State Responds to Concerns, Resets Timeline for Senior Program Transition

State health officials this week said they would extend the timeline for transition into managed care plans for thousands of frail California seniors in the Multipurpose Senior Services Program.

At an Assembly Budget Subcommittee on Health and Human Services hearing this week, the revised timeline was released by Mari Cantwell, chief deputy director at the Department of Health Care Services. She said the change was prompted by stakeholder input about the time needed to make sure the complicated needs of MSSP patients can be met. 

“There have been concerns raised about the readiness of the full integration of MSSP into managed care for the (seven) Coordinated Care Initiative counties,” Cantwell said.

“At the request of the providers as well as this committee,” Cantwell said, “the department has proposed trailer bill language that would extend the full integration to the end of 2017.”

That news came as a huge relief to providers and advocates.

“I wanted to express appreciation for the department for acknowledging the time frames weren’t enough to provide a safe transition for this frail and fragile population,” said Denise Likar, an MSSP site director in Los Angeles County who also is a past president of the MSSP Site Association.

Cantwell said the new proposal would allow earlier integration if the providers and plans agree on it, and if they demonstrate readiness to DHCS and to the California Department of Aging.

MSSP is a federal waiver program, with 38 sites in California serving up to 11,789 people a month. Frail seniors get care and services to help them stay home and out of institutions, such as hospitals or nursing homes.

The majority of seniors in MSSP reside in one of the seven counties participating in the state’s duals demonstration project, or Cal MediConnect, which is part of the state’s larger Coordinated Care Initiative.

Roughly two-thirds of all Californians dually eligible for Medicare and Medi-Cal live in the seven-county demonstration area. For duals in those demonstration counties — Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo and Santa Clara counties — care provided under the MSSP waiver is being moved into Medi-Cal managed care plans. The care and services in MSSP outside of the seven-county demonstration project will remain the same.

The transition to managed care for that population can be tricky because of the complicated nature of their health — people often have multiple chronic conditions, multiple providers and multiple medications. They also can have cognitive issues, language barriers, thin support systems and transportation challenges.

“We do appreciate that the department recognized there was a problem and is addressing it now,” said Monica Miller, legislative advocate for the Jewish Family Service of Los Angeles, addressing the legislators at Monday’s hearing. “We would also urge you to maintain strong oversight of this program.”

Categories: Capitol Desk, Medi-Cal, Medicare