Long Term Care Services and Supports in Michigan

Single Points of EntrySPE Legislation

Jan Christensen JD, MSW

Medicaid Long Term Care Task Force

• The Vision:– Michigan will achieve over the next ten years a

high quality, easily accessible, publicly and privately funded system of long term care supports and services.

– The arrangement and type of care and supports for each person will be determined by “person centered planning.”

“For the Last Two Decades Michigan’s Elderly and Disabled Citizens have Pleaded for a More Humane, Consumer and Family

Friendly LTC System.”

“We will, of course, do the right thing but only after we have tried everything else.”

Winston Churchill

Medicaid Long Term Care

Task Force – Single Points of Entry

• Create a System of Single Points of Entry: – Person Centered Planning / Supports

Coordination – Mandatory Medicaid Access Point;– Nursing Home Transition;– Level of Care Determination;– Quality Assurance;– Advocacy / Consumer Appeals; and – SPEs are non-direct service providers

“Your eyes won’t see too clearly if your imagination is out of focus.”

Mark Twain

Office of Long-Term Care Supports and Servicesand

Medical Services Administration

Long-Term Care Single Points of Entry

Request for Proposals (RFP)Released Pursuant to Governor Granholm's

Executive Order 2005-14

Key Milestone:Date:

Issue Date November 14, 2005

Pre-Bid Meeting December 5, 2005

Questions Due December 2, 2005

Proposal Due Date February 17, 2006

Award Date April 17, 2006

Estimated Grant agreement Start Date July 1, 2006

Single Points of Entry

Required Collaborators for SPE:• Local Department of Human Services• County Community Mental Health Services Program and/or

the Pre-Paid Inpatient Health Plan for• Medicaid Specialty Services• Area Agencies on Aging• Nursing Facilities – at least 50% in region• MI Choice Program Agencies• Hospitals/Health Systems – at least 50% in region

Additional Collaborators • Medicaid Service Providers• Private Service Providers• Hospice Organizations• Local Public Health Departments• Home Health Services Organizations• Centers for Independent Living• Local Advocacy Organizations for• Aging and Disability Populations• Local organizations supporting LTC• issues (religious, volunteer, fraternal,• philanthropic)• Individual Consumers• Regional Governing Authority or• Authorities (e.g., county boards,

multi-county agreements)

• Community Action Agencies• Housing Authority(ies)• County-based or Operated Long-

term• Care Providers• Multipurpose Collaborative Bodies• Transportation Authority(ies)• Dementia Services Agencies,• Organizations, Providers• Traumatic Brain Injury Services• Agencies, Organizations, Providers• Organizations representing specific• cultural groups• Municipalities with populations of• more than 100,000 persons• Others as Appropriate

SPE DELIVERABLES

3.01 SPE Program Transition and Initiation

• Task A: SPE Initiation and Development

3.02 Planning and Collaboration

• Task B: Regional Needs Assessment, Planning, and Coordination

3.03 Outreach and Public Education

• Task C: Outreach and Public Education Plan

• Task D: Health, Risk, and Safety

SPE DELIVERABLES

3.04 Information and Assistance Activities • Task E: Use and Development of Informational

Materials• Task F: Information and Assistance Process

Development3.05 Long-Term Care Options Counseling • Task F: Proactive Choice of Benefits Counseling • Task G: Functional Eligibility for Medicaid Supports and

Services • Task H: Person-Centered Planning Process

SPE DELIVERABLES

3.06 Ongoing Supports Coordination • Task I: Ongoing Supports Coordination • Task J: Provide urgent and emergent support • Task K: Program or Service Transitions3.07 Quality Management • Task L: Development of a Comprehensive

Quality Management System

SPE Proposal Review

• Each Proposal Reviewed by Three Reviewers:– LTC Facilities– Government– Olmstead Coalition

• Presentation to Nine Member Panel

• Top 3-4 Proposals Selected

Questions About SPEs

• Who has applied?

• How will you ensure objectivity?

• Isn’t it another layer?

• Isn’t it too costly?

• How will you know it will work?

Henry Ford is quoted as saying:

“Coming together is a beginning… Keeping together is progress… Working together is success!!!”

Your Questions?