My big takeaway from the keynote address, Tennessee’s Long-Term Services & Supports (LTSS) Program: Employment & Community First (ECF) CHOICES, given by Tonya Copeland, vice president of I/DD Services with UnitedHealthcare (UHC), during The 2020 OPEN MINDS Performance Management Institute in Clearwater Beach was “employment matters.” And that there is a significant relationship between community engagement for people with intellectual and developmental disabilities (I/DD) and their use of health care resources.
UHC Tennessee covers approximately 450,000 lives, of which 3,000 have a diagnosis of I/DD and 450 people out of that population are served by the Employment and Community First CHOICES (ECF CHOICES) program. The other 2,500 are served under a 1915c waiver that is managed by the Department of Intellectual and Developmental Disabilities. Ms. Copeland explained that ECF CHOICES is at risk for medical and behavioral costs, but not the LTSS services. She also noted that there are many more people who have I/DD diagnoses who don’t receive these services.
In the program, there are five service groups—essential family supports; essential supports for employment and independent living; comprehensive supports for employment and community living; intensive behavioral family-centered treatment, stabilization and supports; and intensive behavioral treatment, stabilizations, and supports. United has an “integrated team”—including special education teachers, mental health professionals, and social workers—that coordinates the services for each consumer. This team is made up of United employees. For services other than care coordination, the company contracts with private provider organizations (see Holistic Approach With The I/DD Population Pays Off).
In September of 2019, two new levels of service were added to the program. The first is focused on young consumers with an I/DD who are at risk of out-of-home placement due to behavior management issues or a mental illness. The second is for adults with the same profile.
The focus on employment was clear throughout Ms. Copeland’s discussion of the program and the focus of the model. She said that as of January 31, 2019, 104 consumers in the program were employed in regular wage employment and two people were employed in self-employment ventures. This represented a 28.1% employment rate for members aged 22 to 62. And those consumers who were working currently average $9.24 per hour and are working 16.34 hours per week. At the conclusion of the presentation, Ms. Copeland highlighted the change in the pattern of use of health care resources for consumers who moved to stable housing situations with employment. When asked about the overall cost impact for the program, she said a formal evaluation report was soon to be released.
The Tennessee experience is another illustration of the synergies between health care and social services. For more on social supports and the I/DD populations, check out these resources from The OPEN MINDS Industry Library:
- For I/DD, The Action Is At The State Level
- A Holistic Approach With The I/DD Population Pays Off
- The Changing Face Of Medicaid MLTSS For The I/DD Population
- Managed Health Services For The Population With I/DD– Slow But Growing
- Two Approaches To Bring Quality To I/DD Services
- The Five VBR Competencies I/DD& LTSS Organizations Need
- I/DD& Managed Care – What Are The Early Lessons For Providers?
- The Medicaid Vertical Carve-Out Model Comes To I/DD
- For I/DD Services, Answering The Value Questions
- I/DD & Managed Care? There Will Be Requirements
And for more, join me June 1 at The 2020 I/DD Executive Summit: Strategies For The Future, featuring Ken Anderson, Senior Associate, OPEN MINDS and Drew Di Giovanni, Senior Associate, OPEN MINDS; and facilitated by OPEN MINDS Senior Associate Ray Wolfe, J.D.