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G2 Meeting

G2 Meeting. October 3, 2013. Agenda. Managed Health Care for DFCS Children – Terri Branning Outcome 8B – Counties Stock & Flow – Jim In County vs. Out of County Placements – Betsy and Mable Outcome 2 – Carol Visitation and 8 in 8 - Counties. Managed Health Care for DFCS Children.

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G2 Meeting

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  1. G2 Meeting October 3, 2013

  2. Agenda • Managed Health Care for DFCS Children – Terri Branning • Outcome 8B – Counties • Stock & Flow – Jim • In County vs. Out of County Placements – Betsy and Mable • Outcome 2 – Carol • Visitation and 8 in 8 - Counties

  3. Managed Health Care for DFCS Children Terri Branning

  4. Transition of Children in Foster Care, Receiving Adoption Assistance and Select Youth in Juvenile Justice to Medicaid Managed Care G2 Presentation October 3, 2013

  5. Presenters • Marcey Alter, Deputy Director, Division of Medicaid/Aging and Special Populations, Business Owner • Terri Branning, Medicaid Business Analyst, DCH, Project Lead • Earlie Rockette, Amerigroup, AVP Quality & Process Improvement, Project Lead

  6. Purpose of Transition • The transition of foster care, adoption assistance and juvenile justice members will create a new level of collaboration between DCH, DFCS, DJJ, DBHDD, DOE, DECAL and Amerigroup with a focus on: • Development of new relationships and processes to facilitate the coordination of care for these members • Measureable improvement in physical and behavioral health outcomes • Safety, permanence and well-being • Exchange of health information

  7. Multi-Agency Effort with Public Input • An interagency task force of 7 child serving agencies was formed to address programmatic features, communication, health outcomes and education • DCH also sought input from the Children and Families Task Force, as well as the Mental Health and Substance Use/Abuse Work Group • Public Input • 2 public hearings • Online survey

  8. Background • DCH selected Amerigroup as the single statewide Care Management Organization (CMO) to serve eligible populations • The transition is effective 1/1/14 • Eligible Populations – approximately 27,000 members (approx. 8K members are in foster care) • Children, youth and young adults in foster care (new ACA rule up to 26 years) • Children and youth receiving adoption assistance • Children and youth enrolled in a home- and community-based waivers (excluding the GAPP waiver) and in SSI • Youth in juvenile justice system placed in community residential care

  9. Expenditures • Foster Care and Adoption Assistance represent 1.4 % of Medicaid members and 2.1% of total Medicaid and CHIP expenditures • High behavioral health (BH) needs for eligible populations • BH services represent 70% of total health care costs for members in Foster Care and receiving Adoption Assistance • For members in community residential placement through the juvenile justice system, BH services represent 87% of total costs

  10. Not Business as Usual • The new program will not be the same as current Amerigroup Georgia Families program • New program will: • Provide additional care coordination and improved medical oversight and health outcomes • Improve continuity of care when members transition into and out of foster care • Improve access to necessary physical and behavioral health services covered by the Medicaid program

  11. What’s Different? • Care coordination team and health care plan for each member • Demonstration of individual health outcomes • Virtual Health Record (VHR) • Dental Home • Monitoring & Oversight Committee and subcommittees • Value-based purchasing • NET change • Reporting

  12. What’s Different? • Ombudsman staff • DCH will have 2 Ombudsman staff to advocate for foster children and foster parents, plus members in adoption assistance and juvenile justice • Amerigroup will have advocacy and ombudsman staff • DCH and Amerigroup will continue to work with community advocates

  13. What’s Different? • Medication Management • Focus on psychotropic medications and ADD/ADHD medications • Amerigroup will integrate management protocols with DFCS/DJJ needs to ensure appropriate prescriptions, management and oversight • Emphasis on provider education

  14. Agencies: What’s Different? • Implementation in Year 1: • New processes, procedures and workflows between agencies • Interagency relationship: Enhanced collaboration and communication • Availability of health information through Virtual Health Record • Support for Kenny A. Consent Decree • Challenges: • Changing culture at regional and county level • Critical for agencies: • Consistency and standardization

  15. Current Priorities Formed Interagency Workgroups with Amerigroup • Communications, Education and Outreach • Finance / Reimbursement / Accounting • Information Technology / Health Information Technology • Operations • Provider Network Development (includes recruitment and contracting) • Transition of Care for members moving on 1/1/14 • Use Cases

  16. Current Priorities Final Workflows and Policies • Develop and implement new workflows and policies across agencies • Communication, Education and Outreach: • Agency staff • Providers (all types) • Members, foster parents, adoptive parents • Advocates and other stakeholders

  17. Questions?

  18. Outcome 8B Counties

  19. Outcome Measure 8b Children shall have had one of the following permanency outcomes within 12 months or less after entry: • Reunification • Permanent placement with relatives Or one of the following outcomes within 24 months: • Adoption • Permanent legal custody • Guardianship

  20. DeKalb P12 8B CohortChildren Who Entered Care During Period 12 and Who Will Reach 24 Months in Care Between7/1/13 and 12/31/13 As of 10/1/13

  21. Fulton P12 8B CohortChildren Who Entered Care During Period 12 and Who Will Reach 24 Months in Care Between7/1/13 and 12/31/13

  22. Stock & Flow Jim

  23. What is “Stock and Flow?"

  24. What is “Stock and Flow?" 6-12 month “Tub” 13+ month “Faucet Kids” 13+ month “Tub” Exits from Care Exits from Care

  25. Win Fabulous Prizes!!!

  26. In County vs. Out of County Placements Betsy and Mable

  27. Outcome 2 Update Kenny A. Consent Decree G2 Presented by: Carol Hall Date: October 3, 2013 Georgia Department of Human Services

  28. OUTCOME 2 Completion of CPS Investigations Complete 95% of all CPS investigations of reported abuse or neglect within 30 Days of the report in accordance with … Section 2106 of the Social Services Policy Manual

  29. PAST PERFORMANCE At least 95% of all investigations of reported abuse or neglect of foster children shall be completed within 30 days of receipt of the report

  30. OUTCOME 2 IMPROVEMENT MEASURES

  31. PERIOD 15 RESULTS Goal 95% * Period 15 Performance 87% Total 79 Met 69 Missed 10 * Not yet validated by AA’s 10 Misses Indicated by County DeKalb (4) SSIU (2) Forsyth (1) Fulton (1) Taylor (1) Walton (1)

  32. PERIOD 16 STATS-TO-DATE July – December 2013

  33. UPDATE Closed September with 15 cases Currently 9 open cases due to close in October Currently at 97% for P16; Goal is 95% If (WHEN) all 9 cases close timely, we’ll end Oct @ 98%

  34. OUTCOME 2 - Investigations Over 15 Days

  35. OUTCOME 2 - Investigations Over 15 Days

  36. County Visitation Data August 2013

  37. 8 in 8 Visitation Counties

  38. QA Review of 8 in 8 : DeKalb Results for May 201320% review

  39. Fulton 8 in 8 Sample Review = 20May 2013

  40. DeKalb County PlacementVisitation DataFINAL August 2013

  41. DeKalb CountyAugust2013 OM 20AChild Visits KennyA. Mandate 96.25%

  42. DeKalb CountyAugust2013 OM 20BChildPrivateVisits KennyA. Mandate 96.25%

  43. DeKalbCountyAugust 2013 OM 21 Reunification Visits KennyA. Mandate 85%

  44. DeKalb CountyAugust 2013 OM 22CaretakerVisits KennyA. Mandate 95%

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