Department of Community Health outlines Medicaid managed-care shift, PACE rollout and new state nurse-aide program

The Department of Community Health told the committee it is pursuing several initiatives aimed at expanding managed-care coverage, creating community-based alternatives to nursing homes and easing staffing shortages in assisted living and personal care homes.

Joe Hood, chief operating officer for the Department of Community Health, said an open procurement for care management organizations (CMOs) for Medicaid is ongoing and "under appeal," noting that an initial intent to award has been followed by an appeal process. "It may be a year or more for that to reach resolution," Hood said, adding that changes tied to new contracts will not occur until appeals and operational readiness are resolved.

Hood said the first population slated to shift from fee-for-service into managed care are people who qualify for Medicaid through Social Security (SSI). He said the department estimates that the appeal process and readiness could mean the optional shift of waiver and nursing-home populations would not occur for about three to four years. "Let's just say it took 2 years then it takes another 2 years of contract before we…