STATE OF WASHINGTON

DEPARTMENT OF SOCIAL AND HEALTH SERVICES

Aging and Long-Term Support Administration

Home and Community Services Division

PO Box 45600, Olympia, WA 98504-5600

H17-071 – Policy Procedure

September 11, 2017

TO: / Home and Community Services (HCS) Division Regional Administrators
Area Agency on Aging (AAA) Directors
FROM: / Kathy Morgan, Acting Director, Home and Community Services Division
SUBJECT: / Statewide Go-live for Medicaid Transformation Demonstration (MTD) Initiative 2 Programs
Purpose: / To announce the roll-out of Medicaid Alternative Care (MAC) and Tailored Supports for Older Adults (TSOA) programs effective September 11, 2017.
Background: / MTD or Medicaid Transformation Demonstration (aka the Demonstration) is a five-year 1115 waiver with the Centers for Medicare and Medicaid Services (CMS) that provides up to $1.1 billion in federal investment across three separate initiatives. The 1115 waiver allows the state to “waive” certain Medicaid requirements in order to test innovative, sustainable and systematic changes that will help improve the overall health of Washingtonians. During the five-year waiver period, the state must demonstrate that it can provide these services without spending more federal dollars on its Medicaid program than it would have spent without the waiver. See HCA MTD website for more detail.
The Initiative 2 programs, MAC and TSOA, are mirrored from the successful, non-Medicaid Family Caregiver Support Program (FCSP) and will provide another service option for individuals and their families who need long term services and supports. MAC and TSOA will serve people in two distinct roles: the unpaid family caregiver and the care receiver (collectively known as a dyad). The other population that will be served in TSOA only is the individual without an unpaid family caregiver, referred to as the TSOA Individual.
MAC and TSOA programs are Medicaid funded programs so the care receiver/TSOA Individual must meet eligibility requirements. Once eligibility is established, if serving a dyad, the unpaid family caregiver is screened and/or assessed, and a care plan is completed. If serving a TSOA Individual, that individual is screened and/or assessed in GetCare and a care plan is completed.
People may access MAC and TSOA services through either the Home and Community Services (HCS) office or the Area Agency on Aging (AAA) office. This “no wrong door” approach will be seamless for people as HCS and AAA staff work closely together to ensure a smooth and efficient service delivery system.
Over the last two years, the following activities have been completed:
·  Modifications were made to CARE, GetCare, ProviderOne, ACES, DMS, ACD, and Barcode to accommodate MAC & TSOA programs;
·  Initial field staff training and system testing have been completed;
·  Stakeholder meetings have occurred on a quarterly basis;
·  WAC was developed;
·  Policy related to operationalizing MAC & TSOA has been developed;
·  Warm Hand Off (WHO) Protocols between AAA and HCS offices were created to ensure seamless service delivery;
·  Provider contracts were revised or developed;
·  Network adequacy was defined;
·  A post-implementation support plan has been established;
·  MAC/TSOA training website was developed and continues to be updated; and
·  Tribal Protocols were developed.
What’s new, changed, or
Clarified / Systems are ready for roll-out of Initiative 2 programs. AAA and HCS staff now have the ability to serve clients enrolling in the MAC and TSOA programs.
Staff may visit the MTD Community Workspace for the latest training and program resources available to assist with implementation. Tools available include:
·  Intake to Authorization step-by-step guides
·  Program Decision Tools for ALTSA/AAA staff
·  Short training videos about the MAC/TSOA programs and how to use GetCare, CARE, Barcode/DMS, ProviderOne, etc.
ACTION: / Designated AAA workers and HCS intake staff should begin enrollment of and authorization of services to MAC & TSOA participants effective September 11, 2017.

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Post-implementation support will be available on a daily basis while it is needed. MTD Community WorkSpace (SharePoint site) also provides training, tools, and Q&As to support the successful implementation of MAC and TSOA programs.
AAAs will continue their network adequacy contract development, including reaching out inclusively to tribal partners.
AAA and HCS MTD staff should utilize their local “Warm Handoff” protocols when transferring clients (care receivers) between entities.
HCS MTD intake staff will complete the voter registration assistance in CARE for all MAC and TSOA care receivers regardless of which door the intake originated (AAA or HCS). This will continue to be the responsibility of the HCS MTD intake staff until the voter registration assistance functionality is developed in GetCare.
ATTACHMENTS: / MTD Community WorkSpace
HCS MTD Intranet site
ALTSA MTD internet site
HCA MTD website

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CONTACT(S): / Kim Boon, MAC/TSOA Program Manager
360-725-3292

Debbie Johnson, MTD Program Manager
360-725-2531

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