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Rebalancing: A Key to Pennsylvania’s Community HealthChoices SuccessA top priority for aligning the community living and financial goals

As Pennsylvania rolls out Community HealthChoices (CHC) and Managed Long Term Services and Supports (MLTSS), a number of factors are emerging as key to success, but none more important than achieving rebalancing of the number of individuals living in the community versus those living in nursing facilities. The Commonwealth established consumers living in the community as the first group to enroll in CHC, which is one way to achieve effectiveness and efficiency from a budget perspective. As MCOs’ payments are capitated, the generally lower cost of supporting people in the community aligns the community living and financial goals.

The MCOs have demonstrated their commitment to rebalancing in the pre-enrollment package that was distributed to nursing home residents/CHC participants. The incentives being offered range from $5,000 to $6,000 for individuals who elect to move from a nursing facility to the community, and the funds may be used to subsidize rent or other services needed to assist in that move.

Andrea Costello and Brenda Dare from Transitional Paths to Independent Living (TRPIL) presented “Making Connections: From the Nursing Home to the Community”. TRIPL’s unique approach uses a diverse team in an integrated and systemic delivery system while maintaining the connection between community-based organizations (CBOs), the consumer, and the community.

Juliet Marsala of the Inglis Foundation, Norma Robertson-Dabrowski of Liberty Resources, Inc., and Janet Turner of Inglis House presented “Transitioning Into the Community Post-Nursing Home: What it Takes,” providing insights on the transitions of 29 consumers into the community and the complex coordination required from multi-disciplinary teams and the navigation of complex service systems.

In both workshops, the focus on consumer choice as well as the supports needed to make transitioning successful was evident. The move towards rebalancing will require the participation of all of the community-based providers in MLTSS. The MCOs have demonstrated their initial financial commitment, and it is incumbent on all the other stakeholders to gain an increased understanding of the role CBOs play in making CHC successful.

Onward!

Fady Sahhar

I was honored and pleased to present and participate in the annual conference of the Rehabilitation & Community Providers Association earlier this month in Hershey, Pennsylvania. RCPA is among the largest and most diverse state health and human services trade associations in the nation, and it was an enlightening opportunity to rub shoulders and share insights with top-notch service providers. This is one of my takeaways, to be published in the RCPA newsletter.

 

 

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