Mass Home Care The COMMUNITY LIVING Program. Building an Integrated Care Team : ICOs & ASAPs. November 19, 2012. Topics. ASAP Network Readiness to Contract with ICOs – Joan Butler, Executive Director, Minuteman Senior Services Community Care Linkages – Amy MacNulty, Project Director
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The COMMUNITY LIVING Program
November 19, 2012
ASAP LTSS Coordinators will participate
as a full member of the ICT:
(Sec. 4.6D 3. & 4. Care Delivery Model)
established by ICO, at a minimum:
(Sec. 4.6D 5. Care Delivery Model)
“For too long, too many Americans have faced the impossible choice between moving to an institution or living at home without the long-term services and supports they need. The goal of the new Administration for Community Living will be to help people with disabilities and older Americans live productive, satisfying lives.” – Secretary Kathleen Sebelius
Established in 1974 by state law to create community alternative to nursing home care for low income MA residents 60+ who needed assistance with ADLs (coordinate services on behalf of Medicaid eligible members 60+,Chapter 19A,4B)
Unique statewide infrastructure for home and community based care with 40 years experience serving people with chronic care needs and their caregivers over the long term
On Behalf of MA Executive Office of Elder Affairs
Evidence Based Programs
* Vetted and monitored for compliance and quality
Staying Home: (ECOP/Choices)
ASAPs manageprograms targeted at people who meet the clinical criteria for the nursing home level of care.
Returning Home: (CSSM)
ASAP staff visit nursing homes toscreen elders on a pre-admission and post-admission basis
Geriatric Support Service Coordinators are members of the primary care team who:
ASAPs currently manage Vendor Network for 3 SCOs :
Community Care Linkages is a strategic initiative to effectively integrate services of the Massachusetts Aging Services Access Points (ASAPs) into the evolving healthcare delivery system.
Primary Care Transformation
Bundled Payment for Care Improvement
Initiatives Focused on the Medicaid Population
47 partners announced in three rounds, 4 in Massachusetts
http://www.healthyliving4me.org Transition Services at part of CCTP
The Community Living Program is offered exclusively through Mass Home Care and offers beneficiaries of ICOs, ACOs, PCMCHs, and other care provider organizations access to a wide range of vetted home and community based supports, including care coordination, member education and engagement, and registered nurse assessments.
Statewide network of ASAPs are aligning with local and national trends towards integrating aging and disability services.
The COMMUNITY LIVING Program for ICOs* Transition Services at part of CCTP
Member-Centered Long Term Services for Dual Eligibles:
A Mass Home Care Initiative for Integrated Care Organizations
Putting the pieces together
*Refer to handout for narrative
*Refer to handout for complete matrix