New England Consortium:
Connecticut LifeLong Care (CTLC)

Project Overview

General Approach: Establish a pilot program which integrates primary, acute and long term care using Medicaid and Medicare funding. The planning phase includes development and analysis of a comprehensive database merging Medicare, Medicaid, and state-funded claims data with functional assessment data from individuals in both the community and in nursing homes. The pilot project itself will build on the foundation of a PACE model but with significant variations in the model to expand the potential target population. Key pilot project variations include: 1) developing capitated rates related to functional need of the individuals and 2) expanding the traditional PACE target population to include persons at risk but not yet eligible for nursing home care.

Implementation Date: 2000

Waivers: Medicare 222 [also 1915(a) authority--no waiver needed]

Eligible population: Individuals who meet all of following criteria:

• eligible for either Medicare and Medicaid
• nursing home certifiable or at risk
• resides in the service area of one of the centers, i.e. New Haven or Hartford area
• 55 years of age or older
• has income which does not exceed 300% SSI
• otherwise qualifies for Medicaid (e.g. assets, transfers)

Benefit Package: All services now covered by Medicare Part A or B; all services covered by current Medicaid Services Policy including home and community based services; centers have flexibility to cover services beyond or as an alternative to Medicaid and Medicare services.

Delivery System: Connecticut will initially contract with the two providers who have completed feasibility studies in conjunction with a PACE Technical Assistance Center: the Hebrew Home and Hospital in the Hartford area and Masonicare in the New Haven area.

Quality Assurance Activities: Specific regional performance measures are currently under development and will be used in the evaluation of the project. A variety of methods (data analysis, clinical reviews, consumer surveys, etc.) will be used to measure performance of the centers. Connecticut will require that all Lifelong Care Centers collect the Performance Measures developed by the New England State Consortium Quality Work Group along with those developed by the National PACE Association. Testing of a modified version of the Consumer Assessment of Health Plans Survey (AHPS) is currently underway. Connecticut has also participated in a HCFA workgroup on quality under PACE and a PACE Performance Measures Group established by the National PACE Association.

Technical Assistance Activities: The state agency has assisted sites in resolving issues around licensing and CON requirements, and in identifying data system modifications needed for tracking client information. Now that the provider application is available, assistance will be given with the application process. Analysis of current trends in utilization and outcomes will become the foundation for provider education regarding improving interventions for the target population.

Current Status

Program is on hold.

Contact Information

Michele Parsons, Manager of ACU
Department of Social Services
25 Sigourney St. 11th floor
Hartford, CT 06106-2055

Phone: 860 424-5177
Fax: 860 951-9544
E-mail: michele.parsons@po.state.ct.us
Website: http://www.dss.state.ct.us/ctlc/