Voluntary Foster Care Agency Leadership Forum Follow-Up

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1 Voluntary Foster Care Agency Leadership Forum Follow-Up Funding Application Process & Preliminary Work Plan Decision-Making June 25, 2015: 1 pm 2:30 pm 1

2 2 Objectives Present the vision for the child welfare system, and the role of the voluntary foster care agencies in the new Medicaid managed care environment Review contract process and formula for allocating readiness grants Offer information around work plan development and organizational decision making (work plan required for contract process) Highlight training and other key project dates for Summer/Fall 2015 and beyond

3 3 Agenda 1.Welcome Andrew Cleek, PsyD, Executive Officer, NYU McSilver/CTAC 2.Overview: Vision for the Child Welfare System Through Transition and Beyond Laura Velez, Deputy Commissioner, Child Welfare and Community Services, Office of Children and Family Services, and Ray Schimmer, IPRO Consultant 3.Foster Care Grants and Application Process Lana Earle, Deputy Director, NYS Department of Health, Division of Program Development & Management, Office of Health Insurance Programs 4.Preliminary Work Plan Development and Decision Making Andrew Cleek, PsyD, Executive Officer, NYU McSilver/CTAC 5.Questions and Answers

4 Vision for the Child Welfare System Through Transition and Beyond 4

5 5 WHY and WHAT S AT STAKE? Message from Ray Schimmer Why? A question that is never a waste a breath: The introduction of Health Homes and the introduction of many new services within Medicaid Managed Care are opportunities to create a system that will produce better personal, life-long health platforms for foster children, children served by child welfare, and others severely afflicted by poverty and illness, than they have ever had in history. What s At Stake: Need to reduce risks inherent in transformational reform by: Seizing opportunities for participation Working with families and children to facilitate a smooth transition

6 6 WHEN WE ARE SUCCESSFUL, WE WILL HAVE: Established new 6 State Plan Services and an array of Home and Community Based Services that will afford providers new missionpotential and diversified contracting options that are Medicaidbillable. Served more children and families by creating a new category of service: Level of Need. Built upon the expertise of the Child Welfare community as providers of these new services, we will have integrated child welfare, primary medical care, and behavioral health for foster children during and after their time in care. Expanded the larger concept of health care to include behavioral health and essential social services. Incorporated managed care methodologies to generate efficiencies and improved the effects of services purchased for children by their communities.

7 7 WHAT TODAY IS ABOUT New York State wants Child Welfare providers to succeed they need you to succeed; children and families need you to succeed. If you are confused and overwhelmed, you are not alone, and help is available. If you understand basic concepts and details, and can spread them through your organizations, you have a once-in-a-career chance to be part of extraordinary systemic change.

8 8 Foster Care Managed Care Readiness Activities A collaboration between IPRO, the New York State (NYS) Department of Health s Office of Health Insurance Programs (OHIP) and the New York State Office of Children and Family Services (OCFS). Its purpose is to ensure the achievement of important activities that will facilitate the transition of children placed in voluntary agencies to Medicaid Managed Care.

9 9 Timeline of All Foster Care Readiness Activities February March April May June July August September Data Collection (EHA) Data Collection Activities Preparedness Assessment (CTAC) Work Plan Development (CTAC) Kick-Off Webinar Agencies Complete Surveys Survey Results Leadership Forum Managed Care Training (CTAC) Health Home Training (NYCCP) Work Plan Technical Assistance (including Webinar June 25), Development of Readiness Plan and Work Plan Needed to Submit Contract Work Complete by Mid August Anticipated Contract Approval Date October 1, 2015 Managed Care Trainings thru July Health Home Trainings thru December h_homes/health_homes_and_children.htm

10 Foster Care Readiness Grants and Contract Process 10

11 11 Contract Approval Process We are working to secure contract approval by October 1, 2015 Process for submitting contracts is underway and includes: Securing OSC approval of allocation formula VFCA development and submission of work plans/budgets DOH/OCFS review of work plans/budgets VFCA & DOH sign contracts: mid-august OSC and AG approve contracts - October

12 12 Draft Formula to Distribute Readiness Grants to VFCAs $18.5 million in readiness grants to be distributed via individual contract with each VFCA The proposed DRAFT formula to distribute the grants is a two tier formula: Tier 1: Allocates $50,000 to each VFCA Tier 2: Allocates the balance using the individual VFCA percentage of days to total days Total Award: Tier 1 plus Tier 2 The formula is DRAFT because it is subject to OSC approval DOH/OCFS will distribute proposed schedule of awards by the end of the week

13 What You Need to Work on Now to Be Ready to Submit Contract to Gateway How will you determine how you will spend your readiness grant? Managed Care Readiness Assessment Survey Completed by VFCA and requirement to be eligible to receive grant Using Survey - complete Readiness Template - Identifies Gaps in Readiness Using the Readiness Assessment Form develop a Readiness Work Plan to Address Gaps and Get Ready! From the Readiness Work Plan, make a determination about how you would like to use your grant readiness allocation The Survey, Readiness Assessment Form, and Readiness Work Plan will be required to submit your contract Also: plan to be responsive to requests from the Department to facilitate process and provide information (e.g., Vendor IDs, etc). The proposed contract term is 10/1/15 3/31/16. This is the period in which expenditures can be made. 13

14 Andrew Cleek, PsyD, Chief Executive, McSilver Institute Community Technical Assistance Center of New York 14

15 15 About CTAC & Managed Care (MCTAC) CTAC was founded in 2011 as the Children's Technical Assistance Center (now the Community TAC of NY) In September 2014, the Managed Care Technical Assistance Center launched in partnership with NYS DOH, OMH, and OASAS, to help to prepare providers transition to Medicaid Managed Care CTAC & MCTAC are offering: Foundational information Support and capacity building including tools & training on critical domains necessary for Managed Care readiness

16 Readiness Plan Development and Decision Making Strategy 16

17 Survey to Help Foster Care Agencies Assess their Managed Care Readiness Voluntary Agencies completed a Managed Care Readiness Assessment Survey to help assess the degree to which they are ready to operate in a Managed Care environment Completing the Readiness Assessment was required in order to apply for a Foster Care Grant you may need to share your survey with the Department for contract approval The Contract process will require VAs to use Readiness Assessment results to develop a Readiness Plan that identifies how the agency plans to use its grant allocation to fulfill its readiness needs 17

18 18 Readiness Plan Development Using a template and individualized results of the readiness assessment, agencies will develop individual strategies as part of the contracting process with DOH. Agencies will be guided through what options and activities are intended for Day One readiness and ongoing transition TA needs. Activities and actions across the respective domains have been developed for agencies to consider in their planning

19 19 OCFS Readiness Assessment Domains The 11 domains assessed were as follows: 1. Understanding MCOs 2. MCO/Health Home Contracting 3. Communication/Reporting (Services authorization, etc.) 4. IT System Requirements 5. Level of Care (LOC)/Level of Need (LON) Criteria/Utilization Management Practices 6. Member Services/Grievance Procedures 7. Interface with Physical Health, Social Support and Health Homes 8. Quality Management/Quality Studies/Incentive Opportunities 9. Finance and Billing 10. Access Requirements 11. Demonstrating Impact/Value (Data Management & Evaluation Capacity) Aggregate Mean Score of 11 Domains

20 Score Domains: Mean Scores Readiness Assessment Domain Scores Domain * Responses were scored from 1 to 5, with 1 indicating the lowest degree of readiness.

21 Voluntary Agency Readiness Benchmark Report 21

22 Readiness Assessment Form Template - From Survey 22 Objective Readiness Survey Domain Areas 1. Finance and Billing (Finance) 2. MCO Priorities 9. Finance & Billing 2. IT System (IT) 4. IT Systems Requirement 3. Interface with Physical Health, Social Support and Health Homes (Interface) 4. Data Driven Decision- Making (Data) 7. Interface with Physical Health, Social Support and Health Homes 1. Understanding MCO Priorities & Present Managed Care Involvement 5. Level of Care (LOC) Criteria / Utilization Management Practices 6. Member Services/Grievance Procedures 8. Quality Management/Quality Studies/Incentive Opportunities 10. Access Requirements 11. Demonstrating Impact/Value (Data Management & Evaluation Capacity)

23 Readiness Plan 23

24 24 Readiness Plan Areas Objective: the overall objective that will be accomplished by participation in the readiness activities Domain Area and Readiness Score: the category assessed in the readiness survey and the corresponding score (found on the benchmark tool) Tasks: areas of technical assistance in which your agency staff can participate to build capacity around the specific domain area Performance Measures: specific means to measure progress in the domain area, such as outcome measures, data analysis, and careful tracking of progress Resources Needed: funds, administrative support, or infrastructure needed to succeed in building capacity for each domain Funding Sources: sources from which your agency can obtain financial resources for these projects (i.e., grant allocation) Estimated Completion: set a realistic but strict timeline to complete the tasks laid out in your work plan

25 25

26 26 Successful Readiness Plan Development Designate a Medicaid Managed Care Readiness project team including: Executive leadership Finance & Clinic leadership Evaluation staff when available Review application and allocation letter closely and bring questions (also refer to FAQs!) Attend foundation of managed care training and office hour(s) as needed Work from benchmarking tool and possible initiative activities list

27 27 Strategic Decision Making How will I know what I need? First, consider whether: My agency will provide primary healthcare, behavioral health, and/or substance abuse services My agency will become a downstream Health Home Care Coordinator We are still not sure

28 28 Strategic Decision Making (cont.) Consider your Agency s current business structure: Do we have an Article 31 or Article 28 license? Do we currently have contracts with Managed Care? Is Medicaid billing a significant portion of our business? Do we use revenue cycle management? What is our experience and comfort level with outcomes, utilization management, and credentialing?

29 Strategic Decision-Informed Work Plan Creation for Medicaid Managed Care Transition 1) Develop a business plan for operating under Medicaid managed care This informs build vs buy question and leads agencies to a major leading question for EHR which is... 2) Does it make sense for agencies to form affiliations (IPAs) or legal entities to formalize partnerships or merge in order to best meet needs of clients and be fiscally viable long-term? 3) EHR purchase & implementation. Decision making process review of current documentation and adapting now with future system/need in mind, EHR implementation plan and/or formal contract in place. 29

30 Using the Benchmark Tool to Inform OCFS Voluntary Agency Work Plans Step 1: identify the domains in which your agency had the lowest scores Step 2: consult the recommendation tool for capacity building activities and identify activities that are pertinent to these domains Step 3: focus primarily on these domains when creating your work plan: allocate the most resources (administrative, financial, etc.) to the areas with the lowest scores, however Step 4: don t completely ignore domains for which you had higher scores it is important to remember that the success in the upcoming transition requires attention to all 30

31 31 Available Options to Consider Use the recommendation tool to identify routes to capacity building within your organization Section I: Infrastructure To Succeed In The New Managed Care Environment Data analytic capacity Section II: Effective Channels For Communication Within your organization Across the system of care Section III: Capacity For Continuous Clinical Improvement Improving service delivery Section IV: Successful Business Practices For Working With MCOs Contracting IT system development Section V: Delivering And Demonstrating Value And Impact Communicating your agency s value to MCOs

32 32 Readiness Plan Implementation Have your Medicaid managed care transition team meet regularly to review progress, new opportunities, challenges, and areas where support or assistance may be needed Commit to investing the time and effort needed to assess, diagnosis, improve, and monitor your organization s operations, business practices, and financial performance through the transition and beyond Utilize the available trainings, tools, and resources and send feedback/suggestions to ocfsta.info@nyu.edu

33 Upcoming Trainings and Technical Assistance 33

34 34 Web-Based Office Hours 7/8 & 7/22 Office hours are designed to review information for agencies from questions that arise between trainings or webinars. For purposes of this initiative, agencies will have opportunity to bring questions that are arising as they develop their readiness work plans as well as general questions about Medicaid managed care transition. CTAC recommends sending questions ahead of time so any clarifications can be made prior to the office hour. Questions and answers are reviewed and often added to the standard Q&A documents for the project.

35 35 Foundations of Managed Care Full-Day Training CTAC is partnering with Health Management Associates (HMA) to provide OCFS Voluntary Agencies with the most critical and foundational information over the summer around the transition specifically tailored for OCFS Voluntary Agency Leadership team members CEOs and CFOs of agencies with little to no experience billing Managed Care and/or Medicaid should especially be in attendance Training will be offered three times: New York City: 7/24 Buffalo: 7/28 Albany: 7/30 Curriculum developed by HMA in partnership with: NYS agencies, advocacy groups, IPRO and project partners The Managed Care Technical Assistance Center (MCTAC)

36 Foundations of Managed Care Full-Day Training (Cont.) A short, self-diagnostic tool is distributed in advance for providers to complete and refer back to during the training After a series of presentations and discussion, agencies are provided with breakout time to talk through work plan creation Attendees come away with: Options to consider for addressing infrastructure needs Ideas of immediate next steps to take to refine decision making 36

37 Foundations of Managed Care Full-Day Training (Cont.) Topics include introductions and overviews of: Understanding MCO priorities Managed care terminology MCO contracting Level of care (LOC) criteria Utilization management practices Finance & billing Member services & grievance procedures Access requirements Interface with physical health, social support & health homes Quality management, quality studies and incentive opportunities Demonstrating impact and value IT system requirements 37

38 38 Functional Assessment Overview Approximately one dozen multiple choice questions or statements Response options: Strongly Agree, Agree, Disagree, Strongly Disagree, Don t know/na Providers can use this tool to open a dialogue with stakeholders No right or wrong answers Please submit your answers online and bring a hard copy to the training

39 39 Sample Assessment Questions Do you: Strongly Agree, Agree, Disagree, Strongly Disagree, Don t know/not Applicable? 1. I understand the basic theories underpinning Managed Care, including the priorities of MCOs. 2. My organization will be prepared to manage a Medicaid Managed Care revenue cycle. 3. My organization has the programmatic and technological systems in place to capture data on the outcomes of the services we provide. 39

40 40 Technical Assistance Outline Readiness Domain-Specific Training beginning January 2016 including Contracting, Revenue Cycle Management, Business Practices and Change Management, Utilization Management, Outcomes Trainings will be tailored to specifically reflect the unique needs of foster care agencies In-person and on-line formats will be utilized with supplemental office hours offered

41 Domain-Specific Offerings 41

42 42 Tools & Resources Coming Soon: Managed Care Plan Matrix: an interactive map with contact, authorization, and claims/billing info (Statewide) Managed Care script Managed Care 101 Presentations Available now: Recordings and slides for in-person and online trainings Managed Care Glossary, Top Acronyms, and Key Terms for Managed Care FAQs Outputs to Outcomes online assessment measure database

43 43 OCFS Technical Assistance Online NYS DOH s official announcement of technical assistance offerings and opportunities for grant allocation for participating OCFS Voluntary agencies. Resources from CTAC's Managed Care Kickoff for OCFS Voluntary Agencies and leadership forum webinars are now available including slides, webinar recordings, and

44 Questions? 44

45 45 For additional questions: Visit: General Terri Greco, Project Director, Foster Care Technical Assistance Program, IPRO Anna Dean, New York State Department of Health Patricia Higgins, New York State Department of Health

Transition to Managed Care for New York State Foster Care Agencies. Technical Assistance Kickoff Webinar February 23, PM

Transition to Managed Care for New York State Foster Care Agencies Technical Assistance Kickoff Webinar February 23, 2015 2 4 PM 1 Presenters Lana I. Earle, Deputy Director, NYS Department of Health, Division