Community First Choice: Building Local Partnerships Panel Discussion with Members of the Houston-Galveston Area Regional CFC Focus Group 1

Welcome and Introduction Partners in the Houston-Galveston Area Regional CFC Focus Group Gulf Coast Center, The Harris Center, Texana Center, Tri-County Behavioral Healthcare, Amerigroup, Molina, Superior & United Health Care 2

Welcome and Introduction Panel Members Caren Zysk, Director of Healthcare Services, Molina Healthcare Christianne Burke MS, RN, CCM, Director, Medical Management, CCP, Superior Health Plan Jamee Payne, Administrator of IDD Authority Services, Tri-County Behavioral Healthcare Jenn Stafford, Community First Choice Service Coordinator, Gulf Coast Center 3

Welcome and Introduction Panel Members Kent Allen, Director of Authority Services, Hill Country MHDD Center Kenyonika Johnson, Provider Liaison, The Harris Center Maribel Burgos, Community First Choice Supervisor, Texana Center Michelle C. Goan, Health Services Director, United Healthcare Sheri Talbot, Director of Authority Services, Texana Center 4

Welcome and Introduction Session Objectives How to develop a Regional CFC Focus Group Implementation/Structure/Model Demonstrate value of a Regional CFC Focus Group Achievements Explain how a Regional CFC Focus Group can guide local processes and address local needs Challenges/Next Steps 5

Overview Implementation Structure Achievements Challenges Model Next Steps 6

Implementation Texana Center reached out to LIDDAs and MCO representatives in February 2015 Prepare for CFC Implementation Identify the players and roles Develop a common understanding of the information coming from the state Coordinate for the development of consistent practices within the region 7

Structure So I said to the gym instructor, “Can you teach me to do the splits?” He said, “How flexible are you?” I said, “I can’t make Tuesdays.” Tim Vine Key: Be Flexible, but Routine 8

Structure Location: The Harris Center, central to the region Frequency: Monthly, second Tuesday, 10: Participants: Authority Directors, CFC Managers, CFC Service Coordinators, MCO Directors, MCO LTC Supervisors, RN Case managers 9

Achievements Communication Training Process Toolkit Collaboration 10

Achievements - Communication Opportunity for LIDDAs to better understand the MCO world Opportunity for MCOs to better understand the LIDDA world Learned internal processes Examples 11

Achievements - Communication Develop better understanding of the roles of the MCOs and LIDDAs MCO Authorization MCO Service Coordination LIDDA On-going Service Coordination Role of MCO & LIDDA in PDP process Outcomes Monitoring Progress 12

Achievements - Training Regional CFC Training (June 2015) Assessment Process Individual’s volunteered for onsite assessment MCO Representatives provided expert advice on how to ask questions, how to score responses, and common assessment situations 13

Achievements - Process CFC Implementation “Working the List” (March – June 2015) Exchanged information Identified contacts at LIDDA and MCO to address locating individuals, managing FTP site 14

Achievements - Process Identified issues and resolved through Focus Group discussions Delayed MCO/LIDDA processes Timelines Lack of feedback or direction Lack of process consistencies 15

Achievements - Toolkit Developed forms and instructions necessary to CFC Operations – Models for other centers and state Notification of LIDDA Reassignment LIDDA Contact Information Coversheet and CFC Packet Checklist 16

Achievements - Collaboration Developing Network of Providers with IDD expertise Provider Meetings following CFC meeting every other month Meet and greet for MCO representatives and Providers Panel of MCO representatives to explain contracting process 17

Achievements - Success “Coming together is a beginning; Keeping together is progress; Working together is success.” Henry Ford Key: Shared Commitment, Active Participation 18

Challenges Processes to exchange information Processes to manage labor intensity Communication with families Engaging Providers 19

Challenges Exchanging information – the FTP site Managing labor intensity Demographic Changes Membership Changes Health Status Changes Enrollment into Star Plus Waiver or Comprehensive IDD Waiver Authorization status 20

Challenges Communication with families Provider Choice Disagreement with Authorization Suspension/termination due to non- compliance Clarification of roles – who to contact for what MCO and LIDDA – consistent message 21

Challenges Engaging Providers Network Adequacy Unfamiliarity with habilitation Habilitation Plans 22

Model Interest by state for a regional collaboration between LIDDAs, MCOs and Providers in all areas of the state Getting Started Lessons Learned Next Steps 23

Model – Interest by State Senate Bill 7 IDD System Redesign - Subcommittee for Managed Care Texas Council and IDD Leadership HHSC and DADS Address Network Adequacy 24

Model – Getting Started Designate responsible entities – Contact List, Agenda, Minutes, Liaison to Texas Council Erin Lawler, HHSC and DADS Establish a set meeting date, time & location Meet monthly until membership agrees to alternate schedule 25

Model – Getting Started Set Agenda: Procedures – Developed for Region Review New Information from State Information Letters Procedures and Forms Challenges/opportunities Action Items Hill Country MHDD Center – Experience as a new Focus Group 26

Model – Lessons Learned “Politeness is the poison of collaboration.” Edwin Land Key: Come to the table with issues and willingness to develop solutions. 27

Model – Lessons Learned Do respectfully bring issues and experiences to the table Do have members with a working knowledge of the CFC processes Do focus on work: make assignments, take action Do maintain confidentiality 28

Next Steps – Regional Issues and Solutions Training for CFC providers Habilitation Streamline documentation expectations Decrease the number of declines Increase enrollment numbers Increase timeliness of enrollments Reassessment Process 29

Next Steps – Regional Issues and Solutions STAR Kids Focus Group with MCOs for STAR Kids Intro to Provider Network Develop processes to streamline referral process MCO to LIDDA Identifying kids with DIDs Communication between MCO and LIDDA 30

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