Financial Management Services for a Medicaid Waiver Program in Oklahoma
• Configured the PPL Web Portal to accurately account for spending plan authorization allocations and expenditures, while developing logic to accurately cumulate the Optional Expense Account (OPX); • Introduced an automated e-mail notification system through the PPL Web Portal to ensure timely enrollment of new members and credentialing of potential employees;
THE CLIENT Oklahoma Department of Human Services (OK DHS) Aging Services Division
• Worked with OK DHS to develop new member and employee enrollment packets including mileage reimbursement and payment request forms to ensure an audit trail for OPX expenditures; • Provided onsite training on PPL enrollment processes for service coordinators; • Developed monthly deliverables on customer service, expenditures by service type, tax withholdings, and enrollment trends;
THE PROJECT The provision of Fiscal Reporting Agent services for the Oklahoma Consumer-Directed Personal Assistance Services and Support (OK CD-PASS) program serving elderly and disabled adults on the 1915(C) Advantage waiver.
• Provide monthly “Family Friendly” reports to members to indicate remaining spending plan balances, current OPX balance, and services provided by employee;
• Hold bi-weekly steering committee meetings to ensure that program changes are effectively coordinated.
The OK CD-PASS program had been in existence for several years when the client sought out a new Fiscal Reporting Agent that could better support the growing program and improve overall operational consistency. PCG Public Partnerships, LLC (PPL) was selected to replace a national vendor and transition approximately 380 disabled and elderly members and their accompanying personal service attendants to a customized Web Portal to meet program reporting requirements. The CD-PASS program model posed a particular design challenge as the member service plans allocated funds to obtain personal care and advanced personal care services while also allowing designation of funds to an Optional Expense Account for employer-related expenses such as employment advertisements, postage, mileage reimbursement, and employee bonuses. In addition, the contract included stringent customer service benchmarks in regard to hold times, live answers, and returned voicemails.
THE PPL APPROACH
• Make regular use of automated outbound calls to ensure program changes are readily communicated to members and their employees; and
THE RESULT • The program currently serves 500 members and their supporting employees in the Tulsa region alone and has shown consistent growth rates over the past 12 months. • Monthly call volume totals have remained static despite significant growth with over 90% of callers reaching a live representative. • Total support service funds under management exceed $4.8 million annually with more than 1,000 employees receiving payments. • CD-PASS currently has 23% of the market share of all Advantage waiver members receiving Personal Care services and 44% of the market share of members receiving advanced Personal Care services.
PPL program management met with OK DHS staff members weekly during ramp up to craft a detailed business rules and process flow document to ensure consistent payroll and enrollment processes. In addition, PPL staff members
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Case study released by PCG Public Partnerships on the Oklahoma Consumer-Directed Personal Assistance Services and Support (OK CD-PASS) Progr...