Medicaid Managed Care - U.S. Senate Special Committee on Aging

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<strong>Managed</strong> <strong>Care</strong> Framework (Cont'd)
* Consumer rights should be clearly articulated and consistently applied;
* Protections of individual health and safety should be vigorously enforced without compromising
individual control and self-determination;
* Consumers and families -- as well as other stakeholders -- must be granted ample opportunity to
participate in system redesign, procurement decisions, oversight, and evaluation;
Cost savings which are achieved through system restructuring should be earmarked for waiting
* list reduction and/or quality improvement initiatives; and -
The system should be fully accountable to consumers, public officials, and taxpayers, including
* continuous legislative oversight of the design, implementation, operation, and outcomes of the
new system.
A well-articulated policy framework is absolutely vital to ensuring that managed care concepts
are instituted in a manner that serves the best interest of individuals with disabilities,
their families, and the general public.
MANAGED CARE DESIGN PRINCIPLES
The introduction of managed care
approaches to the delivery of publiclyfunded
services and supports for people
with developmental disabilities must be
framed by the public policy principles outlined
above and-be the end-product of a
design process that is grounded in the
following guidelines and principles:
, All state and federal funding for long-term
services and supports to people with
developmental disabilities should be
consolidated in order to promote integrated
service delivery and global system
management;
, Such funding should be carved out
(rather than folded into a broader managed
care system) and administered
under a separate plan that is crafted
specifically to meet the long-term support
needs of individuals with developmental
disabilities and their families.
This plan should include formal mechanisms
for coordinating the delivery of
developmental disabilities services with
those managed by other public systems
that affect the well-being of such individuals,
including health care and mental
health services;
, The developmental disabilities service
authority (DDSA) in each state, in partnership
and collaboration with individuals,
families, and other stakeholders, should
play a central role in designing, implementing,
and operating the system.
DDSAs, in tandem with other responsible
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