Implementation Status Update: Chapter 257 Provider and Consumer Advisory Council

1. Executive Order No. 536: Establishing the Chapter 257 of the Acts of 2008 Provider and Consumer Advisory CouncilSeptember 12, 2013www.mass.gov/hhs/chapter257

2. Agenda • Chapter 257 Implementation Status Update • Updated Base Data • Current Status • Projects Underway/Planned • Chapter 257 PCAC Member Discussion • Provider Engagement in Rate Setting Process

3. Chapter 257 Status – Updated Base Data • When the Chapter 257 project was started in 2008, EHS agencies participated in a data-gathering exercise, which was then used to develop the initial strategy groups. • Those manual spreadsheets were also used to create an implementation plan and track progress in meeting the legislative benchmarks. • Over time, program spending shifted – funding was cut or added, departments realigned spending within activity codes to reflect reorganizations, or other changes happened – but the manual spreadsheets did not change. • Effort over past 6 months to revisit Chapter 257 activity codes, update spending to FY12, and confirm their human service components. • Also working to create better uniformity in coding, so can ultimately develop a database for ongoing tracking and maintaining underlying process for rate reviews, procurement planning, etc. • Will result in an updated work plan for FY14 and FY15. Actively meeting with departments now to finalize.

4. Chapter 257 Status – Remaining Projects • Review also provided an opportunity to confirm whether programs cover direct human services or indirect supports that enhance those services. • Reassigned some activity codes that had been coded “POS” due to history and habit, but hadn’t been updated to reflect changes to coding definitions.

5. Chapter 257 Status – Remaining Projects • Identified some programs where underlying federal funding and/or requirements are changing due to ACA, sequester or some other factor. • Primarily affects DPH programs as Payer of Last Resort. • Shifting requirements make it difficult to develop a rate – may need to revisit shortly after completing rate development. • Decided to schedule these at end of list in hopes that uncertainty will be resolved by the time the project begins. Affected projects include – • HIV/AIDS ($34.5M) • Women’s Health ($2.5M) • WIC (26.8M) • Lead ($1.1M)

6. Chapter 257 – Current Status (Preliminary) • Using the updated base data, the preliminary Chapter 257 status is noted below – • Note – figures are preliminary and subject to change as review of agency programs continues and corrections to status assignment are made.

7. Chapter 257 Status – Projects Underway • Several projects have had a Public Hearing and are under final review – • Family Transitional Supports • Placement Supports and Adoption Services • The projects below are in development – • Adult Homelessness Supports, DMH • DYS Staffing Supports • DDS Day Hab Supplemental Payments • Family Resource Centers • Community Based Flexible Supports, DMH • Violence and Injury Prevention, DCF and DPH

8. Chapter 257 Status – Reviews Planned • The following regulations are in place, and rate reviews are underway or planned –

9. Agenda • Chapter 257 Implementation Status Update • Updated Base Data • Current Status • Projects Underway/Planned • Chapter 257 PCAC Member Discussion • Provider Engagement in Rate Setting Process

10. Chapter 257 – Provider Engagement • Provider Engagement continues to be an important focus during the Chapter 257 rate development and rate review process. • Developed a handout to describe process. • Review with group – confirmation, discussion, feedback.

11. Wrap-up, Next Meeting • Next Scheduled Meeting, Matta Conference Room • December 12, 2013 – 3:00-4:00