SLIDE 1
Service –Accountability- Innovation
Section 1115 Waiver Renewal Assembly Bill 6, Fourth Extraordinary - - PDF document
Section 1115 Waiver Renewal Assembly Bill 6, Fourth Extraordinary - - PDF document
Section 1115 Waiver Renewal Assembly Bill 6, Fourth Extraordinary Session (ABx4 6) Approved by the Governor July 28, 2009 Requires the submittal of an application for a waiver to CMS. Requires the Department to convene a stakeholder
SLIDE 2
SLIDE 3
Service –Accountability- Innovation
Comprehensive Waiver Goals
Strengthen California’s health care safety net Maximize opportunities to reduce the number of uninsured Optimize opportunities to increase FFP and maximize financial resources to address uncompensated care Promote long-term, efficient, and effective use of state and local funds Improve health care quality and outcomes Promote home-and community-based care
SLIDE 4
Service –Accountability- Innovation
Waiver Concept
In October 2009 a draft concept paper was released for review and comment Met with stakeholders and the health committees from both houses of the Legislature convened hearings The draft concept paper was revised and incorporated much of the comments and input received In December 2009 this concept paper was submitted to CMS
SLIDE 5
Service –Accountability- Innovation
Centers for Medicare and Medicaid Services
Ongoing discussion and guidance Based on input from CMS and technical workgroups some of the concepts have been adjusted
SLIDE 6
Service –Accountability- Innovation
Formation of Technical Workgroups
California Children’s Services (CCS) Seniors and Persons with Disabilities (SPD) Behavioral Health Integration (BHI) Health Care Coverage Initiative (HCCI) Dual Eligibles
SLIDE 7
Service –Accountability- Innovation
Workgroup Objective
Provide technical support to the Department regarding the development of the section 1115 comprehensive waiver implementation plan
SLIDE 8
Service –Accountability- Innovation
Select Workgroup Activities
SPD – discussing mandatory enrollment in managed care and alternative systems where managed care is not appropriate BHI - looking at strategies for integrated delivery of service for people with behavioral health and medical needs and possible pilot models HCCI – discussing how CI might facilitate the transition to health reform http://www.dhcs.ca.gov/provgovpart/Pages/WaiverRenewal
SLIDE 9
Service –Accountability- Innovation
Possible CI Considerations
Benefit package Enrollment system Eligibility Provider network
SLIDE 10
Service –Accountability- Innovation
Waiver & Health Care Reform
Bridge to Health Care Reform Opportunity to increase federal funds
SLIDE 11
Service –Accountability- Innovation
CI & Health Care Reform
CI may be the key to bridge health reform Possible enrollment gateway to transition to federal Health Care Reform
SLIDE 12
Service –Accountability- Innovation
Next Steps in Waiver Renewal Process
Early summer, submit to CMS:
- Final concept paper
- Draft implementation plan
- “Interim Evaluation of California’s CI” by UCLA
SLIDE 13
Service –Accountability- Innovation
Continued Steps in Waiver Renewal Process
Receive CMS approval Negotiate with CMS and finalize Special Terms and Conditions September 2010 begin implementation of the new waiver
SLIDE 14
Service –Accountability- Innovation