The Legislative Oversight Commission on Health and Human Resources Accountability met this afternoon for its December Interim meeting.
First, the commission heard from Aetna, which has been working with the state for four years and is on its second contract series. Aetna operates on size pillars: (1) individualized care to meet the needs of children and families, (2) building community capacity with high quality of community-based services, (3) right level, right time, and the right length of time of care received, (4) shifting mindsets, (5) bring together a culture of collaboration, and (6) a meaningful exchange of information. Aetna has a three-tier care management system: intensive, supportive, and population health. Intensive CM is for members receiving care in facilities. Supportive is for members who have monthly check-ins. Population Health is for members who are adopted or in kinship care and doing well so they do not need oversight; they receive a check-in at 90 days.
Access to pediatric psychiatry is critical in community care. There is a $1.5 million innovative collaboration between Community Care of WV and Aetna Better Health of WV. The number of children with serious emotional disorder waivers has tripled each year since the inception of the waiver. A CSEDW Trainer has been added and there are now CSEDW Services in schools. Success stories are being seen in local communities. However, more CSED providers are needed in the state.
Aetna works with key partner focus groups to meet the needs of members. The five focus groups mentioned include Member Advisory Council, Socially Necessary Services Focus Group, Residential Treatment Facility Focus Group, Grand Families Group, and Governance Council.
Aetna is also working with a statewide foster care recruitment campaign.
Next, the commission heard an update on the transition of DHHR, Shared Administration.
First, it was noted that between November 1, 2022, and October 31, 2023, the department identified 133 employees who became eligible for retirement. Of those, 26 left within six months of becoming eligible. This is concerning because, within the next five years, a large percentage of employees will be eligible to retire.
The Office of Shared Administration will include the Office of Finance, the Office of Human Resources Management, the Office of Constituents, the Office of Communications, the Office of Operations, the Office of Information Services, and a Liaison to Boards and Commissions.
The Department will be hosting a round table discussion with directors on December 15, 2023, to go into more detail on how the Office of Share Administration will operate.
Next, the commission heard a review of preliminary findings and recommendations from the Recovery Residence Taskforce. Recommendations include:
- State law to designate an existing agency to convene a group that will investigate and procedure recovery residence crimes;
- Designate an agency to assess fines listed in statute;
- Amend the code to allow for new recovery residences to receive state funding in areas where there are gaps in the continuum of care;
- Mandate the use of an outcome-tracking system for all certified recovery residences;
- Create reentry housing infrastructure;
- Life and safety requirements consistent with applicable state and federal law for uncertified recovery residences; and
- Statewide recovery residence registry
The commission heard a review of costs and rates for Intellectual/Development Disabilities Services. The project overview includes:
- Engaged stakeholders to identify concerns with service delivery and/or reimbursement rates
- Created a project-specific webpage
- Developed a cost report to capture provider wage and service provision costs
- Analyzed data from provider cost reports
- Designed services-specific rate models and developed associated rates
Lastly, the commission moved to introduce the four bills listed in the 2024 regular session. Those bills include the renaming of DHHR, reorganization of the Office of Inspector General, removing extended managed care in foster care, and expanding the powers of LOCHHRA.
