State Team Members
- NH Bureau of Developmental Services
- NH Bureau of Elderly and Adult Services
- Community Support Network Inc. (CSNI) – representing the 10 Area Agencies in NH
- Disability Rights Center
- Community Bridges (Region 4 Area Agency)
- NH Legal Assistance
- Granite State Case Management (services to people who are elderly and/or disabled)
Achievements & Successes, as of January 2018
- Assembling two stakeholder groups which has generated a large amount of interest across the state.
- To harness that interest, establishing four working committees to support our work. The committees will assist in establishing and implementing strategies and action steps for their area of focus. The committees are aligned with our priority areas and include:
- Performance and Value Based Contracting and Payment Process
- Utilization Review Process
- Linkages between CBOs and Integrated Healthcare Organizations
- Information Technology System Development
- Value Based Contracting and Payment:
- RFP Process Subcommittee – developing a statewide process to identify provider agencies to deliver waiver services to adults with DD
- State agency discussion on implementation of 525 contracts (Participant Directed and Managed Services) and comparison of performance statewide.
- Governance Audit: Three year review of Area Agency performance as required by annual contracts was just published and shared with Area Agencies.
- Utilization Review Process:
- High Cost Budget Calls – for any budget submitted over $150,000 a high cost budget call must occur. 3 – 6 month review is scheduled after the initial call to discuss utilization of the initial budget amount and any potential adjustments up or down.
- Post Payment Review Process – This has been drafted and is being combined with the existing “clinical review” which requires a sampling of clinical records for audit and quality assurance review.
- Wait List Registry Tracker: This tracks money that has been allocated to individuals that are receiving wait list dollars. Funding is tracked through a formula that takes into account “date services needed”, “projected start date” and “actual start date”. This formula identifies areas of “lapse” due to delays in start dates, which allows for reallocation of funds.
- Linkages between CBOs and Integrated Healthcare Organizations:
- IDN Training – scheduled for 12/12/17 and postponed. This is an education session for Integrated Delivery Networks (IDNs) to educate them on Medicaid Services and how Medicaid works.
- Wrap Meetings occur monthly at the State level to include the following services:
- Bureau of Drug and Alcohol Services
- Quality Assurance and Improvement
- Bureau of Developmental Services
- Bureau of Mental Health Services
- Bureau of Elderly and Adult Services
- Other Relevant Department Staff
- ED Protocol is recommended for people who are in the Emergency Department for 24 hours or more for behavioral vs. medical needs. Protocol requires a case conference with all members of the individual’s support team, including MCOs, primary care, psychiatric, etc.
- Information Technology System Development:
- IT Core Team – This team is working on the development of IT System to streamline various applications that are being used: BTS, Wait List Registry, New HEIGHTS, MMIS (Medicaid Billing) and Service Link (eligibility).
- RFI has been written and published; we are awaiting consultant RFP update
Lessons Learned, as of January 2018
- It is difficult to move forward when there are so many voices at the table – start with a framework and ask people for their input on what has already been determined as the plan.
- Breaking down silos between services and identifying opportunities for collaboration is important.
- Communication with all parties from the beginning is essential to ensure trust and collaboration throughout the process.
Do you have questions for the New Hampshire state team? Please email your questions to email@example.com.