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HomeMy WebLinkAboutMINUTES - 08162005 - C42 ool TO. BOARD OF SUPERVISORS ;. _ �, =_,,, Contra ►, /' F r J �* William Walker M.D. Director a� r**,�; _- Costa FROM: �3 ..Ta Health Services Department JohnCullen, Director �. Count; Employment and Human is #Zow DATE: July 26, 2005 SUBJECT: Sponsor Legislation for the Acute and Long Term Care Integration Program SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATION: SPONSOR legislation that would authorize the State Department of Health Services to enter into agreements with the Contra Costa Health Plan to pilot an Acute and Long Term Care Integration (ALTCI) Program. DIRECT the Health Services Department and Employment and Human Services Department to work cooperatively with the County Administrator's Office in negotiating terms, conditions, and capitated rates for ALTCI. FISCAL IMPACT: No fiscal impact is associated with this request. However, if the legislation is successful, implementa- tion funds may be made available to Contra Costa County. BACKGROUND: The Employment and Human Services and Health Services Departments have collaborated since 1999 on the planning and implementation of Long Term Care Integration. Long Term Care Integra- tion refers to a comprehensive program that integrates Medicare and Medi-Cal funding streams and coordinates medical, social and supportive benefits for seniors and adults with disabilities who are Medi-Cal and Medicare eligible. Now named Acute and Long Term Care Integration (ALTCI), this proposed program will develop a comprehensive service delivery system which creates incentives to more effectively utilize services that support an individual's ability to continue to live at home and par- ticipate in the community. Over the past 6 years the Board of Supervisors has expressed on-going support for this effort with Board Orders that have enabled the County to be awarded four planning and implementation grants in excess of$700,000 from the California Department of Health Services. CONTINUED ON ATTACHMENT: YES SIGNATURE: S k � RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER SIGNATURE(S): ACTION OF BOARD ON OA� APPROVED AS RECOMMENDED OT ER 0 VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF AN ACTION TAKEN AND ENTERED ON MINUTES OF UNANIMOUS{ABSENT THE BOARD OF SUPERVISORS ON THE DATE SHOWN. � } AYES: NOES: ABSENT: ABSTAIN: Contact: Dorothy Sansoe(5-1009) f--.00 cc: Health Services Department ATTESTED �W&(Pic C. Employment and Human Services DepartmentJOHN SW TEN,CLERK OF HE BOARD OFSUPERVISORS County Administration i'I_I Sen M-C r ksa y"e.rr' (—P)4 CAV) BY: , DEPUTY Page 2 Over 10 years ago, concerned citizens in Contra Costa County realized that seniors and persons with disabilities face a fragmented system of care for both medical and social services. Advocates were concerned that consumers had to work with a multitude of stand-alone agencies and programs to get the care and services they needed. Consequently, this convergence of concern encouraged citizens in our County to dedicate time and effort to developing a plan to address these issues. Public meetings have been held since 1995 with a variety of stakeholders to discuss various options. The advisory body currently spearheading long term care integration efforts is the Acute and Long Term Care Advisory Committee. This body is made up of consumers, advocates, and community based organization representatives. A common challenge discussed in health care arenas today is the aging baby boomer population. In Contra Costa County, we not only have the highest percentage of people over 85 years old in the en- tire State, that segment of the population is also the fastest-growing in our County. The State has also been very aware of the aging population issue, as the Medi-Cal program is the single largest payer of long-term care services for State residents. The elderly persons' need for services could cause an unsustainable burden on the State budget. To address these issues, the State's Medi-Cal Redesign proposal included identifying three counties to implement an ALTCI program, namely: Con- tra Costa, San Diego and Orange Counties. ALTCI will benefit seniors and adults with disabilities. There are over 30,000 individuals in Contra Costa County who are possibly eligible; of whom 70% are already receiving some services from the Contra Costa Health Plan's Community & Health Center Provider Network. Over 6,000 of these indi- viduals are currently being served by the In-Home Supportive Services (IHSS) program. Approxi- mately 3,000 of the potentially eligible individuals are currently Contra Costa Health Plan members. ALTCI will bring together a comprehensive array of medical, social and supportive services such as care coordination; needs assessments; personal care; nutrition services; primary, acute and specialty care; transportation assistance; medical supplies and equipment; and home health and hospice care. An interdisciplinary care management team will design a care plan, in cooperation with enrolled members, which will address each individual's care needs and personal goals and maximize personal independence. ALTCI could result in fewer people needing costly custodial/institutional care, with greater numbers being served in the County's IHSS program. Since other long term care services are primarily fi- nanced through State and Federal revenues and IHSS requires significant County funding, it will be very important to structure the terms, conditions and capitated rate for the ALTCI so that the pilot does not result in increased County expenditures for IHSS or other services. For this reason, it will be important for Health Services, Employment & Human Services and the County Administrator's Office to work closely during negotiations with the State Department of Health. As a managed care organization, the Contra Costa Health Plan will be the lead agency, working with the Employment and Human Services Department to implement ALTCI in Contra Costa County. Leg- islation is required to authorize the State Department of Health Services to enter into agreements with the Federal government and the Contra Costa Health Plan to pilot an Acute and Long Term Care In- tegration Program (ALTCI).