Slide 1: One Care:  Implementation Council Meeting
Executive Office of Health & Human Services
MassHealth Demonstration to Integrate Care for Dual Eligibles
December 8, 2020, 10:00 AM – 12:00 PM
Virtual Meeting via Zoom
Slide 2: Topics to be discussed…
•	One Care Plan Clinical Audit of Care Coordination Processes 
•	MassHealth efforts to address Health Disparities 
•	Overview of MCE Bulletin 44 – Community Support Program for Chronically Homeless Individuals
Slide 3: One Care Plan Clinical Audits
•	MassHealth will coordinate a clinical audit of One Care Plans beginning in December 2020
•	Overall goal of audit is to confirm that Plans are in compliance with contractual requirements and identify Care Coordination and Care Planning processes that can be improved upon through ongoing technical assistance
•	To assess One Care Plans’ ability to create policies and procedures, trainings, and systems that support care planning processes that are person-centered and support Independent living and recovery models 
Slide 4: One Care Plan Clinical Audit Process
•	Medical Record Review
o	Sample reviews of Comprehensive Assessments and Care Plans of members in various stages of engagement 
o	Confirm if Care Plans reflect member-identified goals and specific interventions to work towards those goals, including the person accountable for each
•	Member Tracer Interviews
o	Targeted interviews with Care Coordinators/Clinical Care Managers (and LTS Coordinators as indicated)
o	Corresponding Record Review of Comprehensive Assessment and Care Plan
o	Targeted interview questions that assess the Care Coordinator’s ability to incorporate the results of the Comprehensive Assessment into the Care Plan and their level of engagement with the member in the development of the Care Plan 
•	Policy and Procedure Review
o	Evaluation and review of One Care Plan policies and procedures that support onboarding, continuous training, and ongoing supervision for Care Coordinators and Clinical Care Managers
Slide 5: MassHealth Efforts to address Health Disparities
•	MassHealth is engaging in broader efforts to address health disparities related to Race, Ethnicity, Language, and Disability (RELD)
•	As part of this effort, MassHealth is assessing our Plans’ and Providers’ current abilities to collect, analyze, and provide RELD data to MassHealth
o	This assessment includes what RELD data is currently being collected, where the information comes from (e.g. enrollment files, member assessments), and where it is stored (e.g. in electronic medical records, in assessment tools)
•	This work is an important preliminary to ensure MassHealth and the One Care plans have infrastructure in place to identify, measure, and report on health disparities experienced by our Enrollees
•	Beginning next year, we look forward to engaging with the Implementation Council and expected 2022 One Care plans to develop One Care specific disparities metrics.
Slide 6: MCE Bulletin 44 - Community Support Program for Chronically Homeless Individuals
•	Provides additional information and guidance for the delivery of Community Support Program for Chronically Homeless Individuals (CSP-CHI) services, including:
o	Provider qualifications
o	Billing instructions
o	Documentation and reporting requirements
•	This is an existing service in One Care that may also be referred to as CSP for Persons Experiencing Chronic Homelessness
•	Released in October 2020; posted at https://www.mass.gov/masshealth-provider-bulletins
•	Requirements set forth in the Bulletin are effective as of January 1, 2021
Slide 7: One Care MassHealth+Medicare
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