HEALTH HOMES ARKANSAS DEPARTMENT OF HUMAN SERVICES LONG-TERM CARE POLICY SUMMIT SEPTEMBER 5, 2012

HEALTH HOMES OPTION Health Homes for Enrollees with Chronic Conditions Option is authorized by Section 2703 of the Affordable Care Act The option became effective on January 1, 2011 A state may elect this option through an amendment to the Medicaid State Plan Section 2703 of the Affordable Care Act

COMMON HEALTH HOME QUESTIONS What is it? Where is it located? What purpose will it serve?

PURPOSE OF HEALTH HOMES OPTION State plan option to provide enhanced integration and coordination of primary, acute, behavioral health (mental health and substance use), and long-term services and supports for persons across the lifespan with chronic illness

POPULATION CRITERIA The health home population the State elects must consist of individuals eligible under the State plan or “under a waiver of such plan” who: HAVE AT LEAST TWO CHRONIC CONDITIONS HAVE ONE CHRONIC CONDITION AND BE AT RISK FOR ANOTHER HAVE ONE SERIOUS AND PERSISTENT MENTAL HEALTH CONDITION

CHRONIC CONDITIONS: THE CHRONIC CONDITIONS DESCRIBED IN SECTION 1945(H)(2) OF THE ACT INCLUDE: Mental health condition Substance use disorder Asthma Diabetes Heart disease Being overweight, as evidenced by a body mass index over 25 Section 1945(h)(2) of the Act authorizes the Secretary of DHHS to expand the list of chronic conditions reflected in this provision. Additional chronic conditions, such as HIV/AIDS, will be considered for incorporation into health home models.

CURRENT CARE COORDINATION ROAD MAP

OR…

HEALTH HOME SERVICES Section 1945(h)(4) of the Act defines health home services as comprehensive and timely high quality services” COMPREHENSIVE CARE MANAGEMENT CARE COORDINATION AND HEALTH PROMOTION COMPREHENSIVE TRANSITIONAL CARE FROM INPATIENT TO OTHER SETTINGS, INCLUDING APPROPRIATE FOLLOW-UP INDIVIDUAL AND FAMILY SUPPORT, WHICH INCLUDES AUTHORIZED REPRESENTATIVES REFERRAL TO COMMUNITY AND SOCIAL SUPPORT SERVICES, IF RELEVANT THE USE OF HEALTH INFORMATION TECHNOLOGY TO LINK SERVICES, AS FEASIBLE AND APPROPRIATE

HEALTH HOME PROVIDERS: Designated providers A team of health care professionals, which links to a designated provider A health team States can choose providers arrangements from one or more of the following options:

PROVIDER STANDARDS: STATES WILL BE EXPECTED TO DEVELOP HEALTH HOME MODEL S WITH COMPONENTS THAT FOCUS ON: Service delivery Provider qualifications Ongoing standards compliance

KEY CONSIDERATIONS FOR ARKANSAS’ HEALTH HOME MODEL Defining target populations to benefit from health home services Utilizing a person-centered approach while ensuring personal choice in service planning and delivery options Aligning efforts with other payment improvement initiatives Developing performance measures to ensure improved care coordination, patient engagement, and health outcomes

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