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Support for Demonstration Ombudsman Programs Serving Beneficiaries of Financial Alignment Models for Medicare-Medicaid Enrollees for Rhode Island CMS-1J1-19-001

Award Number: 1J1CMS331787
ORGANIZATION: HEALTH CARE FINANCING ADMINISTRATION, OFFICE OF ACQUISITION AND GRANTS
OPDIV: CMS
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: OTHER

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Support for Demonstration Ombudsman Programs Serving Beneficiaries of Financial Alignment Models for Medicare-Medicaid Enrollees for Rhode Island CMS-1J1-19-001 - The State of Rhode Island and Providence Plantations, Executive Office of Health and Human Services (EOHHS, seeks to continue its existing Ombudsman program in collaboration with sister state agencies, Rhode Island Parent Information Network (RIPIN), and other community stakeholders. EOHHS’s mission is to transform the healthcare delivery system through the purchasing of person-centered, comprehensive, coordinated, quality health care and support services that promote and enhance the ability of dually eligible and Medicaid-only recipients to maintain a high quality of life and live independently in the community. Consistent with Rhode Island’s Financial Alignment Demonstration (FAD), the continued goal of EOHHS’s Ombudsman program is to ensure Demonstration beneficiaries, caregivers and authorized representatives have person-centered assistance that supports the resolution of Demonstration-related issues and concerns. The objectives of the Ombudsman program under this grant award will continue to: a) offer beneficiaries accessible, credible, culturally appropriate, linguistically appropriate, confidential and skillful conflict-free resources to assist beneficiaries in matters related to services received under the Demonstration; b) address beneficiary concerns through education, self-help skills and empowerment; c) offer beneficiaries an advocacy resource that is authorized to access needed information to investigate and resolve complaints in a HIPAA compliant manner; d) employ data-driven investigations of complaints with an emphasis on successful resolution of issues; e) coordinate Ombudsman services with other entities across Rhode Island in order to resolve beneficiary issues effectively and efficiently; f) conduct outreach and educational activities throughout the state geared to reach all dually eligible individuals; and g) identify trends and promote data-driven program improvements based on the identified trends and tracking of information regarding inquiries and complaints. The estimated cost of this program is $1,056,306.73 over a four-year period. The Ombudsman program will serve the entire state of Rhode Island and target an estimated 47,330 dually eligible persons living in the state.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = -$8,665 )
2025	2023	Health & Human Services, Rhode Island Executive Office of	3 West Rd	Cranston	RI	02920	PROVIDENCE	USA	Support for Ombudsman and Beneficiary Counseling Programs for States Participating in Financial Alignment Model Demonstrations for Dually Eligible Individuals	02	4	12/10/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	-$8,665
2025	2022	Health & Human Services, Rhode Island Executive Office of	3 West Rd	Cranston	RI	02920	PROVIDENCE	USA	Support for Ombudsman and Beneficiary Counseling Programs for States Participating in Financial Alignment Model Demonstrations for Dually Eligible Individuals	02	4	12/10/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2025	2021	Health & Human Services, Rhode Island Executive Office of	3 West Rd	Cranston	RI	02920	PROVIDENCE	USA	Support for Ombudsman and Beneficiary Counseling Programs for States Participating in Financial Alignment Model Demonstrations for Dually Eligible Individuals	02	4	12/10/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2025	2020	Health & Human Services, Rhode Island Executive Office of	3 West Rd	Cranston	RI	02920	PROVIDENCE	USA	Support for Ombudsman and Beneficiary Counseling Programs for States Participating in Financial Alignment Model Demonstrations for Dually Eligible Individuals	02	4	12/10/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
														Subtotal = -$8,665

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2023	Health & Human Services, Rhode Island Executive Office of	3 West Rd	Cranston	RI	02920	PROVIDENCE	USA	Support for Ombudsman and Beneficiary Counseling Programs for States Participating in Financial Alignment Model Demonstrations for Dually Eligible Individuals	01	4	9/10/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $157,895 )
2023	2023	Health & Human Services, Rhode Island Executive Office of	3 West Rd	Cranston	RI	02920	PROVIDENCE	USA	Support for Ombudsman and Beneficiary Counseling Programs for States Participating in Financial Alignment Model Demonstrations for Dually Eligible Individuals	00	4	8/1/2023	NON-COMPETING CONTINUATION	$157,895
														Subtotal = $157,895

Issue Date FY: 2022 ( Subtotal = $236,843 )
2022	2022	Health & Human Services, Rhode Island Executive Office of	3 WEST RD	CRANSTON	RI	02920	PROVIDENCE	USA	Support for Ombudsman and Beneficiary Counseling Programs for States Participating in Financial Alignment Model Demonstrations for Dually Eligible Individuals	00	3	8/1/2022	NON-COMPETING CONTINUATION	$236,843
														Subtotal = $236,843

Issue Date FY: 2021 ( Subtotal = $236,843 )
2021	2021	Health & Human Services, Rhode Island Executive Office Of	3 WEST RD	CRANSTON	RI	02920	PROVIDENCE	USA	Support for Ombudsman and Beneficiary Counseling Programs for States Participating in Financial Alignment Model Demonstrations for Dually Eligible Individuals	00	2	7/30/2021	NON-COMPETING CONTINUATION	$236,843
														Subtotal = $236,843

Issue Date FY: 2020 ( Subtotal = $236,843 )
2020	2020	Health & Human Services, Rhode Island Executive Office Of	3 WEST RD	CRANSTON	RI	02920	PROVIDENCE	USA	Support for Ombudsman and Beneficiary Counseling Programs for States Participating in Financial Alignment Model Demonstrations for Dually Eligible Individuals	00	1	7/30/2020	NEW	$236,843
														Subtotal = $236,843

Grand Total All Awards = $859,759

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Support for Demonstration Ombudsman Programs Serving Beneficiaries of Financial Alignment Models for Medicare-Medicaid Enrollees for Rhode Island CMS-1J1-19-001

Award Number: 1J1CMS331787

ORGANIZATION: HEALTH CARE FINANCING ADMINISTRATION, OFFICE OF ACQUISITION AND GRANTS

OPDIV: CMS

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: OTHER

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