WEBVTT 1 "Lizzy Whitehorn" (2129746944) 00:00:00.000 --> 00:00:08.392 Okay. 2 "Melishia Bansa" (1101461760) 00:00:08.392 --> 00:00:28.310 Okay, welcome, everyone. Welcome to the 1115 healthcare transformation waiver regarding testing Medicaid coverage of health related and social needs. We're gonna get right into it. Regarding any meeting basics, welcome again. Please note this. 3 "Melishia Bansa" (1101461760) 00:00:28.310 --> 00:00:52.520 Town hall meeting is being recorded, if possible. Attendees are asked to attend this meeting with their cameras turned on. Please be sure to mute your audio except when speaking. Please note that HFS staff may mute participants to minimize any type of disruptive noise or feedback. Comments or questions during the meeting. If you have a question during this town hall meeting, please. 4 "Melishia Bansa" (1101461760) 00:00:52.520 --> 00:01:11.460 Utilize the Webex chat feature to send your question or comment directly to the host. Please also provide your full name and contact information as well as the name of your organization if applicable. Please also state your full name in the chat when asking your question or providing your comment. 5 "Melishia Bansa" (1101461760) 00:01:11.460 --> 00:01:31.460 Okay regarding all of the questions and comments that will be addressed today, your questions are important to us and will help inform the development of future. 6 "Melishia Bansa" (1101461760) 00:01:31.460 --> 00:01:50.520 Presentations and informational materials. HFS will prepare a FAQ document to be posted later addressing your comments and questions that were submitted today during this town hall. Today's slide deck will be posted to the HFS website in the following location provided for you today on this slide. 7 "Melishia Bansa" (1101461760) 00:01:50.520 --> 00:02:07.830 Regarding ADA compliance, HFS is committed to hosting meetings that are accessible when ADA compliant. Closed captioning accommodations have been provided for you via the Webex platform. Patients please many participants attending today maybe new to this virtual town hall format. 8 "Melishia Bansa" (1101461760) 00:02:07.830 --> 00:02:20.258 Without further ado, I would like to introduce the director of HFS with welcoming remarks, Director Lizzie Whiteman. Thank you. 9 "Lizzy Whitehorn" (2129746944) 00:02:20.258 --> 00:02:22.935 Thanks Malaysia. Hi, everyone. 10 "Gabriela Moroney" (3689362688) 00:02:22.935 --> 00:02:26.576 And thanks for bearing with us jumping through some. 11 "Lizzy Whitehorn" (2129746944) 00:02:26.576 --> 00:02:45.570 Very quick housekeeping items at the beginning that Malicia went through. I would just remind everyone we have a lot of people on this call today wish we are so excited about, but if you can please make sure to mute yourself so we don't hear background noise that will help everyone. 12 "Lizzy Whitehorn" (2129746944) 00:02:45.570 --> 00:03:05.570 So good afternoon, Asia said, I'm the HFS director, Lizzy Whiteboardn. Thank you all for joining us today. We are really, really excited about the recent federal approval of Illinois healthcare Transformation 1115 demonstration waiver, and it's so exciting to see. 13 "Lizzy Whitehorn" (2129746944) 00:03:05.570 --> 00:03:25.570 Be so much interest and enthusiasm around this 1115 waiver. So, the, we got the approval in July and that is the starting point for this nation leading work to meaningfully address health related social needs and the root causes of health disparities. Our ultimate goal is to. 14 "Lizzy Whitehorn" (2129746944) 00:03:25.570 --> 00:03:47.730 Improve health outcomes and create a more equitable health care system for all Illinois. As many of you know, 1115 waivers are designed to allow state Medicaid programs to test the impact of innovations that are not traditional medical services and therefore have not been covered by Medicaid traditionally. We believe that this will be transformational. 15 "Lizzy Whitehorn" (2129746944) 00:03:47.730 --> 00:04:07.730 Both for the individuals who can access critical services that haven't been covered by Medicaid before, but also for the health care system broadly because it allows us to better address the causes of health disparities and prevent them from leading to poor health outcomes to begin with. This is just the beginning. There is a great deal of implementation. 16 "Lizzy Whitehorn" (2129746944) 00:04:07.730 --> 00:04:32.450 Planning and work that we will be doing with our federal partners and with many of you. As we roll this out, we will be engaging with a range of stakeholders, community partners, our managed care organizations, health care providers, customers, our sister state agencies, federal partners, and many more. We strongly value your diverse perspectives and your shared commitment to improving health outcomes in Illinois. 17 "Lizzy Whitehorn" (2129746944) 00:04:32.450 --> 00:05:00.829 We have a lot of work in front of us to implement these newly approved services and your ongoing partnership will be critical as we move ahead. I also just wanted to take a moment to thank the HFS staff who have worked on this for their tireless efforts 1st on the waiver application and now into implementation planning. Your work is going to have a tremendous impact on the lives of people across Illinois. In particular, I want to recognize HFS medication. 18 "Lizzy Whitehorn" (2129746944) 00:05:00.829 --> 00:05:30.899 Administrator Kelly Cunningham, who should be on the call somewhere with us here, as well as Kristen Hartza and Gabriella Moronie, who you will hear from later in the presentation. They really have been leading the work and I know many of you have interacted with them and really appreciate everything that they've done to get us where we are today. So I think we're gonna dive into the presentation now. 19 "Lizzy Whitehorn" (2129746944) 00:05:30.899 --> 00:05:46.229 So again, you know, I discussed some of this in the, the remarks I just gave, but the vision for this waiver is really to address health related social needs, to advance access, quality and equity in health care. 20 "Lizzy Whitehorn" (2129746944) 00:05:46.229 --> 00:06:06.229 We must go beyond simply investing in the traditional health care provision and healthcare system. Health related social needs include racism, poverty, unequal access to care, housing, food and security community violence, and unemployment, all of which contribute to health and equities, and there are so many statistics. 21 "Lizzy Whitehorn" (2129746944) 00:06:06.229 --> 00:06:26.429 Good site, but one that I think is really powerful is that individuals with unmet health related social needs are two and a half times more likely to report four physical health, more than five times more likely to report mental health issues and two times more likely to report higher health care utilization. 22 "Lizzy Whitehorn" (2129746944) 00:06:26.429 --> 00:06:43.259 So with the approval of this waiver, we can start to bring more federal resources in to support critical efforts to improve health outcomes and ultimately reduce costs down the road. We go to the next slide. 23 "Lizzy Whitehorn" (2129746944) 00:06:43.259 --> 00:07:04.589 So I'm just gonna do a quick few slides with some brief background on overview of what an 1115 waiver is. I think Kelly would have done this with all of you, but she's a little under the weather, so I'm gonna jump in here and then turn it over to my team. So. 24 "Lizzy Whitehorn" (2129746944) 00:07:04.589 --> 00:07:24.589 We call it an 1115 waiver because it's actually from section 1115A of the Social Security Act, which provides waiver and expenditure authority for state Medicaid programs to test or demonstrate the impact of proposed innovations that otherwise wouldn't be allowed under the traditional Medicaid program. 25 "Lizzy Whitehorn" (2129746944) 00:07:24.589 --> 00:07:28.289 Okay. 26 "Lizzy Whitehorn" (2129746944) 00:07:28.289 --> 00:07:48.289 Go to the next slide. So just some 1115 fundamentals, approval of the waiver allows for the addition of new services or the introduction of flexibilities that would not ordinarily be allowed under Medicaid. 27 "Lizzy Whitehorn" (2129746944) 00:07:48.289 --> 00:08:22.609 And it allows services and flexibilities to be targeted towards particular priority populations or geographic areas or designated pilot initiatives, which is different than Medicaid which generally has to be offered to anyone who's eligible and not across certain populations or certain areas of the state. And then the funding piece of it authorizes federal matching to offset state expenditures on the approved approved services and flexibilities. And importantly, the. 28 "Lizzy Whitehorn" (2129746944) 00:08:22.609 --> 00:08:42.609 Matching is available for state expenditures that are not otherwise supported by another federal funding source, so we can't spend federal money from one pot and then seek match through Medicaid on that federal, those federal dollars. It has to be on state investments. And the match rate for our 1115 waiver programs generally is the same. 29 "Lizzy Whitehorn" (2129746944) 00:08:42.609 --> 00:09:05.269 As our regular match rate for the state 51 ish percent. So, $51 for every hundred dollars spent. Go to the next slide. So just some big picture highlights from what was approved in this waiver. We, as I said, we. 30 "Lizzy Whitehorn" (2129746944) 00:09:05.269 --> 00:09:25.269 Received approval in July of 2024. It actually contains new and continuing authorities and benefits. We actually, revised or amended an existing 1115 waiver as a way to more efficiently gain approval from the federal government. So there's a few programs that. 31 "Lizzy Whitehorn" (2129746944) 00:09:25.269 --> 00:09:52.129 We're continuing and then of course the new ones and the team will be highlighting those in more detail shortly. The approval kicks off an implementation planning process that is dictated significantly by federal CMS. So, we still have to work through more detailed operational protocols and other post approval deliverables. In order to do this work, we are going to be. 32 "Lizzy Whitehorn" (2129746944) 00:09:52.129 --> 00:10:12.129 Collaborating with many of you, with providers, with our sister state agencies, with the mcos, with other stakeholders, we cannot I can't emphasize enough that we cannot do this work alone, and this is really about bringing systems together to provide services that have not traditionally been part of. 33 "Lizzy Whitehorn" (2129746944) 00:10:12.129 --> 00:10:32.129 The healthcare system. So I say that to say, the timeline is still to be determined and will be worked out through these operational protocols that are due to the federal governments throughout the fall. And again, we'll be sharing more details on that shortly, but likely because there are so many new. 34 "Lizzy Whitehorn" (2129746944) 00:10:32.129 --> 00:10:54.409 New services we we will be standing up. We will be rolling things out in a phased approach. We can go to the next slide. Alright, I think I'm turning it over now to Kristen? Kristen. Gabriella. Oh yeah. Okay. 35 "Gabriela Moroney" (3689362688) 00:10:54.409 --> 00:11:10.279 Thanks director. Hi everybody. So I'm gonna talk a bit about the benefits themselves in some granular detail. We, in the 1115 extension request. 36 "Gabriela Moroney" (3689362688) 00:11:10.279 --> 00:11:31.759 We thought approval for new benefits. We had originally conceived of all of these buckets of benefits as health related social needs and learned that federal CMS is actually considering only two of these technically to be health related social needs, but the rest did. 37 "Gabriela Moroney" (3689362688) 00:11:31.759 --> 00:11:58.909 Secure federal approval to implement. So we're shifting our nomenclature just a bit. Among the newly approved benefits are those that target health related social needs as CMS thinks of them. This includes a housing support benefit, a package of benefits that includes programming that we have called medical respite in Illinois, and that the federal government. 38 "Gabriela Moroney" (3689362688) 00:11:58.909 --> 00:12:15.239 Refers to as recuperative care. Also in the health related social needs bucket, are a host of nutrition supports, which we'll talk about in greater detail as we go forward in the presentation. 39 "Gabriela Moroney" (3689362688) 00:12:15.239 --> 00:12:32.159 We were also approved to offer re entry services for individuals preparing to leave cursoral settings and this will allow the state, to demonstrate the impact of coverage of pre release services 90 days prior to release. 40 "Gabriela Moroney" (3689362688) 00:12:32.159 --> 00:12:51.569 We also worked with our colleagues at the Department of Human Services in the Office of Firearm violence prevention to outline a set of violence prevention and intervention services that will advance the state's work under the reimagined public Safety Act. 41 "Gabriela Moroney" (3689362688) 00:12:51.569 --> 00:13:11.569 And then we also are, I believe the 3rd state in the country who have received approval to cover non medical transportation that will allow individuals who are receiving health related social needs benefits or supported employment services, the. 42 "Gabriela Moroney" (3689362688) 00:13:11.569 --> 00:13:36.379 Ability to obtain transportation to and from those services. And then also wanna call out the fact that there were some, benefits outlined in our original 1115 health behavioral health transformation waiver which have carried over into this extension. That is. 43 "Gabriela Moroney" (3689362688) 00:13:36.379 --> 00:13:52.499 Includes supported employments, SUD case management as well as SUD treatment in institution for mental disease. 44 "Gabriela Moroney" (3689362688) 00:13:52.499 --> 00:14:12.499 For invs as we refer to them. Next slide please. So, these benefits will be available, in targeted ways in demonstration ways to individuals who are eligible for. 45 "Gabriela Moroney" (3689362688) 00:14:12.499 --> 00:14:33.049 So thinking about the health related social needs, which, are under the federal definition, housing supports and nutrition interventions, eligibility for these benefits will be for individuals who are Medicaid. 46 "Gabriela Moroney" (3689362688) 00:14:33.049 --> 00:14:53.279 Eligible and enrolled in managed care. That's the vast majority of our Medicaid membership at this stage in our managed care system development. The eligibility for specific benefits will be tied to both clinical and social criteria. 47 "Gabriela Moroney" (3689362688) 00:14:53.279 --> 00:15:08.999 That is a requirement of federal CMS, and that's the same requirement that other states who are implementing these sorts of benefits will cover. We also want to. 48 "Gabriela Moroney" (3689362688) 00:15:08.999 --> 00:15:25.199 Highlight that we have been taking a really broad and inclusive approach to eligibility for health related social needs. When we were developing our requests, we looked for opportunities to write very broad definitions. 49 "Gabriela Moroney" (3689362688) 00:15:25.199 --> 00:15:45.199 We will, of course, under our stcs, be narrowing down as we develop our operational protocols and our final implementation plans and processes, but we wanted to preserve as much flexibility as possible, to bring as many. 50 "Gabriela Moroney" (3689362688) 00:15:45.199 --> 00:16:11.719 Of our members and partners into the umbrella of 1115 authority. Next slide please. So actually Malicia I'm gonna ask you to go back to the previous slide because I think I made a mistake in this in that prior slide, in terms of labeling. I apologize for that. 51 "Gabriela Moroney" (3689362688) 00:16:11.719 --> 00:16:44.009 This is eligibility not only for those housing and nutrition interventions, but for those other four buckets of, benefits that I showed folks earlier. See for service, enrollies will remain eligible for the SUD case management and SUD services provided in imds, but all the rest of the benefits we're talking about will follow the guidelines that you see on this particular slide. 52 "Gabriela Moroney" (3689362688) 00:16:44.009 --> 00:17:04.009 Thanks for letting me correct that and I'm gonna ask you now to advance to the next slide again. So we wanted to talk in some detail about the housing and nutrition interventions. These are covered. 53 "Gabriela Moroney" (3689362688) 00:17:04.009 --> 00:17:29.149 For individuals who are high risk or high costs based on their service utilization or their healthcare history or it could be for individuals who have complex physical health needs, such as the persistent disabling or progressively like threatening physical health conditions or for individuals. 54 "Gabriela Moroney" (3689362688) 00:17:29.149 --> 00:17:54.829 Or individuals who have behavioral health needs such as SMI or SUD. Another category of eligibility eligible populations for housing and nutrition interventions are individuals who are experiencing a high risk, high risk pregnancy or experiencing complications arising from the pregnancy or those who have. 55 "Gabriela Moroney" (3689362688) 00:17:54.829 --> 00:18:20.659 Chronic health conditions that have nutritional needs as a component of that condition. That those are the populations that we are seeking to address in our 1115 implementation work, and we will be further defining the eligibility criteria in our HRS and implementation. 56 "Gabriela Moroney" (3689362688) 00:18:20.659 --> 00:18:49.499 Patient plan. This is one of many post approval deliverables that the state will be preparing and submitting to federal CMS in the coming months. Next slide please. So, I'm not gonna go through each one of these approved housing benefits, but I just want to highlight that again in the spirit of going broad. 57 "Gabriela Moroney" (3689362688) 00:18:49.499 --> 00:19:09.499 We have thought and received approval for a pretty wide variety of housing support services. It includes housing support both pretendency and tendency sustaining as well as one time transition and move. 58 "Gabriela Moroney" (3689362688) 00:19:09.499 --> 00:19:30.649 Getting costs and case management should go with that. We also are introducing, recuperative care or as we say in Illinois medical respite for individuals who are perhaps stepping, experiencing homelessness and stepping down from a. 59 "Gabriela Moroney" (3689362688) 00:19:30.649 --> 00:19:50.649 Hospitalization or who may need a place to prepare for or recover from some kind of a procedure, as well as individuals who maybe sick, not sick enough to go into, a hospital but who are experiencing homelessness and, and, can access medical respect. 60 "Gabriela Moroney" (3689362688) 00:19:50.649 --> 00:20:13.939 That as one of the approved housing benefits. Both the housing support benefits, and the medical respite which is now part of housing benefits, these are part of hfs's commitment to the state's plan to prevent an end homelessness and are prioritized for some fast track implementation. 61 "Gabriela Moroney" (3689362688) 00:20:13.939 --> 00:20:38.399 In support of the work two and homelessness in Illinois. One last item that I'll highlight here is the approval for some short term post transition housing, that would cover room and board for up to six months. Another way to think of this is rental assistance and for folks who have been following Medicaid for a long time. 62 "Gabriela Moroney" (3689362688) 00:20:38.399 --> 00:20:58.399 You all know that this is really a historic change with the ability of Medicaid match, to be used to support rental assistance. And then when we're talking about, you know, what kinds of transitions can be supported with the housing benefits that have been. 63 "Gabriela Moroney" (3689362688) 00:20:58.399 --> 00:21:18.399 Been Approved here. We're really thinking about individuals who are experiencing homelessness or who are at risk of homelessness, and who are at a stage of transitioning. So this would include folks who are leaving a congregate residential setting or an institutional setting. 64 "Gabriela Moroney" (3689362688) 00:21:18.399 --> 00:21:45.479 Or who are coming out of prisons or child welfare settings as well as more traditionally, the way we more traditionally think of individuals experiencing homelessness. Next slide, please. So turning to the approved nutrition services, the nutrition services are. 65 "Gabriela Moroney" (3689362688) 00:21:45.479 --> 00:22:05.479 Varied as well. It'll include case management services that are targeted at helping individuals access food and nutrition. And it will also include nutrition counseling and instructions. 66 "Gabriela Moroney" (3689362688) 00:22:05.479 --> 00:22:38.539 That's tailored to an individual's health risk, or to their health conditions that are sensitive to the kinds of foods that an individual is eating. It will also, can, it can also cover home delivered meals and medically tailored meals, as well as stock pantries for individuals who are moving into, a new home. Additionally, it can cover nutrition prescriptions that are ta. 67 "Gabriela Moroney" (3689362688) 00:22:38.539 --> 00:23:10.849 To health risk, as well as grocery provisions for high risk individuals that are needed to avoid unnecessary admission to care or institutionalization. Next slide please. So we've covered the health related social needs of CMS to finds them housing supports and nutritions assistance. And now we're gonna shift to another one of the benefits that we. 68 "Gabriela Moroney" (3689362688) 00:23:10.849 --> 00:23:36.349 We have received approval for, which is a re entry demonstration. Under this initiative, we are seeking to provide services to individuals who are residing in a state or local jail prison or youth correctional facility. And this will allow the state to cover pre. 69 "Gabriela Moroney" (3689362688) 00:23:36.349 --> 00:23:56.349 These services up to 90 days prior to the expected date of release. And, those services are, are, are, I think, very generous and potentially extremely helpful to individuals preparing for discharge. It includes case management. 70 "Gabriela Moroney" (3689362688) 00:23:56.349 --> 00:24:13.769 Management to get at the physical and behavioral health needs as well as the social needs of individuals who are returning to the community. It includes medication assisted recovery for individuals who have SUD substance use disorder. 71 "Gabriela Moroney" (3689362688) 00:24:13.769 --> 00:24:33.769 It includes a 30 day supply of all prescriptions and over the counter drugs that an individual needs immediately upon release, so they're going forward with a month's worth of meds in hand. It, includes services that are provided by a very specialized. 72 "Gabriela Moroney" (3689362688) 00:24:33.769 --> 00:24:53.769 Type of community health worker focused on reentry. It'll cover diagnostic and treatment services, things like labs and radiology in order to shore up any needs that an individual may need treatment for as they go forward. It will also include those prescribed. 73 "Gabriela Moroney" (3689362688) 00:24:53.769 --> 00:25:13.769 Drugs while an individual is still in the carcerol setting beyond the medication assisted recovery drugs that I mentioned earlier. And finally, it will cover medical equipment and supplies that an individual might need in those days leading up to release as well as upon release and. 74 "Gabriela Moroney" (3689362688) 00:25:13.769 --> 00:25:46.331 Going out into the community. Next slide please. And before I dive right into violence prevention and intervention, I am gonna ask my colleague Kristen Hartsaw to come off of mute and correct me if I'm wrong. I believe that under Kristen's expert negotiations with federal CMS, Illinois, is the 1st to cover the violence prevention and intervention benefits. Is that. 75 "Kristin Hartsaw" (3205792000) 00:25:46.331 --> 00:26:09.468 Correct, from the community violence prevention, yes, we, there are other 1115 waivers that cover what you might think of in terms of family violence or domestic violence, but we really worked to address what our sister state agency is doing and really part of that reimagined public Safety Act really trying to get at some of those services. 76 "Gabriela Moroney" (3689362688) 00:26:09.468 --> 00:26:29.779 Right. And so because we're the 1st state to get at community violence prevention, we know that this is new for CMS, and this will likely take more time for the state to operationalize and we'll be doing that in partnership with our colleagues. 77 "Gabriela Moroney" (3689362688) 00:26:29.779 --> 00:26:49.779 At the Department of Human Services Office of firearmed violence prevention and intervention. Our request was really intended to support that work and leverage the plans and the responsibilities that the state has under the reimagined public Safety Act. 78 "Gabriela Moroney" (3689362688) 00:26:49.779 --> 00:27:08.189 And so, this will be a benefit for which a Medicaid beneficiaries, who have, experienced violent or who have survived violence or are at risk, can hopefully benefit from the following kinds of interventions. 79 "Gabriela Moroney" (3689362688) 00:27:08.189 --> 00:27:28.189 Screening and assessment of needs related surveillance, as well as things like psychoeducation, trauma specific and trauma informed therapies, conflict mediation, mentoring, crisis intervention. 80 "Gabriela Moroney" (3689362688) 00:27:28.189 --> 00:27:49.789 Care support service, care coordination services, and life skills training. So let's give it up for Illinois, securing this approval 1st in the country. Next slide please. Okay, so, under supported employment, I think it's important to note that. 81 "Gabriela Moroney" (3689362688) 00:27:49.789 --> 00:28:18.289 That, supported employment is part of our original 1115 behavioral health care, waiver and we have thought to retain the authority to cover it under the 1115 and also to expand it to a larger group of individuals. And so we are, hoping to implement pilot. 82 "Gabriela Moroney" (3689362688) 00:28:18.289 --> 00:28:48.569 To deliver these services to Medicaid beneficiaries who are 18 or older with serious and persistent behavioral health conditions or physical, intellectual or developmental needs. This includes both pre employment services such as, pre vocational discovery and assessment, person centered planning, and job development. 83 "Gabriela Moroney" (3689362688) 00:28:48.569 --> 00:29:08.569 As well as services that can sustain employment, such as career advancement, job coaching, transportation, asset development, and additional kinds of support to help individuals continue to succeed. 84 "Gabriela Moroney" (3689362688) 00:29:08.569 --> 00:29:10.889 In the workplace. 85 "Gabriela Moroney" (3689362688) 00:29:10.889 --> 00:29:30.889 Next slide please. Okay, so the last benefit that I'll be talking about today is non medical transportation. I believe that we are one of only a few states that has been approved for non medical transport. 86 "Gabriela Moroney" (3689362688) 00:29:30.889 --> 00:30:00.739 We defined it very broadly in our request. What was ultimately approved by CMS was somewhat narrower than what we received, but we believe what we have approved is still gonna be an incredibly useful tool to support individuals who have health related social needs. And so the non medical transportation service, the folks who are eligible will be either receiving those other health related social needs. 87 "Gabriela Moroney" (3689362688) 00:30:00.739 --> 00:30:16.949 Services housing supports and, nutrition assistance or supported employment or to home and community based services, that are offered. 88 "Gabriela Moroney" (3689362688) 00:30:16.949 --> 00:30:36.949 By Medicaid through a number of, 1915C waivers, I don't wanna go down into the rabbit holes of the different kinds of waivers, but we also have a number of individuals who are receiving home and community based services under, a 1915C. 89 "Gabriela Moroney" (3689362688) 00:30:36.949 --> 00:30:54.269 And the 1915 eye, that allows so so those individuals may also be eligible for non medical transportation. And so, they'll be able to use that benefit to move to and from HRSM services. 90 "Gabriela Moroney" (3689362688) 00:30:54.269 --> 00:31:10.949 Or in conjunction with supported employment services, the big caveat from federal CMS is that use of the non medical transportation services must be directly related to a goal on the beneficiary service plan. 91 "Gabriela Moroney" (3689362688) 00:31:10.949 --> 00:31:30.949 And so I believe that I've reached the end of, the section that I'm covering in this conversation, but pertaining back to some of the contents that director white Horn covered, I just want to reiterate that under the 1115 waiver is often referred to as a demonstration. 92 "Gabriela Moroney" (3689362688) 00:31:30.949 --> 00:31:50.949 Waivers that used to be called research waivers. Our goal is to stand up these benefits in order to support existing initiatives and look for ways that we can target implementations to other areas of need throughout the state. I say that just to temper. 93 "Gabriela Moroney" (3689362688) 00:31:50.949 --> 00:32:10.941 Expectations unlike state plan benefits services, these aren't gonna be, you flip a switch and they're available to everyone. We've got a lot of work to do in order to establish what our landscape of implementation is going to look like. And Kristen is gonna tell you a lot more about what that process is. So with that, I'm gonna hand it over to kris. 94 "Kristin Hartsaw" (3205792000) 00:32:10.941 --> 00:32:11.609 Yeah. 95 "Kristin Hartsaw" (3205792000) 00:32:11.609 --> 00:32:31.609 Alright, thank you so much Gabriella. And I just also want to remind everyone just due to time and the large size of the audience, please do submit any questions that you may have via, the Q and A chat option. We will collect all of those and we are already in the process of. 96 "Kristin Hartsaw" (3205792000) 00:32:31.609 --> 00:32:51.609 Developing a frequently asked question document to share with the public and so we will take your questions and work diligently to get some answers out there as soon as possible. So I have the pleasure of talking a little bit about where we are right now in terms of post approval. 97 "Kristin Hartsaw" (3205792000) 00:32:51.609 --> 00:33:03.449 We received that approval on 2 July and we've been working diligently since on a number of the immediate deliverables. So next slide please. 98 "Kristin Hartsaw" (3205792000) 00:33:03.449 --> 00:33:23.449 So with approval of an 1115 waiver comes a series of expectations from federal CMS around, operational protocols, reporting and monitoring, evaluation design, and much, much more. And before we get to that state of where we can implement and. 99 "Kristin Hartsaw" (3205792000) 00:33:23.449 --> 00:33:43.449 Start claiming federal match on services in this waiver, we have to make sure we have our deliverables approved by federal CMS. So I sometimes use we we just had the Olympics finished, right? And so when you think about, you know, you're, you're packing your bags for Paris perhaps. 100 "Kristin Hartsaw" (3205792000) 00:33:43.449 --> 00:34:16.519 To go and compete, and that was all the negotiation with federal CMS and now you have arrived and you're at the opening ceremony. Perhaps that's what we receive approval, and now we're going to our event, and maybe it's the start of the marathon that is our event. I feel like that's really where we're at. The federal CMS requires that we develop operational protocols for both the health related social needs benefits as well as the re entry demonstration. For hrsns, those are due by the end. 101 "Kristin Hartsaw" (3205792000) 00:34:16.519 --> 00:34:32.849 End of September and then we get one extra month for the reentry demonstration. So we've been doing a lot of work behind the scenes, not all on our own, and I'll talk a little bit about the stakeholders who've been engaged with us, but we've really been working through. 102 "Kristin Hartsaw" (3205792000) 00:34:32.849 --> 00:34:50.339 All of those services that Gabriella just shared with you, further defining the service descriptions, further defining what eligibility for Medicaid members to be able to access those services, what will that eligibility screening look like? 103 "Kristin Hartsaw" (3205792000) 00:34:50.339 --> 00:35:10.339 We need to fine tune the provider qualifications. What is a, what does a provider type look like for housing supports or for food and nutrition services? And we are very grateful to our sister agencies as well as many key informance and key stakeholders who've been. 104 "Kristin Hartsaw" (3205792000) 00:35:10.339 --> 00:35:38.569 Assisting us with this process. And I just really want to reiterate, you know, part of what we even started before we got to approval was some of the stakeholder engagement and really trying to understand the lay of the land. HFS is not seeking to stand up a new service delivery system in the housing and food and nutrition space. We are looking to bring Medicaid resources to the good work. 105 "Kristin Hartsaw" (3205792000) 00:35:38.569 --> 00:36:01.369 That is already happening in that space. This slide just lists a little bit more about what goes into some of the operational protocols, that will include our timeline for implementation. We also have to report out on all of these activities, so CMS expects us to have monitoring protocol. 106 "Kristin Hartsaw" (3205792000) 00:36:01.369 --> 00:36:21.369 Calls in place and on top of that, there's also a full scale evaluation that needs to be designed with independent evaluators. So a lot of work happening behind the scenes. I think I celebrated for all of 30 min when we got news of our approval, and then it is right back to work with the entire. 107 "Kristin Hartsaw" (3205792000) 00:36:21.369 --> 00:36:43.579 Your team that is working on this. Next slide please. So again recognizing that there are a lot of providers working in this space and, wanting to understand the current state and systems of service delivery so that we. 108 "Kristin Hartsaw" (3205792000) 00:36:43.579 --> 00:37:09.949 We can inform our implementation plan. We embarked on a multi phase process in terms of stakeholder engagement. So 1st we completed a landscape scan. We, we brought in a partner who helped us develop a survey and focus group guide, and we really did some information gathering as well as key informat meetings with leaders and. 109 "Kristin Hartsaw" (3205792000) 00:37:09.949 --> 00:37:35.149 Partners who are already working in the HRSN and other spaces. Now that we've gotten our approval, we've shifted very quickly into operational design and and even though we had already started some of that work, you know, until you know what services CMS is approving, you can't get too far down the road. So now we have convened several provider technical. 110 "Kristin Hartsaw" (3205792000) 00:37:35.149 --> 00:38:08.029 Workgroups. I'll I'll talk about that in a moment, and we're also developing a very focused survey to get at some things that will help us inform rate development and much more. Additional phases of stakeholder engagement as we bring all of these moving parts and pieces together, you know, we will want to validate and finalize our protocols and then even post implementation as we continue to monitor the demonstrations and the various pilot initiatives. 111 "Kristin Hartsaw" (3205792000) 00:38:08.029 --> 00:38:29.640 We know we will have to make adjustments along the way. That's the very design of an 1115 waiver. It's a demonstration and we're trying to develop best practices that ultimately improve the health of our Medicaid members. Next slide. 112 "Kristin Hartsaw" (3205792000) 00:38:29.640 --> 00:38:49.640 Since some of you on this line may have participated in our initial landscape scan, we wanted to share just a few highlights from the survey that was sent out very early this year. I believe it went out either end of January or very early February. And then I'll also share some key themes from the. 113 "Kristin Hartsaw" (3205792000) 00:38:49.640 --> 00:39:09.640 Focus groups that convened. But essentially what we were seeking to understand with our survey was to really understand some of the services that are happening now, what are the primary funding mechanisms, you know, what services are going to measure. 114 "Kristin Hartsaw" (3205792000) 00:39:09.640 --> 00:39:27.390 Decade members specifically in this space, also getting an understanding of what providers use in terms of data management systems, referrals, and much more. We recognize that some of the housing and nutrition service providers. 115 "Kristin Hartsaw" (3205792000) 00:39:27.390 --> 00:39:47.390 May not work in the Medicaid space at all. So understanding their current state is very critical to inform our implementation plan. And then that we know we have some providers as well who do currently bill Medicaid and so bringing them together to help inform the implementation planning is another. 116 "Kristin Hartsaw" (3205792000) 00:39:47.390 --> 00:40:10.070 Strategy that we have embarked on. But what this survey initial landscape scan survey showed us is that as we suspected many social service providers today rely on those states and or federal grants. And so then when we think about bringing in Medicaid dollars and thinking about billable services. 117 "Kristin Hartsaw" (3205792000) 00:40:10.070 --> 00:40:37.850 Really what will that all mean? And so that that's one reason we did this survey is to understand current state to then inform planning. We do see that many of the respondents of the survey use a variety of data management systems and that that really varies by sector. And also we asked about referral sources and also as expected, you know, the referral sources and mechanisms. 118 "Kristin Hartsaw" (3205792000) 00:40:37.850 --> 00:41:01.460 That was really vary by stakeholder groups as well. Next slide. So we really wanted to dig in a bit further, and so we held three focus groups earlier this year. And at that time we really focused on reentry, housing as well as medical respite. And I've I see a few names who participated. 119 "Kristin Hartsaw" (3205792000) 00:41:01.460 --> 00:41:28.760 In those folks focus groups are here today, so thank you for participating and we we wanted to share a little bit about what we learned from those focus groups. And so that's what this slide is really illustrating. So, you know, how you screen members for services, there, there's a wide variability with that. And so as we think about our implementation planning, you know, how can we have con. 120 "Kristin Hartsaw" (3205792000) 00:41:28.760 --> 00:41:48.760 Consistency across sectors. That's something that now our provider work groups are discussing and working through. We know that care coordination is available and certainly in the managed care system that care coordination is available, but when we think about that linkage to social services, again. 121 "Kristin Hartsaw" (3205792000) 00:41:48.760 --> 00:42:08.900 A wide range of variability. We know there's concern about continuity of care, especially when people are transition transitioning maybe from settings or from program or to community, and that we know connections, the focus group shared with us and, and reaffirmed. 122 "Kristin Hartsaw" (3205792000) 00:42:08.900 --> 00:42:40.700 What what some of us know is that the connections to those other wrap around services are just so critical. There are some infrastructure related costs authorized under this 1115 waiver, and so the focus group was also very helpful informing us around what potential infrastructure related supports could, could be necessary to help small providers especially, be able to come into the Medicare. 123 "Kristin Hartsaw" (3205792000) 00:42:40.700 --> 00:43:03.710 Enterprise. And then always meeting the needs of the customer, right? That is a major focus area for, those who participated and, and really a focus of HFS. I've only been with HFS for a little over two years and I will say one of the things that really struck me when I 1st joined was that. 124 "Kristin Hartsaw" (3205792000) 00:43:03.710 --> 00:43:23.710 Many of my colleagues, even within regular meetings, are always focused on what about the needs of the client? And I know it may not always seem like that, but there are very strategic conversations happening about how can we improve the health of our clients? How can we build. 125 "Kristin Hartsaw" (3205792000) 00:43:23.710 --> 00:43:43.710 A health system that is equitable and really this whole vision of healthcare transformation and where the waiver fits in to that entire vision. I, I really do feel like the department is working hard to meet those needs. And that is why we are taking the time to engage with stakeholders as we further plan. 126 "Kristin Hartsaw" (3205792000) 00:43:43.710 --> 00:43:50.040 The delivery of 1115 waiver services. Next slide, please. 127 "Kristin Hartsaw" (3205792000) 00:43:50.040 --> 00:44:10.040 So that was our landscape scan. Now in terms of the provider technical workgroups, you know, a big piece of their work is to really provide that external subject matter expertise as we work on our app operational design and continue the planning, but also we need. 128 "Kristin Hartsaw" (3205792000) 00:44:10.040 --> 00:44:27.960 Information from them to inform rate development for these services. How do we determine the rates for some of the nutrition or housing support services in a silo? You can't. And so having these provider technical work groups come together and work thoughtfully through. 129 "Kristin Hartsaw" (3205792000) 00:44:27.960 --> 00:44:47.960 Various topics has been incredibly helpful. And we also are going to rely on them to help us identify opportunities to engage with Medicaid customers as well because if we're not designing these programs with the Medicaid customer in mind and the member journeys that they have in accessing these services, we won't. 130 "Kristin Hartsaw" (3205792000) 00:44:47.960 --> 00:45:19.640 To be successful. So we know we need to do that. Right now we have three provider work groups operating, medical respite housing and nutrition services. So there's some very early work happening right now to reflect upon our draft language for our operational protocols in terms of the service descriptions and provider qualifications and some of those other things. And then we anticipate even post these protocols being delivered. 131 "Kristin Hartsaw" (3205792000) 00:45:19.640 --> 00:45:39.640 Word Further regular meetings to inform the additional implementation planning and rate development. We vetted our invitation lists for these work groups with some of our key informance and sister agencies and other key subject matter experts working in this space. 132 "Kristin Hartsaw" (3205792000) 00:45:39.640 --> 00:45:56.820 We do anticipate another work group for reentry coming this fall. Right now we are starting with the actual correctional system partners being DOC, DJJ Department of Juvenile justice, as well as Cook County jail. 133 "Kristin Hartsaw" (3205792000) 00:45:56.820 --> 00:46:16.820 But we do anticipate bringing in to the fold community based providers who also work into the reentry space and fall feels like it's right around the corner, so probably by mid September, hopefully is when we will convene the community based providers around this. 134 "Kristin Hartsaw" (3205792000) 00:46:16.820 --> 00:46:43.160 Need to, yeah, I'm just gonna say mid September right now. All timelines subject to change depending on need. And then we also cannot do this work without our managed care organizations. And so the mcos responded very quickly when we put out the call to engage with them now that we had approval. So we have been working since July with an. 135 "Kristin Hartsaw" (3205792000) 00:46:43.160 --> 00:47:10.010 The Hawk work group, again, working through the same topics that we're working with our provider technical workgroups on. Next slide. So I know this is a lot, but we really wanted to make sure we were communicating what exactly is in the approval document and where we are with our implementation planning because really approval is just the beginning. 136 "Kristin Hartsaw" (3205792000) 00:47:10.010 --> 00:47:30.010 So over the next several months, you'll see us continue to work with sister agencies, with these stakeholders, with the mcos. We also have some other deliverables. We have to really complete that fiscal analysis, determine rate methodologies and billing requirements. 137 "Kristin Hartsaw" (3205792000) 00:47:30.010 --> 00:47:50.010 It's been a small but mighty team working on this and we are most grateful to have some additional support coming on board soon and building out an HFS team that will really help manage and oversee all of the various areas needed for implementation. But we also are very. 138 "Kristin Hartsaw" (3205792000) 00:47:50.010 --> 00:48:07.080 We committed to developing mechanisms in which we can communicate all of you and other stakeholders and customers especially as we get closer and closer to really beginning to deliver these services within the Medicaid space, right? 139 "Kristin Hartsaw" (3205792000) 00:48:07.080 --> 00:48:27.080 So please look for ongoing updates, whether that's at some of our Mac meetings, whether that's through our newer HFS newsletter, and then we dropped the link to our 1115 webpage in the chat, and that is another place where you will be. 140 "Kristin Hartsaw" (3205792000) 00:48:27.080 --> 00:48:55.130 Able to see updates as they become available, especially some of these public facing materials and documents. And then next slide and there's the links as well. And then of course CMS federal CMS that is also maintains an official record of all states, 1115 waivers and state plans and more, but I've given you the link here to. 141 "Kristin Hartsaw" (3205792000) 00:48:55.130 --> 00:49:08.983 Our Illinois page. So we will be posting this slide deck to the HFS webpage, and with that, I think we are finished with our content. So thank you so much for attending. 142 "Gabriela Moroney" (3689362688) 00:49:08.983 --> 00:49:19.500 Before you, before you adjourn Yes, please, before you adjourn us, I want to make sure that. 143 "Gabriela Moroney" (3689362688) 00:49:19.500 --> 00:49:39.500 We leave the, we leave our chat window, we, we, that we leave our meeting up and running, in order to make sure that everyone has an opportunity to submit any questions that you have into the chat. Just to reiterate what we talked about at the beginning. 144 "Gabriela Moroney" (3689362688) 00:49:39.500 --> 00:50:14.264 Of the call, we wanna make sure that we collect all of the questions and that will inform the development of an FAQ document, which we hope to be able to post before too much time goes by. So Felicia, if you're able and willing to please leave the meeting open, we've concluded the formal part of our presentation, but we want to give you an opportunity to drop any questions that you have into the chat if you haven't already, and then go on about. 145 "Melishia Bansa" (1101461760) 00:50:14.264 --> 00:50:17.921 Your afternoon. Absolutely Gabriel. 146 "Gabriela Moroney" (3689362688) 00:50:17.921 --> 00:50:19.909 Yeah. 147 "Kristin Hartsaw" (3205792000) 00:50:19.909 --> 00:50:25.861 Thank you. Thank you again for attending and have a great rest of. 148 "Melishia Bansa" (1101461760) 00:50:25.861 --> 00:50:35.480 A week. Thank you everyone. 149 "Melishia Bansa" (1101461760) 00:50:35.480 --> 00:50:55.480 Okay, uh. 150 "Melishia Bansa" (1101461760) 00:50:55.480 --> 00:51:15.480 Okay, uh. 151 "Melishia Bansa" (1101461760) 00:51:15.480 --> 00:51:23.868 Okay.