Arizona

Project Title: AHCCCS Direct Service Workforce Expansion Phase I: Establish Foundation for Consumer Directed Care and Reimbursement of Spousal Caregivers

The Arizona Health Care Cost Containment System (AHCCCS)/Arizona Long Term Care System (ALTCS) will develop and implement policies and procedures as well as mechanisms to support, monitor, assess and allow consumers to move from consumer focused care to consumer directed care – within the context of Arizona’s comprehensive integrated managed care model. In its 2006 contracting process, AHCCCS included a requirement that the ALTCS managed care entities address consumer directed care (CDC). Arizona has requested intensive technical assistance with two initiatives scheduled for statewide implementation on October 1, 2007; consumer directed care and reimbursing spousal caregivers.

Arizona plans to implement a CDC model for the ALTCS Elderly and Physically Disabled program that blends well with the program’s comprehensive integrated managed care model to improve member satisfaction and quality of care by enabling members to make sound and meaningful choices about their care from a large and well-trained pool of caregivers.

In its recent 1115 waiver renewal submission to CMS, the AHCCCS Administration requested waiver authority for spouses to be paid caregivers. By providing reimbursement to spouses of eligible Medicaid members who require long term care services the state wants to allow members to remain in their own home, improve their quality of life, create cost savings for the program by reducing higher costs associated with institutionalization, and free up the already limited supply of direct service workers for other beneficiaries for whom this is not an option. Arizona hopes that implementing this waiver will also potentially provide an additional pool of direct caregivers to serve other members after spousal caregivers are no longer providing care to their spouses

The National Direct Service Workforce Resource Center will be providing Arizona with intensive technical assistance with the following tasks:

• Facilitating stakeholder group discussions that will lead to concrete recommendations for successfully implementing CDC for ALTCS members who are elderly or have physical disabilities.
• Providing guidance and resources on developing policies to ensure the participation of members who choose CDC and the development of quality service plans, establishing mechanisms to support individuals in scheduling and implementing service plans, establishing mechanisms to ensure delivery and monitoring of quality care, and identifying other appropriate measures of program success.
• Providing guidance and resources on: 1) developing policies to ensure quality of care provided by paid spousal caregivers, including appropriate number of hours to authorize, skills and training required, 2) developing policies that can reasonably assure cost neutrality, 3) establishing mechanisms to determine the cost effectiveness of the program, 4) designing mechanisms to ensure coordination of care with other service providers, and 5) provide training and other supports to spousal caregivers.

Populations Served: Aging, Physical Disabilities, consumers with mental illness/addiction within those populations.

For More Information Contact:

Alan Schafer

ALTCS Manager

AHCCCS, DHCM

701 East Jefferson, MD 6100

Phoenix, AZ85034

602-417-4614 (ph)

602-256-6421 (fax)

alan.schafer@azahcccs.gov