Beneficiary Participation on Governing and Advisory Boards. As part of the Demonstration, CMS and the State shall require Health Home Networks to establish mechanisms to ensure meaningful beneficiary input processes and the involvement of beneficiaries in planning and process improvements. This will be addressed in the State’s qualification process for Health Home Networks. In addition, the State will provide avenues for ongoing beneficiary or beneficiary advocates to provide input into the Demonstration model, including participation in the Service Experience Team (SET). The SET works in partnership with the State to promote choice, quality of life, health, independence, safety, and active engagement to program improvement and development. The SET consists of up to 12 clients representing a diverse cross-section of geography, gender and programs being utilized, three to five Advocacy Representatives, a Tribal Representative, and State staff. Feedback collected by the State will be shared with Health Home Networks and will be part of the State’s process improvement efforts.
Beneficiary Participation on Governing and Advisory Boards. CMS and the State shall require Demonstration Plans to obtain meaningful beneficiary input on issues of Demonstration management and Enrollee care. Demonstration plans must establish an independent Demonstration Plan beneficiary advisory committee. Throughout the operation of the Demonstration, Demonstration Plans will be required to meet quarterly with the beneficiary advisory committee. The Demonstration Plan must also assure that the beneficiary advisory committee composition reflects the diversity of the Demonstration population including Enrollees, caregivers, and local representation from key community stakeholders such as faith-based organizations, advocacy groups, and other community-based organizations. The State will maintain its website3 to provide updates on the Demonstration and have ongoing, quarterly stakeholder meetings through forums such as the Medicaid Advisory Committee (MAC), the MAC Care Coordination Subcommittee, or the Seniors and Persons with Disabilities (SPD) stakeholder group.
Beneficiary Participation on Governing and Advisory Boards. As part of the Demonstration, CMS and the State shall require the establishment of mechanisms to ensure meaningful beneficiary input processes and the involvement of beneficiaries in planning and process improvements. In addition, the State will provide avenues for ongoing beneficiary input into the Demonstration model, including beneficiary participation through the Colorado Medicare-Medicaid Enrollees Advisory Subcommittee, the ACC Program Improvement Advisory Committee and its standing subcommittees, the Community Living Advisory Group and its subcommittees, and the Nursing Facility Culture Change Accountability Board, which provide regular feedback to the State on the Demonstration. The Department also will continue to gather and incorporate stakeholder feedback as it works collaboratively with other state agencies and local partners serving Medicare-Medicaid enrollees in the Demonstration. Additionally, the State will monitor client and provider experiences through surveys, focus groups, and data analyses. The State will develop input processes and systems to monitor and measure the level of care provided to Medicare-Medicaid enrollees in the Demonstration. Moreover, as referenced previously in Section III.B.4, the State will utilize the beneficiary rights and protections alliance as a vehicle for additional beneficiary input and feedback throughout the Demonstration’s planning processes, implementation, and operation.
Beneficiary Participation on Governing and Advisory Boards. As part of the three-way contract, CMS and the State shall require Participating Plans to obtain consumer and community input on issues of program management and Enrollee care through a range of approaches, which may include beneficiary participation on Participating Plan governing boards and quality review bodies. The ICO must also establish at least one consumer advisory committee and a process for that committee to provide input to the governing board. The ICO must also demonstrate participation of consumers with long term care needs, including Enrollees, within the governance structure of the ICO.
Beneficiary Participation on Governing and Advisory Boards. As part of the Demonstration, CMS and the State shall require Health Home Networks to establish mechanisms to ensure meaningful beneficiary input processes and the involvement of beneficiaries in planning and process improvements. This will be addressed in the State’s qualification process for Health Home Networks. In addition, the State will provide avenues for ongoing beneficiary input into the Demonstration model, including beneficiary participation in the HealthPathWashington Advisory Team (HAT), which provides regular feedback to the State on the Demonstration. Other mechanisms such as focus groups, surveys, and attendance at community meetings will be used to ensure beneficiaries participating in the Demonstration are encouraged to share their feedback and experience and help inform system improvements. Beneficiary feedback collected by the State will be shared with Health Home Networks and will be part of the State’s process improvement efforts.
