Medicaid program offers improved services for LGBT seniors

Medicaid program offers improved services for LGBT seniors

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As they age, some 76 percent of LGBT adults are anxious about having adequate family and/or social supports to rely on, according to a 2018 AARP survey, because they are more likely to be estranged from family because of their sexual orientation or gender identity.

Instead, support networks will often include LGBT and straight friends rather than family. LGBT individuals are also significantly less likely to have children and more likely to be single. All of these social conditions present significant risks to the LGBT population as they age and demonstrate the vulnerability of this population, especially as they progress to need long-term services and supports.

Community HealthChoices, or CHC, is designed to support vulnerable populations such as those individuals in the LGBT community eligible for this program. CHC is a Medicaid-managed care program that will improve service delivery and offer better healthcare coverage for some of our most vulnerable friends, family members and neighbors. This program covers individuals who are 21 years of age or older and includes physical-health benefits and long-term services and supports (LTSS). Care in CHC may be provided in the home, community or nursing facility. When fully implemented on Jan. 1, 2020, CHC managed-care organizations (MCOs) will serve more than 450,000 Pennsylvanians.

CHC will enhance the quality, efficiency and effectiveness of all services offered by the program, as well as serve more people in communities, giving them the opportunity to work, spend more time with their families and experience an overall better quality of life. Specific aspects of LGBT identity will be part of the discussion to articulate a plan for the future and help determine the services and supports that an individual needs.

Additionally, the CHC-MCO agreement with the state requires the CHC-MCOs to address issues of cultural competency within their organization and among their network providers. It is imperative that racial, ethnic, linguistic, gender, sexual orientation, gender identity and cultural differences between providers and participants do not present barriers to participants’ access to and receipt of quality services. For this reason, CHC-MCOs are required to have comprehensive provider-education strategies and commit to cross-cultural training of staff to provide relevant, effective programs for the diversity of people served. Increased oversight and education of cultural competency among the CHC-MCOs and their network providers will increase access to high- quality care.

The first phase of this program was implemented in the Pittsburgh area in January and, thus far, the program has seen great success. With about nine months completed of our southwest-zone rollout, nearly 80,000 Pennsylvanians have transitioned into the CHC program. DHS continues to support enrollees and providers as they adjust to this transition in the program.

The second phase is the Philadelphia area, and will include approximately 128,000 individuals. The launch date for this phase is Jan. 1, 2019. In preparation of this launch, community sessions are taking place for eligible members to learn more about this program.

The program represents an exciting time in the commonwealth with the move towards managed care for hundreds of thousands of older Pennsylvanians and individuals with a physical disability. I encourage each of you to take some time to visit healthchoices.pa.gov to stay up to date on any and all information regarding Community HealthChoices.

Kevin Hancock is the Deputy Secretary for the Office of Long-Term Living in the Pennsylvania Department of Human Services. For a complete schedule of these CHC information sessions, visit healthchoices.pa.gov or call 833-735-4416.


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