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Massachusetts' Innovation Grant

Project Title: Managed Care & Participant Direction
Organization/State Lead(s): Commonwealth Care Alliance
Contact Person:  Jan Levinson, Director of Program Development

Project Goals:

  • Strengthen community surrogate network by developing a training program and recruiting a pilot group of community-based surrogates that can be utilized to support and complement SCO enrolled consumers when they are not able to manage the PCA program on their own
  • Use results of consumer survey to identify PCA support and training needs
  • Demonstrate that aligning the Senior Care Options HMO (SCO) member, the PCA, and the SCO care team enhances self-direction and participant-centeredness

Project Description:

A core Commonwealth Care Alliance value is patient-centered care; CCA seeks to empower older adults to be at the center of their care systems, thus acknowledging their control over their health, their care, and their lives. CCA has adopted a number of system-wide innovations to achieve this goal, including offering the Stanford Chronic Disease Self-Management Program to its members and conducting multilingual Consumer Advisory Meetings.  This value is also reflected in the organization’s governance, as Board members are nominated through agencies committed to consumer advocacy and participation. One of the most powerful mechanisms to achieve empowerment is the establishment of self-directed personal care attendants (PCAs) as CCA’s preferred approach to meeting members’ personal care needs.  CCA does not limit self-direction to personal care and services; it applies the concept of self-direction to the entire individualized plan of care and to the relationship between members and the interdisciplinary care team. In this conception, personal care is no longer isolated from the provision of other health care; it is fully integrated into the totality of care and extends the principle of self-direction to other domains. Thus, there is no longer a distinction between the PCA and other members of the care team; they all serve the goals and preferences of the participant. In bringing the PCA into the fold of the SCO interdisciplinary team, CCA seeks not only to enhance the capacity of the PCA to meet the needs of the participant, but equally important, to strengthen the core value of self-direction with respect to the entire care team.

Summary of Accomplishments:

Commonwealth Care Alliance received an Innovation Grant from the NRCPDS funded by the Robert Wood Johnson Foundation that set out to expand self-direction in a managed-care setting.  During the project they developed sample policies and protocols for integrating participant direction and managed care policies.  The products developed in this project include; a manual for HCBS services, an individual preference plan, a representative referral template, a task form for representatives and personal care attendants, sample job description for a PCA Project Coordinator, and a representative agreement template.  The resources developed are intended to be utilized to support the expansion of participant direction nationwide.

Resources Developed:

  • Casa Care Manual
  • Individual Preference Plan
  • New Casa Care Referral Template
  • Project Final Report
  • PCA Sample Schedule
  • PCA Project Coordination
  • Surrogate Agreement

Follow this link to download the resources