The Massachusetts Executive Office of Elder Affairs (EOEA), in partnership with the Massachusetts Executive Office of Health and Human Services (EOHHS) Office of Disability Programs and Policy, the Massachusetts Office of Medicaid (MassHealth) and the Massachusetts Rehabilitation Commission (MRC), seeks from the U.S. Centers for Medicare and Medicaid Services (CMS) and Administration for Community Living (ACL) to finance Support for Ombudsman and Beneficiary Counseling Programs for States Participating in Financial Alignment Model Demonstrations for Dually Eligible Individuals. The project will continue the Massachusetts Financial Alignment Model approved in 2012, which uses combined Medicaid and Medicare funding to contract with Integrated Care Organizations (ICOs), known in Massachusetts as One Care, to provide integrated, comprehensive care for dually eligible adults ages 21 to 64 years old. The One Care plans arrange the delivery and management of all covered medical, behavioral health care and long-term services and supports (LTSS).
Massachusetts respectfully requests total funding of $1,300,000 from CMS and ACL for the 45 months of the project that will leverage the capacity of the SHINE program (Serving the Health Insurance Needs of Everyone - the State Health Insurance Assistance Program in Massachusetts), and its work with Aging and Disability Resource Consortia (ADRC) partners as well as disability, recovery, mental health, homeless and health advocacy organizations to best serve the needs of individuals seeking unbiased, objective information and counseling regarding the One Care plan services and options.
EOEA expects to achieve the following outcomes:
1. A sustainable corps of up to 650 volunteer and in-kind agency staff SHINE counselors to provide education and counseling surrounding the One Care plans;
2. A centralized 800 number and website for consumers to contact SHINE counselors, first directed to the regional office then to the local site in the consumer’s town;
3. Seamless referral and coordination system between SHINE counselors, consumers, My Ombudsman, MassHealth, One Care plans, stakeholders and disability organizations;
4. Increased numbers of consumers counseled, increased number of presentations and numbers of consumers/caregivers at presentations
5. Enhanced and additional counseling services for limited English-speaking and deaf/blind, rural and tribal duals beneficiaries
6. Improved communication to duals beneficiaries and caregivers through social media, cable TV, video telephone, computer based webinars and training
