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Long Term Care Integration Project

Long Term Care Integration Project. May 14, 2003. 02-03 Development Grant Update. June 30, 2003 Deliverable: Recommendations for Scope of Work in Final Actuarial RFP $150,000 grant/contracts for fully integrated strategy w/LTCIP staff Lead consultant Actuary consultant

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Long Term Care Integration Project

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  1. Long Term Care Integration Project May 14, 2003

  2. 02-03 Development Grant Update • June 30, 2003 Deliverable: Recommendations for Scope of Work in Final Actuarial RFP • $150,000 grant/contracts for fully integrated strategy w/LTCIP staff • Lead consultant • Actuary consultant • Health Plan consultant

  3. Lead Consultant • Dr. Mark Meiners, UMCA, MMIP • Provide national expertise on LTCI • Lead team of 3 to produce deliverable • Provide health plan CEOs with info to decide if the vision of LTCIP is supported by available resources

  4. Actuary Consultant • Dave Ogden, Milliman USA • Provide national expertise on LTCI rate-setting • Work with team to produce deliverable • Develop assumptions upon which to base Final Actuarial • Recommend data summary layout for final actuarial

  5. Health Plan Consultants • Charlie Birmingham & Karin Kalk • Provide national expertise on LTC provider network development • Work with team to produce deliverable • Assess needs of individual HSD Health Plans interested in pilot LTCIP • Relay needs to actuary for developing assumptions, data summary requirements, populations, services to be included

  6. Consultant Activity To-Date • April 15, 2003 USC Data Center meeting • April 15, 2003 HSD Health Plan meeting • April 16, 2003 Stakeholder meeting • Consultants impressed by the ownership of LTCIP stakeholder group. • Consultants are committed to involving community-based organizations in all planning and development phases.

  7. Consultant Activity To-Date (Cont.) • Health Plan Interviews • Community Health Group • Sharp • Blue Cross • Universal Care • Kaiser • HealthNet • Evercare

  8. California Endowment Update • Staff have re-drafted the Physician Strategy application • To be forwarded to Endowment by May 30, 2003 • Will be posted on LTCIP web site

  9. Network of Care Update • RWJF E-Health grant to support testing/improvement of the Network of Care was not funded • Other foundations will be approached in the next 6 months

  10. 2003-04 Development Grant Update • In March, Planning Committee voted to support application and award of 2003-04 Development Grant from the State Office of Long Term Care for the purpose of developing a local administrative action plan. • Resources to develop that plan ($150,000) • Supports fully integrated strategy while other strategies continue locally.

  11. 2003-04 Development Grant (cont.) • LTCIP Advisory Group voted to support the application and award of 2003-04 Development Grant for the fully integrated strategy while continuing to develop the Network of Care and Physician (fee-for-service) Strategy. • Board of Supervisor action scheduled for May 13, 2003. • Application submitted April 11, 2003.

  12. Next steps: • CA Endowment application (5-30-03). • Board of Supervisor Action for new Development Grant application/award and update on 3 strategy development (5-13-03). • Notice of award on May 28. • Identify other funding options for NOC in the next 6 months. • Contract deliverable from team: recommendations for Final Actuarial RFP (6-30).

  13. Announcements • Mark Meiners next visit, May 26 and 27 • No June Planning Committee Meeting • July Planning Committee Meeting: • Consultant report • Dr. Medina presents on his senior health center model • Summary of Development Grant II goals

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