We must urge legislators to oppose
the Single Assessment Entity RFR
By Meg Coffin, CEO
The Executive Office of Health and Human Services (EOHHS) recently released a Request for Responses (RFR) looking to award a contract to a Single Assessment Entity.
This single entity will conduct clinical evaluations for over 240,000 elderly and disabled individuals across Massachusetts covered by numerous Mass Health-funded programs, enabling these individuals to continue living independently in their communities.
Advocates across the state strongly oppose this move. Currently, these evaluations are largely conducted by community-based organizations such as Aging Service Access Points (ASAPs), Independent Living Centers (ILCs), Group Adult Foster Care, and Adult Foster Care Providers. These organizations send nurses to recipients’ homes
at least once a year to assess their needs for Long-Term Services and Supports (LTSS).
They also manage the complicated assessments and approval requirements before submitting them to MassHealth Optum for determination of services. Members may then choose to appeal these determinations with support
from the assessments of the community- based nurses.
The programs that will be impacted by this change are adult foster care, group adult foster care, personal care
management, day habilitation, adult day health, senior care options, PACE and OneCare.
EOHHS released this RFR without consulting with any of the providers or consumers who currently utilize these
services. The intent is to streamline the onboarding process and lessen the confusion about where to find services.
Massachusetts has long been the beacon for providing a variety of long-term services and supports that are
looked at with envy by my colleagues in other states. Now, instead of continuing to be an innovative leader,
Massachusetts is looking to follow what has been implemented in other states with disastrous results like Pennsylvania, New York, and North Carolina. What we have been told by our colleagues in other states is that wait times and confusion have increased, incorrect information is being provided and, in many cases, services are being cut. This is a prime opportunity for a large private equity firm or healthcare system to take over and medicalize what have been consumer-directed and consumer choice programs.
As advocates, we are not saying there is no room for improvement and simplification. The LTSS structure in
Massachusetts is complex and can be confusing to navigate. Often, the complexities are caused by the contractual
regulations set by the very agency,
EOHHS, that is now looking to remove all clinical services from community-based agencies and place them in one
large, potentially for-profit, entity.
EOHHS must collaborate with the providers that have been working with these programs for years. Invest in the
current system of providers to streamline our procedures, as it has streamlined procedures for this new entity in
the RFR. Adding yet another entity in the mix will only be more confusing for those we work with.
In addition, this will cause many clinical and administrative staff in these community-based agencies to lose their jobs.
The state has been at the forefront of the No Wrong Door approach with Options Counseling and Mass Options.
This allows individuals to contact any ILC or ASAP and receive information on the multitude of options available to
them.
As community-based providers, we know the individuals we work with daily and the services available to them.
Do not take away their choice and options with this change.
EOHHS has slowed the process due to the concerns raised by those impacted, but they intend to move forward.
As advocates, we feel this initiative needs to be stopped. This will disrupt over 40 years of services we have been
providing and will have no impact on the issues EOHHS is trying to solve.
Plese urge your legislator to tell EOHHS to work with the consumers using these services and the agencies currently providing them to implement innovative and lasting changes that will have a positive impact and resolve the issues.
|