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SCDuE Weekly Update | May 19, 2013

The proposed model of the South Carolina Dual Eligible (SCDuE) Demonstration has been changed to reflect a carve-in of home and community based services (HCBS). These changes will be outlined in the Memorandum of Understanding (MOU) between the State and CMS (e.g., transition of HCBS authority to the Coordinated and Integrated Care Organization (CICO) during the Demonstration period). Some implementation details are subject to change pending a fully executed MOU; therefore, the State will not issue a procurement solicitation until such time.

INTEGRATED CARE WORKGROUP | MAY 22, 2013, 10AM – 12:30PM

EDUCATION SESSION #3 | CONSUMER ENGAGEMENT

South Carolina Department of Health and Human Services

11th Floor Conference Room

1801 Main Street, Columbia, South Carolina 29201

We are pleased to announce that CMS-MMCO Director Melanie Bella will join our stakeholder session on May 22, 2013 and will address the group during the first part of the meeting.  In preparation for the Demonstration’s implementation, it is important to develop a strategy to educate and engage consumers.  Key to developing this strategy is identifying the factors that influence the health care decisions of the target population.  This education session will address such factors and will give stakeholders the opportunity to provide the State input on its overall communication strategy.  Members of the Integrated Care Resource Center, Sarah Barth and Michelle Herman, will facilitate the session to: 

  • Review the SCDuE stakeholder engagement planning process;
  • Identify target stakeholders for education and outreach activities, as well as the various communication methods and forums; and,
  • Present information on SCDuE plans for training internal staff, providers and other stakeholders (e.g., state agency partners, advocacy groups, community based organizations).

Please join us for this very important education session.
Melanie Bella, MBA, is the director of the Medicare-Medicaid Coordination Office at the Centers for Medicare & Medicaid Services (CMS). This office, officially the Federal Coordinated Health Care Office, was established by the Patient Protection and Affordable Care Act (Section 2602).   As director, Ms. Bella leads the work of this office charged with more effectively integrating benefits for individuals eligible for both Medicare and Medicaid and improving coordination between the federal government and states for such beneficiaries.
Prior to joining CMS, Ms. Bella was the senior vice president for policy and operations at the Center for Health Care Strategies (CHCS). She led the organization’s efforts to integrate care for populations with complex needs, including people with multiple chronic conditions, disabilities, serious mental illness, and dual eligibles. In addition, she directed a unique leadership training institute to help Medicaid directors enhance the skills they need to transform their state programs into national models for high-quality, cost-effective care.
Prior to CHCS, Ms. Bella served as Medicaid director for the state of Indiana from 2001 through 2005. During her tenure, one of Ms. Bella's most notable accomplishments was spearheading the creation of the Indiana Chronic Disease Management Program. She earned a master’s degree in business administration from Harvard University and a bachelor's degree from DePauw University
Sarah Barth, JD, is the director of long-term services at the Center for Health Care Strategies (CHCS). In this role, she primarily works on CHCS' initiatives to help states advance integrated models of care for managed long-term service and supports systems and dual eligibles. She also provides targeted technical assistance focusing on integrated care to states under the Robert Wood Johnson Foundation's Medicaid Leadership Institute.  Prior to CHCS, she served in a consulting role to several state Medicaid programs; non-profit foundations, including the Massachusetts Medicaid Policy Institute at the Blue Cross/Blue Shield Foundation of Massachusetts and the Center for Health Law and Economics at the University of Massachusetts Medical School; and managed health care organizations. Ms. Barth has more than 18 years’ experience in Medicaid administration working for both the states of New Mexico and Massachusetts. In New Mexico, she oversaw long-term services programs, managing all aspects of the design, waiver submissions to the Centers for Medicare & Medicaid Services and implementation of the Coordination of Long-Term Services program. She also worked at the Massachusetts Medical Assistance Division for 12 years on the state's Medicaid program with a brief break to serve as the legislative director for Health and Human Services for the Massachusetts Governor's Office. At Massachusetts Medicaid, she developed legislative and media strategies, oversaw large interagency projects, and contributed to state health care reform initiatives.   Ms. Barth has a bachelor's degree from the University of Pennsylvania and a law degree from Suffolk University Law School.
Michelle Herman, MHS, is a senior program officer at the Center for Health Care Strategies (CHCS). She plays an integral role in CHCS' work with state and federal agencies to improve care delivery and financing for individuals who are dually eligible for Medicare and Medicaid. Prior to CHCS, she served as special assistant to the executive director and acting director of communications for the Medicaid and CHIP Payment and Access Commission (MACPAC). Previously, she served as special projects coordinator for the Office of Chronic and Long-Term Care within the District of Columbia's Department of Health Care Finance, where she led projects to improve the delivery of long-term care and care for chronic conditions. She also held posts at Avalere Health and the National Conference of State Legislatures. She has considerable experience working with government, non-profit, and private sector stakeholders on Medicaid finance, delivery, managed care and other related federal and state health policy issues. Ms. Herman has a master's degree in health science from The Johns Hopkins School of Hygiene and Public Health and a bachelor's degree in psychology from Tufts University.

 

INTEGRATED CARE WORKGROUP | LONG TERM SERVICES AND SUPPORTS TRAINING SERIES
In an effort to facilitate our current discussions related to the integration of HCBS in the Demonstration, the SCDuE team is offering a series of training sessions on South Carolina’s long term services and supports (LTSS). This training will be held in addition to the on-going education series related to the Demonstration’s implementation.
Members of the Integrated Care Workgroup, as well as other stakeholders, are invited to attend these sessions either in person or by webinar. Webinar information will be provided prior to the meeting.

TRAINING SERIES SCHEDULE

Consumer Directed Care in the Demonstration
Thursday, June 6, 2013, 9am – 10am

South Carolina Department of Health and Human Services

1801 Main Street, Columbia, South Carolina 29201
Facilitators: SCDHHS Staff
Consumer directed care is an important part of the Demonstration model. Information about South Carolina’s self-directed care options including paid family caregivers will be discussed. Staff from SCDHHS will be joined by the State’s contractor for oversight of attendant care.

How a Multidisciplinary Team Functions
Tuesday, June 18, 2013, 10am – 12noon

South Carolina Department of Health and Human Services

1801 Main Street, Columbia, South Carolina 29201
Facilitators: To Be Determined
The multidisciplinary care team is an important component of care coordination in the Demonstration. This session will cover how the team can best function to integrate care.

 

OTHER STATE DEMONSTRATIONS | CALIFORNIA
California
On Monday, May 6, 2013, the Department of Health Care Services (DHCS) announced that the Cal MediConnect duals program would be launched no earlier than January 2014.  DHCS noted that implementing this “kind of systematic change takes time.”  The revised timeline will allow the State to give full consideration to other issues that impact the Demonstration.  The State will continue to assess readiness as it develops its final start date. 

  • Stakeholder Letter | PDF

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Medicare-Medicaid FAQs (Frequently Asked Questions) | PDF
Contact CMS for any questions or concerns regarding the meetings, guidance, or the MMP application. Emails can be directed to MMCOcapsmodel@cms.hhs.gov
Contact the SCDuE Team for more information, questions, and/or comments related to the SCDuE Demonstration by email at scdue@scdhhs.gov.
For additional assistance, please contact the SCDuE Program Coordinator, Teeshla Curtis by email at curtist@scdhhs.govor by telephone at (803) 898-0070.
Visit the SCDuE Website at https://msp.scdhhs.gov/scdue/
Visit the CMS-MMCO Website at https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/index.html
 
 
 
 

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