Advocates met with Jim Parker, Deputy Administrator Division of Medical Programs, and other staff at Health Care & Family Services to get an update on the Integrated Care Pilot and other health related disability issues.
Regarding the Integrated Care Pilot for AABD, it will be expanding into Central Illinois sometime in 2013 as I have been reporting to you. That project will not have three phases but enrollment into managed care will be phased in. It is unlikely the Chicago will be a part of this pilot at anytime.
Integrated Care Pilot for Phase 2 will probably begin implementation in September, 2012! This phase includes all waiver funded services including: Home Services, traumatic brain injury, everything else except developmental disability waiver services. Developmental disability waiver services are Phase 3 which The Arc strongly opposes. Phase 3 could begin as early as Sept, 2014!
It is my understanding, that individuals who are Dual Eligible’s (persons enrolled in both Medicaid & Medicare) will also be enrolled into a different managed care program that will be developed through a Request for Proposals (RFP) process in 2013. The areas of the state covered in this project will include Chicago, the Collar Counties and Central Illinois. Dual Eligible’s will have the choice of opting out of this program. Any saving from this program will be returned to Medicare services.
I fear too many silos are being developed for health care, one for Chicago, one for the AABD population, one for Dual Eligibly, etc… All of this is getting very complicated and HFS is moving way too fast in my opinion!
We also discussed the Katie Beckett Waiver or the Medically Fragile- Technology Dependent Waiver. This continues to be a work in progress. HFS intends to reapply for this waiver but it is restructuring the program. Here are some of the things HFS is looking at changing:
There may be a cap on family income. This means if you make too much money your child will not be in the waiver!
There would probably be some guidelines for income disregard when determining the cap on income.
Cost sharing is also being considered so families can expect to be paying a portion of services rendered under the waiver.
New assessment tools and a new process for care planning is also under review. This means that your Doctors role in determining the supports necessary in the waiver will be subject to new assessment tools and planning process.
Tony Paulauski Executive Director
The Arc of Illinois
20901 S. LaGrange Rd. Suite 209
Frankfort, IL 60423