ON MEDICARE?  ON MEDI-CAL?  ON BOTH?

BIG CHANGES ARE COMING TO CLIENTS & CONSUMERS WHO RECEIVE HEALTHCARE AND SOCIAL SUPPORTS THROUGH MEDI-CAL ONLY OR MEDICARE & MEDI-CAL.

A new super agency, called the Administration for Community Living, was created in 2003 by combining three agencies under a single umbrella.  These are the Administration on Aging (AoA), the Office on Disability (OD) and the Administration on Developmental Disabilities (ADD).  There is a local manifestation of these three support networks in the forms of Passages, Independent Living Services of Northern California (ILSNC) and the State Council on Developmental Disabilities – Area Board 2

People who receive straight Medi-Cal or both Medicare & Medi-Cal, the so-called “dual eligibles,” will be switched from a “Fee-for-Service” method of payment to a “Managed Care” method by 2013-2014 in our area, according to plans from the California Departments of Health Care Services and Health & Human Services, in conjunction with the U. S. Health & Human Services.  To add to the confusion, military veterans, along with the dual eligibles and straight Medi-Cal clients will soon be directed to a new agency, called the Aging and Disability Resource Connection (ADRC).  All long-term support services requiring public funding will be referred to through a local ADRC.  Eventual plans call for an ADRC for all of California’s 58 counties.

In 2007, a contract was signed between ILSNC and Passages establishing an ADRC in a 5-county area served by Passages and ILSNC (Plumas, Butte, Colusa, Glenn and Tehama).  4 of our counties are served by a separate AoA based in Siskiyou County, serving Shasta, Modoc and Lassen counties as well, for which no ADRC exists.

These are momentous changes for our consumers and clients, who have been operating under a fee-for-service model whether utilizing Medicare or Medi-Cal for healthcare and attendant social supports.

How will people with disabilities and their families and caregivers going to be affected by the proposed changes?  How will the outcomes in the “Demonstration Project” in 8 counties affect healthcare and social supports in our service area?  Even among the professionals there are far more questions than answers.  Stay tuned for future developments as these initiatives are rolled out and the inevitable bumps in the road are smoothed out to create an operational network designed to provide a more efficient referral and service delivery process.

Additional information is available at:  http://www.communitychoices.info and http://www.hhs.gov/acl