Direct Service Purchase (DSP) Restructure Vendor Council Meeting March 30, 2011
Current DSP model Vendors sign bid agreement to participate Agree to rate and service area Referrals or authorizations not guaranteed More than 200 vendors Services authorized for care management clients mostly MI-Choice waiver 1201 Medicaid Waiver vs. 434 Community care management in 2010 13,226 authorized services in 2010; nearly 8000 in FY 2011 (Oct – March) Majority of vendors that apply are accepted 2
DSP Services Adult Day Health Services Medication Management Chore Nursing Facility Transition Community Living Program Personal Care Services (non-Medicaid) Personal Emergency Community Living Supports Response Systems (MI-Choice) Private Duty Nursing Counseling Residential Services Environmental Accessibility Respite Services Adaptations Specialized Medical Equipment Fiscal Intermediary & Supplies Home Delivered Meals Transportation Homemaking Unmet Needs Italicized also contracted services 3
Why change the DSP? Improve Efficiency and Effectiveness High quantity of vendors exceeds actual need for service, increases administrative costs Some providers high quality – others low Vendors still do not actively serve some areas of region Improve ROI for vendors Many vendors currently get little to no referrals T echnology and insurance requirements costs exceed business opportunities Smaller pool = potential increase in number of referrals 4
Why change the DSP? Align vendors with AAA 1-B goals & standards AAA 1-B Strategic Plan CARF Accreditation (preliminary exploration) Commission on the Accreditation of Rehabilitation Facilities Signifies a higher standard of quality Pursuing two standards: Aging Service Network, Home & Community Services Focus on Quality Difficult to monitor quality (i.e. long periods between assessments, limited performance monitoring) Need to improve satisfaction, person-centeredness, self determination of participants 5
Person Centered Service Delivery Focus on Quality of Life and participant choice Each participant knows their own needs best Service delivery with more open communication between workers and participants Care Managers still support the participant to meet their goals Improve Participant outcomes and satisfaction Community Living Service allows personalized service to be defined by participant Greater flexibility in delivery of service hours through Self Determination 6
Satisfaction & Quality review Participant satisfaction results (2009-2010 survey) Recommend personal care services to family or friend? >20% = No, Maybe or Unsure Does the worker arrive late? ~13% Yes Agency notifies me if worker will be late or can’t come? >16% = No State quality standards Timeliness of first service delivery Variance between planned and delivered service Communicating status changes, inpatient stays, other Critical Incident reporting 7
Restructuring Plan Approval from Board of Directors in Feb 2011 Request for Proposals (RFP) to participate in DSP pool Purchase agreement will define full serving area and bid rates DSP will not guarantee a number of clients/units 3 year agreement cycle Clients receiving services from vendors not chosen will be transitioned to new vendors: Begin Process Summer 2012 Exceptions may be made for SD clients Inclusive development process: various AAA 1-B staff including care managers; vendor feedback, participant feedback Not all DSP services included in RFP process 8
Proposed services included in RFP Adult Day Health Services Counseling Homemaking Medication Management Personal Care PERS Private Duty Nursing Respite services *Services not included will continue to do business through our current bid agreement process Exception criteria may apply for services in assisted settings **Final list to be determined 9
Selection Process Open to current pool & new vendors Exact number of vendors accepted not yet know Estimating 40-50 Will set a specific application deadline Applications reviewed by AAA 1-B Application Review Committee (ARC) Consists of board members, advisory council members Appeal process for those not selected Applications will be kept on file if a selected agency drops out or is removed from pool Weighted rating system/selection criteria… 10
Selection criteria Potential criteria – may expand or change In business 3+ years Accreditations (where appropriate) Service flexibility i.e. 24 hour service, intermittent or short time periods (1 hour) Bilingual workers Will work with AWC or SD clients Provide service in hard to serve areas May need to designate/mandate service area 11
Selection Criteria cont. No subcontracting of direct service workers Demonstrate internal satisfaction/quality assurance procedures Private pay process (for non Mi-Choice participants) Hire CNA’s Demonstrate excellent training protocols Non-profit status priority CARF criteria adherence, i.e.: Risk management plan Demonstrate collaboration with participant family/support system Demonstrate ability to respond to diversity of participants i.e. cultural competency training Demonstrate vendor alliance with AAA 1-B mission 12
Timeline FY 2011 Vendor FY 2012 Select Implement Appeals Issue RFP Candidates RFP October January/Feb April October Applications Notify Client Due selected transitions December 1 vendors May- March September 13
Next steps Vendor feedback 1 st opportunity today Focus group in May Participant feedback in June Develop & finalize selection criteria Develop RFP materials Approval from Office of Services to the Aging & AAA 1-B Board of Directors Public review & comment AAA 1-B website 14
Questions/Feedback Please state your name and agency when you ask a question or comment. 15
Recommend
More recommend
