DEI Initiatives in Higher Education
Inaugural year initiatives at a university focus on diversity, equity, and inclusion across various departments, including Art, Communication, and Education. Efforts include creating DEI committees, revising curricula, diversifying faculty, and promoting underrepresented artists and voices. Events like the Disability Studies Lecture, student panels, and alumni listening sessions highlight a commitment to fostering an inclusive learning environment. The incorporation of diverse perspectives and themes in courses reflects a dedication to addressing racism and social justice. Collaboration with artists of color and promoting non-western art further enhance DEI efforts in education.
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CHFS Organizational Structure, Operations and Administration Task Force Department for Medicaid Services Lisa Lee, Commissioner Veronica Judy-Cecil, Sr. Deputy Commissioner July 19, 2022
Evolution of Medicaid Evolution of Medicaid Affordable Care Act all Adults based on income Expansion becomes option for states following 2012 Supreme Court Ruling Kentucky Implemented Expansion in 2014 and creates State Based Exchange Medicaid established to cover very-low- income individuals People Receiving Welfare no eligibility rules and no application process Very-low- income Parents regardless of eligibility for welfare Late 1980 s 1965 1996 1997 2010 Enactment of Children s Health Insurance Program covers Children up to 200% of FPL Congress extends coverage to Children and Pregnant Women whose family income is above welfare eligibility levels 2
At a Glance At a Glance Serving approximately 1.6 million Kentuckians, including over half of Kentucky s children 3
Covered Populations Covered Populations 4
Covered Populations Covered Populations 5
Covered Populations Covered Populations 6
Covered Populations Covered Populations 7
Covered Populations Covered Populations 8
Organizational Structure Organizational Structure 9
Organizational Structure Organizational Structure 10
Personnel Personnel 146 full time employees 1 part time employee 71 vacant positions Approximately 15 temporary employees Approximately 94 contractors 11
Department Functions Department Functions Serve as the single state agency authorized by the Center for Medicare and Medicaid Services (CMS) to administer the Medicaid program Ensure compliance with federal and state policy governing the program Administer the Kentucky Children s Health Insurance Program (KCHIP) Administer the State Health Benefit Exchange Administer the associated complex technology systems Coordinate and provide administrative support for routine meetings held by the 22 Member Medicaid Advisory Council and 17 Technical Advisory Committees 12
Technical Advisory Committees Technical Advisory Committees Behavioral Health Children s Health Consumer Rights and Client Needs Dental Emergency Medical Services Health Disparity and Equity Home Health Hospital Intellectual and Developmental Disabilities Nursing Home Care Nursing Services Persons Returning to Society from Incarceration Optometric Pharmacy Physician s Podiatry Primary Care Therapy 13
Services Services Provides medically necessary services to enrolled members Mandatory services Optional services (Refer to the latest LRC report ) 14
Services Services Non-Emergency Medical Transportation Administered by Office of Transportation Delivery within Transportation Cabinet School Based Services Billed through KY Department of Education and includes admin and services Health Access Nurturing and Development Services (HANDS) Administered by Department of Public Health First Steps Administered by Department of Public Health 15
Funding Funding Federal/State partnership Approximately 70% federal funds for traditional Medicaid population Approximately 80% federal funds for KCHIP population 90% federal funds for Medicaid Expansion 50% federal funds for administrative expenses currently 3% of spend is administrative 16
Medicaid Budget Medicaid Budget SFY 2022 Expenditures Managed Care $11,796,456,200 Nursing Facilities $1,233,348,100 Hospitals $462,164,200 Pharmacy $122,784,700 Dental $2,401,300 ICF/IDD $147,788,100 Transportation $128,341,400 All Other $(450,777,600) Physicians & Clinics $340,810,400 Alternative Community Care $1,108,953,800 17
Types of Waivers Types of Waivers Section 1115 waivers Often referred to as research and demonstration waivers, these allow states to temporarily test out new approaches to delivering Medicaid care and financing. Section 1915(c) waivers Home and Community-Based Services (HCBS) waivers are designed to allow states to provide home and community-based services to people in need of long-term care. This means they can stay in their own home or a community setting (such as a relative s home or a supported living community) instead of going into a nursing facility. Section 1915(b) waivers Freedom of choice waivers allow states to provide care via managed care delivery systems. These organizations contract with state Medicaid agencies, and are paid from the state Medicaid fund for providing health care services to the beneficiaries, thus limiting the individual s ability to choose their own providers. 18
Evolution of Medicaid Evolution of Medicaid HCBS Waivers HCBS Waivers Home and Community Based Services (HCBS) early 1980s Large percent of Medicaid resources spent on long-term care (LTC) Studies show 1/3 of Medicaid residents in LTC facilities could live at home with supports Residents in LTC facilities and intermediate care facilities for individuals with developmental disabilities reported unsatisfactory quality of life Number of court cases resulted in orders to deinstitutionalize persons with developmental disabilities Specific Services in HCBS Case management Homemaker Home health aid Personal care Adult day health Habilitation Respite 19
Administration of Kentucky Medicaid 1915(c) Administration of Kentucky Medicaid 1915(c) Waivers Waivers DMS has oversight of all six 1915(c) waivers and operates the two Acquired Brain Injury waiver programs and the Model II waiver program. DMS also has oversight of the PDS program. The Department for Aging and Independent Living (DAIL) shares operating functions with DMS for the Home and Community-Based waiver and supports operation of PDS for all waivers that allow PDS. The Department for Behavioral Health, Developmental and Intellectual Disabilities (DBHDID) shares operating functions with DMS for the SCL and Michelle P. waivers. 20
Kentuckys 1915(c) HCBS Waivers: The Basics Kentucky s 1915(c) HCBS Waivers: The Basics Acquired Brain Injury Long Term Care (ABI LTC) Acquired Brain Injury (ABI) ABI & ABI LTC: For individuals age 18 or older with an acquired brain injury MIIW: For individuals dependent on a ventilator 12 or more hours a day or on an active, physician monitored weaning program Model II Waiver (MIIW) Home and Community Based (HCB) HCB: For individuals age 65 and older or individuals of any age with a physical disability Michelle P. Waiver (MPW) Supports for Community Living (SCL) MPW & SCL: For individuals with an intellectual or developmental disabilities 21
Participant Directed Services (PDS) Participant Directed Services (PDS) Participant Directed Services (PDS) allows individuals receiving 1915(c) HCBS Medicaid waiver services to hire their own providers for non-medical, non-residential waiver services. This option gives waiver participants more choice, flexibility and control over their supports and services. Formerly known as the Consumer-Directed Option (CDO). Eligibility Individuals receiving services through the Acquired Brain Injury and Acquired Brain Injury Long-Term Care, Michelle P. or Supports for Community Living waivers may participate in the PDS program. Providers Can be friends, neighbors or certain family members 22
Kentucky Transitions Kentucky Transitions Kentucky Transitions helps people move out of nursing facilities or institutions and into their own homes. The Department for Medicaid Services developed the program in 2008 with a Money Follows the Person (MFP) demonstration grant from the Centers for Medicare and Medicaid Services. Kentucky Transitions has helped more than 750 people leave institutional care. Qualified Individuals: Elderly, physically disabled, have a mental illness or an acquired brain injury Currently reside in a nursing facility and have been there at least 60 days Must have the ability to live in the community with support and services. Meet existing Medicaid eligibility requirements Receiving Medicaid-paid services at least one day prior to being referred to Kentucky Transitions. 23
1915(c) Waiver Enrollment 1915(c) Waiver Enrollment 24
Kentucky Medicaid 1915(b) Waivers Kentucky Medicaid 1915(b) Waivers Managed Care Allows KY to use MCOs to deliver care to enrollees Risk based capitated payment model Non-Emergency Transportation (NEMT) Operated through a contract with the Kentucky Department of Transportation (DOT) DOT contracts with brokers Brokers contract with transportation providers Risk based capitated payment model 25
Kentucky 1115 Waiver Kentucky 1115 Waiver Extends coverage to former foster care youth under age 26 who were in foster care under the responsibility of another state on the date they turned 18 and who were enrolled in Medicaid Substance use disorder (SUD) program available to all Medicaid members Waives non-emergency medical transportation (NEMT) for methadone treatment services Aligns Medicaid member redeterminations with their employer-sponsored insurance open enrollment period Expires September 20, 2023 Being amended to include SUD for incarcerated 26
Medicaid Funded IT Initiatives Catalog Medicaid Funded IT Initiatives Catalog Current Applications/Systems/Solutions Replacement/Future Solutions Key Electronic Health Records Incentive Program EHR-IP Fee for Service Pharmacy Benefits Manager FFS PBM Decision of Support System/Data Warehouse DSS/DW Enterprise Electronic Health Records System Enterprise EHR Medicaid Partner Portal Application MPPA Analytics Solution TBD* No Replacement Scheduled Managed Care Organization Pharmacy Benefits Manager MCO PBM Electronic Visit Verification Home Health Care Services EVV HHCS Medicaid Claims Administration and Financial Solution MCAFS Fee for Service Pharmacy Benefits Manager FFS PBM Kentucky Health Information Exchange KHIE Interim Analytics Solution IAS Planning Phase In Procurement Medicaid Management Information System MMIS Guardianship Fiduciary Information System GFIS Integrated Eligibility & Enrollment Solution IEES Utilization Management UM Basic Health Plan BHP Design, Development, and Implementation (DDI) Operations & Maintenance (O&M) Medicaid Waiver Management Application MWMA Electronic Visit Verification Personal Care Services EVV PCS Critical Incident Reporting System CIRS Medicaid IT Catalog 27
Medicaid Funded IT Initiatives Catalog (cont.) Medicaid Funded IT Initiatives Catalog (cont.) Key No Replacement Scheduled Additional Applications/Systems/Solutions enhanced Management, Accounting, and Reporting System eMARS Planning Phase Certified Community Behavioral Health Clinic CCBHC Independent Verification & Validation IV&V Health Information Technology HIT Kentucky On-Line Gateway KOG Systems Integrator SI In Procurement Procurement, Payables, and Asset Tracking System PPATS Microsoft Office (Excel, Word, PowerPoint, Project) MS Office AURA Voice Over Internet Protocol (VoIP) Telephones AURA State Medicaid Health Plan SMHP Kentucky Invoice Tracking System KITS Design, Development, and Implementation (DDI) Operations & Maintenance (O&M) Medicaid IT Catalog 28
QUESTIONS/DISCUSSION QUESTIONS/DISCUSSION
