State of California—Health and Human Services Agency
Department of Health Care Services
TOBY DOUGLAS EDMUND G. BROWN JR.
DIRECTOR GOVERNOR
California Dual Eligibles Demonstration
Long-Term Services and Supports Workgroup
Meeting # 1: Thursday, May 3, 1:00 to 3:30 pm
Network Readiness
Location: California Department of Social Services
Office Building No. 8 Room No. 235-237, 744 P St. Sacramento, CA 95814
Call-in Number: To receive a unique call-in and pin number for the meeting, use this link: http://bit.ly/IpcnzT. If you need help registering, please call 916-552-8684
1:00 to 1:10 Introduction to Overall Work Group Process
Margaret Tatar, Chief, Medi-Cal Managed Care Division, Department of Health Care Services (DHCS)
An introduction to the overall stakeholder work group process.
1:10 to 1:20 Work Group Approach for LTSS
· John Shen, Chief, Long-Term Care Division, DHCS
· Lora Connolly, Director, Department of Aging
· Sarah Steenhausen, Senior Policy Advisor, The SCAN Foundation.
A discussion on the goals of the LTSS workgroup and strategy for future meetings.
1:20 to 1:30 Existing LTSS Services by Demo County and Number Dual Consumers
Lora Connolly
The work group will be presented with data regarding the types of existing LTSS services and the number of dual eligible individuals receiving those services in each of the Demonstration Counties.
1:30 to 2:00 How do health plans think about LTSS capacity today?
· Sarita Mohanty, Medical Director, Medical Management, L.A. Care Health Plan
· Peter Schied, Medical Director, CalOptima
· Candice Gomez, Interim Executive Director, LTC Integration, CalOptima
The work group will be presented current approaches to assess network capacity.
2:00 to 2:30 Setting a Frame for Thinking about Readiness and Capacity in LTSS
John Shen, Lora Connolly, Sarah Steenhausen
· Do traditional views of network adequacy apply to LTSS?
· What does capacity and adequacy mean in LTSS?
2:30 to 3:15 Principles for Plan Network Readiness Standards
John Shen, Lora Connolly, Sarah Steenhausen
· Given the frame discussed for network readiness in the 2pm session, what standards should plans be required to do in order to pass readiness for LTSS services?
· Solicit input on establishing LTSS readiness standards and contractual arrangement between LTSS and managed care plans.
· Solicit input on Plans’ reporting on LTSS network.
· Discuss the CMS matrix as a tool for stetting Demonstration standards.
3:15 to 3:30 Wrap up and next steps
Lora Connolly
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