1. “Reaching across Arizona to provide comprehensive quality health care for those in need” Our first care is your health care Arizona Health Care Cost Containment System Arizona Long Term Care System (ALTCS) Update AHCCCS Update Meeting May 16, 2012

2. “Reaching across Arizona to provide comprehensive quality health care for those in need” Our first care is your health care Arizona Health Care Cost Containment System 2 SCAN Transition  SCAN terminated its contract with AHCCCS, effective May 1, 2012  Approximately 2,700 ALTCS members transitioned to remaining ALTCS E/PD contractors in Maricopa County -- Bridgeway Health Solutions, Evercare Select and Mercy Care  Readiness review process – January-May 2012 Tracked receiving contractors’ progress in making necessary staffing adjustments, training new staff, transitioning member information and member records, notifying new membership, responding to provider inquiries  Receiving contractors required to contact all new members with 30 days and visit each member within 90 days of transition date or immediately if critical needs identified at point of contact

3. “Reaching across Arizona to provide comprehensive quality health care for those in need” Our first care is your health care Arizona Health Care Cost Containment System 3 Community First Choice (CFC)  Option under the Affordable Care Act  Will allow the state to draw down additional 6% in federal matching funds for members served through the model implemented under CFC  ALTCS/CFC Development and Implementation Council proposing the establishment of an Agency with Choice attendant care model  Regulations for CFC finalized on May 7, 2012  Targeting fall 2012 for implementation  Next step: submit State Plan Amendment to CMS

4. “Reaching across Arizona to provide comprehensive quality health care for those in need” Our first care is your health care Arizona Health Care Cost Containment System 4 Direct Care Worker Training and Testing Initiative  Initiative aimed at ensuring that all Direct Care Workers (DCWs; attendant care, personal care, homemaker) are proficient in a core set of competencies needed to serve ALTCS members in their own homes  Beginning on October 1, 2012, all DCWs employed by ALTCS providers will be required to demonstrate proficiency through the passage of a competency-based exam  Current DCWs will be grandfathered  DCWs will have 90 days to complete the training  Providers agencies have option of offering training in-house or contracting for training  All training programs will be monitored by ALTCS contractors

5. “Reaching across Arizona to provide comprehensive quality health care for those in need” Our first care is your health care Arizona Health Care Cost Containment System 5 CMS Site Visit  CMS team (Central Office, Region IX, CMS-contracted consultants) conducted an ALTCS site visit - May 1-3, 2012  Purpose: to learn about operational and oversight components of Arizona’s managed care long term care program in order to advise other states  Team met with AHCCCS staff, community stakeholders, contractors and providers Discussion items: case management, quality management/quality oversight, performance tracking/data utilization, member-directed service options, community collaboration, etc.  Follow up meeting with California long term care program on June 5, 2012

6. “Reaching across Arizona to provide comprehensive quality health care for those in need” Our first care is your health care Arizona Health Care Cost Containment System 6 Restructuring of Division of Health Care Management ALTCS and Acute Operations Units  Integrating Acute and ALTCS Operations Units  Contractors with Acute and ALTCS lines of business will have one Operations and Compliance Officer  Enhance efficiency and ensure consistency in approach to oversight  Operations and Compliance Officer assignments going forward Bridgeway Health Solutions - Karen Edgley APIPA/Evercare Select (including CRS) - John Black Mercy Care Plan - Michelle Holmes Division of Developmental Disabilities, Comprehensive Medical and Dental Program - Jay Dunkleberger Division of Behavioral Health Services - Jay Dunkleberger (acting as of 05/14/12) Health Choice, Care 1st, Maricopa/UFC, Phoenix Health Plan - Connie Williams

7. “Reaching across Arizona to provide comprehensive quality health care for those in need” Our first care is your health care Arizona Health Care Cost Containment System Questions