HCBS Technical Assistance for Alaska’s Division of Senior and Disabilities Services

From November 2015 to June 2016, HCBS Strategies provided technical assistance to the Division of Senior and Disabilities Services (SDS) and the Alaska Mental Health Trust Authority around a variety of HCBS topics. HCBS Strategies provided guidance to SDS about national trends in Federal Financial Participation (FFP) claiming and how FFP may be implemented in Alaska. More recently, we coordinated with the current 1915(i) and (k) contractor and SDS to review deliverables, provide guidance on relevant national trends, and establish the next steps for implementing and sustaining the effort.

HCBS Strategies was awarded a second Technical Assistance contract in June 2016 to support the Division of Senior and Disability Services with the ongoing planning and implementation of the 1915(i) and (k) efforts.

Conflict Free Case Management in Alaska

HCBS Strategies partnered with Agnew Beck Consulting to develop a draft plan for Alaska to come into compliance with CMS conflict free requirements contained in CMS HCBS rules.

As part of this project, HCBS Strategies and Agnew Beck facilitated interviews with a number of State agencies to gain a better understanding of the implications of the conflict free requirements on the processes of the State and local agencies. HCBS Strategies interviewed State staff in Colorado, Wyoming, Minnesota, and Hawaii about their efforts to comply with conflict free requirements.

HCBS Strategies and Agnew Beck then developed a report documenting the following:

  • Rationale for CMS Rules and interpretation of the conflict free requirements
  • Summary of the delivery of case management in Alaska and lessons from other states
  • Draft plan to comply with the conflict free requirements in Alaska
  • The vision for the case management system in Alaska

HCBS Strategies is now working with the State to pre-certify HCBS case management agencies as conflict free. HCBS Strategies has developed a solicitation that will be used by agencies in Alaska who wish to perform case management functions to provide assurances that they meet the conflict free requirements.

Development of Standard Tools

HCBS Strategies worked with Alaska to develop a standardized intake and screening tool. This tool will help clarify which programs individuals may be eligible for and who should be referred for an assessment. The tool should help reduce the number of people who are referred to programs that may not be the best fit and minimize the number of unnecessary assessments.

Development of Community First Choice Option

HCBS Strategies assisted the State of Alaska in exploring the development of the Community First Choice (CFC) option for attendant care services under the provisions of the Affordable Care Act. We reviewed Alaska’s current attendant care programs and facilitated discussions with the State on key design decisions that would be required in the implementation CFC. The design considerations included providing consultation of the program framework and participant access, quality assurances, support infrastructure, fiscal impact analysis, and proposed an implementation timeline.

As part of this scope of work and as a requirement under CFC we facilitated a participant advisory group designed to provide feedback and guidance to the State on the development of CFC. We also facilitated community forums to obtain additional feedback to the State on the proposed design of CFC. These design decisions and stakeholder feedback were integrated into our final report deliverable that advised the State on the implementation of CFC.

Developing a Long Term Care Plan for the State of Alaska

HCBS Strategies assisted the Alaska Department of Health and Social Services develop a plan for improving their long term care system. The purpose of this website is to facilitate the sharing of information among stakeholders and provide greater visibility to the project.

This report presents the following:

  • A summary of the input received from stakeholders via focus groups, interviews and surveys.
  • Our analyses of strengths and vulnerabilities of the operational infrastructure the State uses to deliver and monitor long term care services.
  • Our analyses of expenditure trends.
  • Recommended actions to be included in the LTCP.
  • A summary of stakeholder reactions to these recommendations and modifications we made based upon this input.
  • A three year action plan (3YAP) that translates the recommendations to be implemented within the first three years into discrete and interrelated tasks.
  • The framework for an Ongoing Planning Process to oversee the implementation of these changes.

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