Last Two Decades Michigan’s Elderly and Disabled Citizens have Pleaded for a More Humane, Consumer and Family Friendly LTC System.”
“We will, of course, do the right thing but only after we have tried everything else.” Winston Churchill
Medicaid Long Term Care Task Force – Single Points of Entry • Create a System of Single Points of Entry: • Person Centered Planning / Supports Coordination • Mandatory Medicaid Access Point; • Nursing Home Transition; • Level of Care Determination; • Quality Assurance; • Advocacy / Consumer Appeals; and • SPEs are non-direct service providers
“Your eyes won’t see too clearly if your imagination is out of focus.” Mark Twain
Office of Long-Term Care Supports and Services and Medical Services Administration Long-Term Care Single Points of Entry Request for Proposals (RFP) Released Pursuant to Governor Granholm'sExecutive Order 2005-14
Single Points of Entry Required Collaborators for SPE: • Local Department of Human Services • County Community Mental Health Services Program and/or the Pre-Paid Inpatient Health Plan for • Medicaid Specialty Services • Area Agencies on Aging • Nursing Facilities – at least 50% in region • MI Choice Program Agencies • Hospitals/Health Systems – at least 50% in region
Medicaid Service Providers Private Service Providers Hospice Organizations Local Public Health Departments Home Health Services Organizations Centers for Independent Living Local Advocacy Organizations for Aging and Disability Populations Local organizations supporting LTC issues (religious, volunteer, fraternal, philanthropic) Individual Consumers Regional Governing Authority or Authorities (e.g., county boards, multi-county agreements) Community Action Agencies Housing Authority(ies) County-based or Operated Long-term Care Providers Multipurpose Collaborative Bodies Transportation Authority(ies) Dementia Services Agencies, Organizations, Providers Traumatic Brain Injury Services Agencies, Organizations, Providers Organizations representing specific cultural groups Municipalities with populations of more than 100,000 persons Others as Appropriate Additional Collaborators
SPE DELIVERABLES 3.01 SPE Program Transition and Initiation • Task A: SPE Initiation and Development 3.02 Planning and Collaboration • Task B: Regional Needs Assessment, Planning, and Coordination 3.03 Outreach and Public Education • Task C: Outreach and Public Education Plan • Task D: Health, Risk, and Safety
SPE DELIVERABLES 3.04 Information and Assistance Activities • Task E: Use and Development of Informational Materials • Task F: Information and Assistance Process Development 3.05 Long-Term Care Options Counseling • Task F: Proactive Choice of Benefits Counseling • Task G: Functional Eligibility for Medicaid Supports and Services • Task H: Person-Centered Planning Process
SPE DELIVERABLES 3.06 Ongoing Supports Coordination • Task I: Ongoing Supports Coordination • Task J: Provide urgent and emergent support • Task K: Program or Service Transitions 3.07 Quality Management • Task L: Development of a Comprehensive Quality Management System
SPE Proposal Review • Each Proposal Reviewed by Three Reviewers: • LTC Facilities • Government • Olmstead Coalition • Presentation to Nine Member Panel • Top 3-4 Proposals Selected
Questions About SPEs • Who has applied? • How will you ensure objectivity? • Isn’t it another layer? • Isn’t it too costly? • How will you know it will work?
Henry Ford is quoted as saying:“Coming together is a beginning… Keeping together is progress… Working together is success!!!”