podesta_email_10528.txt

podesta-emails 1,854 words email

P17 P18 P19 V11 V16

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message dated 11/28/2012 12:01:58 P.M. Pacific Standard Time, [email protected] writes: -----Original Message----- From: [email protected] Date: Wed, 28 Nov 2012 02:34:55 -0500 (EST) Subject: IHSS Consumers Union Comments to CMS regarding the Coprdinated Care Initiative To: [email protected] CC: [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected] The deadline to give comments on this most enormous change in our MEDI-CAL NEXT YEAR CALLED “COORDINATED CARE INITIATIVE” is December 10th. Marty's summary below tells you almost everything you need to know. Members of the IHSS Consumer’s Union are very concerned about some people put into mandatory managed care last year who are experiencing harmful interruptions and difficulties in receiving their medical care that appear to not have been solved. We are also asking that a small enough pilot be performed successfully before any more Seniors and People with Disabilities are added into these poor performing health plans. Because the CMIPS pilot caused a great deal of suffering for consumers and providers, it is a good thing it was stopped until they got it right and that it was a small pilot project. we DO NOT WANT Los Angeles County included because it has far too many Seniors and People with Disabilities for a pilot. We have seen no performance safety in the hurried transition of Seniors and People with Disabilities into the adult day services (now called CBAS), MediCal managed care and CMIPS that the California Department of Health Care Services moves prudently and slowly enough not to harm us, or with enough consumer protections to prevent Discontinuity of Care. We will be giving these kind of comments from the IHSS Consumers Union, and it would be good if we all gave our own comments personally. AND MAKE YOUR COMMENTS TO CMS AS WELL AT [email protected]_ (mailto:[email protected]) because they will be deciding. Your Sisters and Brothers Susan, Nancy, Ben, Lillibeth, Bertha, Blane, Deborah, and Ellyn on behalf of the IHSS Consumers Union Join the IHSS Consumers Union on Facebook at http_://www.facebook.com/groups/IHSS.ConsumersUnion/_ (http://www.facebook.com/groups/IHSS.ConsumersUnion/) “Never doubt that a small group of committed people can change the world. Indeed, it is the only thing that ever has.” -Margaret Mead -----Original Message----- From: [email protected] Date: Tue, 27 Nov 2012 17:17:27 -0500 (EST) Subject: GIVE YOUR COMMENTS BY DECEMBER 10TH ON MASSIVE CHANGES; COORDINATED CARE INITI To: [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected] CC: [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected] The deadline to give comments on this most enormous change in our MEDI-CAL NEXT YEAR CALLED “COORDINATED CARE INITIATIVE” is December 10th. Marty's summary below tells you almost everything you need to know. Members of the IHSS Consumer’s Union are very concerned about some people put into mandatory managed care last year who are experiencing harmful interruptions and difficulties in receiving their medical care that appear to not have been solved. We are also asking that a small enough pilot be performed successfully before any more Seniors and People with Disabilities are added into these poor performing health plans. Because the CMIPS pilot caused a great deal of suffering for consumers and providers, it is a good thing it was stopped until they got it right and that it was a small pilot project. we DO NOT WANT Los Angeles County included because it has far too many Seniors and People with Disabilities for a pilot. We have seen no performance safety in the hurried transition of Seniors and People with Disabilities into the adult day services (now called CBAS), MediCal managed care and CMIPS that the California Department of Health Care Services moves prudently and slowly enough not to harm us, or with enough consumer protections to prevent Discontinuity of Care. We will be giving these kind of comments from the IHSS Consumers Union, and it would be good if we all gave our own comments personally. AND MAKE YOUR COMMENTS TO CMS AS WELL AT [email protected]_ (mailto:[email protected]) because they will be deciding. Your Sisters and Brothers Susan, Nancy, Ben, Lillibeth, Bertha, Blane, Deborah, and Ellyn on behalf of the IHSS Consumers Union Join the IHSS Consumers Union on Facebook at http_://www.facebook.com/groups/IHSS.ConsumersUnion/_ (http://www.facebook.com/groups/IHSS.ConsumersUnion/) “Never doubt that a small group of committed people can change the world. Indeed, it is the only thing that ever has.” -Margaret Mead BROWN ADMINISTRATION RELEASES FOR PUBLIC COMMENT DRAFT DOCUMENTS MPLEMENTING MASSIVE CHANGES TO MEDI-CAL NEXT YEAR CALLED “COORDINATED CARE INITIATIVE ” · Part of 2012-2013 State Budget and Would Initially Cover 8 Counties (Alameda, Los Angeles, Orange, San Bernardino, San Diego, San Mateo, Santa Clara and Riverside Counties) – Eventually Entire State by 2015 · Coordinated Care Initiative Has Two Major Pieces: One for People with Disabilities & Seniors Eligible for Both Medicare and Medi-Cal – and Second Piece for Other Medi-Cal Recipients Receiving Long Term Services and Supports Such As IHSS · Certain People Excluded or Exempted – But Feds Expected to Approve State’ s Proposal in December That Could Impact 560,000 People in 8 Counties SACRAMENTO, CA (CDCAN) [Last updated 11/26/2012 04:00 PM] – The Brown Administration released this afternoon two important draft documents for public comment regarding the implementation next year of a massive change to the state’s Medi-Cal program called the “Coordinated Care Initiative” that will include - pending federal approval expected in December – implementation of an 8 county demonstration project to shift people with disabilities, the blind and seniors eligible for both Medicare and Medi-Cal (referred to as “ dual eligible”) from “fee-for-service” to a Medi-Cal managed are type plan. The demonstration project piece of the Coordinated Care Initiative is expected to begin implementation sometime after March 2013. The second draft document focuses on assessments and standards for the other major piece of the Coordinated Care Initiative that will require that all Medi-Cal recipients (including those eligible for both Medicare and Medi-Cal) in those 8 counties – with certain specific exceptions – join a Medi-Cal managed care type plan to receive their Medi-Cal services – including any long term services and supports (such as In-Home Supportive Services) and Medicare wrap-around benefits. Both draft documents are revisions from drafts previously released to the public late last summer and reflect, according to the Department of Health Care Services, changes and other input suggested by stakeholders. PUBLIC COMMENTS ON DRAFT DOCUMENTS · The Department of Health Care Services said it welcomes and encourages “… stakeholder comments on these documents” but noted that since the two documents are revised versions of the Long Term Services and Supports (LTSS) standards previously shared late last summer, that comments for the revised 2 draft documents be focused on “…key policy issues of concern.” · Deadline to submit comments: December 10, 2012 (Monday) · How to submit comments: Send comments via email to [email protected] by using comment template on the calduals website at: _http://www.calduals.org/news-and-updates/_ (http://www.facebook.com/l.php?u=http://www.calduals.org/news-and-updates/&h=1AQGpSWwXAQE2sqjMZcLQn3xq_Lebl6ADiRVkisrC0x1bcA&s=1) (the template is a word document blank form that has a column for a person to indicate the page number, section title, the existing text and column for comment or suggested edit. While the Department of Health Care Services requested that people use this template when submitting comments – they have in the past accepted regular emails to the [email protected] address without a template. Some persons have noted difficulty in using a template comment form on their computers – and some have limited or no access to the internet. INITIATIVE DRAWS SOME PRAISE BUT ALSO CONTROVERSY · The Coordinated Care Initiative – as proposed in its early form last January and May by Governor Brown and approved by the Legislature as part of the enacted 2012-2013 State Budget – has drawn some praise – but also controversy. The Brown Administration says the Coordinated Care Initiative will improve quality of care, improve continuity and integration of long terms services and supports in the community and improve ability of people to remain in their own homes safely – while reducing costs, with significant potential savings over time. · Some advocates have praised the State’s efforts to integrate long term services and supports that the Brown Administration promises will be made easier to obtain and provide under Medi-Cal managed care plans. Those advocates however also have expressed some reservations regarding the implementation timeline and urged a more slower process, especially in the piece dealing with “dual eligible”. · Other advocates have expressed major concerns who worry about whether Medi-Cal health plans will be ready in time to provide quality health care to hundreds of thousands of people with disabilities, the blind and seniors who are currently receiving their care through the Medi-Cal “fee for service” model (where the recipient chooses their own doctor and services among participating Medi-Cal/Medicare providers in their community). · They also have raised concerns – and even opposition – to the part of the Coordinated Care Initiative’s plan to fold into Medi-Cal managed care several long term services and supports – including In-Home Supportive Services (IHSS) and the Multipurpose Senior Services Programs (MSSP). · Some of those advocates worry that the State is not prepared to undergo such major changes by next year and have urged a more deliberative timeline to minimize harm to people whose health situations are considered very fragile. · Some advocates have pointed to the reported problems that have occurred dealing with the elimination of the Adult Day Health Care Medi-Cal benefit for nearly 37,000 people with disabilities and seniors and the transition to the new Community-Based Adult Services Medi-Cal benefit that replaced it. Those advocates say that the pervious and on-going problems is evidence that the State is not prepared to deal with a transition involving hundreds of thousands of people. · State officials have countered those concerns in hearings and other forums – most recently at the November 15th Olmstead Advisory Committee meeting in Sacramento – that much has been learned from previous changes and transition to the Medi-Cal program, and that health plans involved in the demonstration project counties have experience dealing with people with disabilities and seniors. They also say the development and implementation of the tools and other measurements to determine health plan readiness and quality of care will make for successful transition that will address concerns raised by advocates. · Some advocates however still strongly disagree and point to continued reported serious problems in other Medi-Cal program areas undergoing transition.