1. Development of Virginia’s Long Term Care (LTC) Partnership VIRGINIA DEPARTMENT OF MEDICAL ASSISTANCE SERVICES February 2008

2. Presentation Overview The “Nuts and Bolts” - Administrative Requirements and Additional Implementation Components Step-by-Step: Virginia’s Partnership Development Lessons Learned

3. The “Nuts & Bolts”

4. The “Nuts & Bolts” Administrative Requirements Legislation Medicaid State Plan Amendment Medicaid Agency Regulations Insurance Commission Regulations

5. The “Nuts & Bolts” Additional Implementation Components Bringing the right stakeholders to the table  Bureau of Insurance, Department of Social Services, Department for the Aging, Medicaid Agency, Virginia Retirement System, Governor’s Office Interpreting the DRA’s rules for Long-Term Care (LTC) Partnerships  Inflation protection, duration and design of coverage, reciprocity with other states, exchanging a non-partnership policy for a Partnership Policy, group policies, self-insured policies

6. The “Nuts & Bolts” Additional Implementation Components Developing protocols and trainings for Medicaid eligibility determination staff Establishing protections, awareness, and education for consumers Ongoing Operation of Partnership Program  Staffing, consumer/agent/press inquires, training (for agents and consumer inquiry staff), website development and maintenance, and funding

7. The “Nuts & Bolts” Additional Implementation Components Partnership Policy Utilization Forecast Treatment of existing long-term care insurance policies Inflation protection Agent Training Requirements

8. Step by Step

9. Step by Step Development of Virginia’s LTC Partnership 2004 & 2006: Virginia General Assembly passed legislation enabling Virginia to develop a LTC Partnership April 2006: Meeting with Governor’s Office to discuss LTC Partnership development June 2006: Meeting with state agency stakeholders (Bureau of Insurance, Department for the Aging, Social Services, Secretary of Health and Human Resources)

10. Step by Step Development of Virginia’s LTC Partnership August 2006:  Established regular meetings with Bureau of Insurance  Drafted State Plan Amendment and Regulations October 2006: Submitted Medicaid State Plan Amendment to CMS

11. Step by Step Development of Virginia’s LTC Partnership November/December 2006:  Worked on development of: consumer disclosures, eligibility protocols, consumer outreach program, agent training materials, and basic educational information December 2006:  State Plan Amendment approved  Regulations submitted through “Fast Track” regulatory process

12. Step by Step Development of Virginia’s LTC Partnership January/February 2007:  Trained social service eligibility staff and DMAS asset recovery staff  BOI reviewed regulations with insurance carriers  Searched for funding for outreach campaign  Applied for Center for Health Care Strategy grant  Continued work with Own Your Future and set launch date

13. Step by Step Development of Virginia’s LTC Partnership March 2007: Developed consumer outreach and education plan in conjunction with Department for the Aging’s State Health Insurance Assistance Program (SHIP) counselors April/May 2007:  Bureau of Insurance submitted their final regulations  Training of SHIP insurance counselors  Recruited “SHIP LTC Partnership Advisory Team”

14. Step by Step Development of Virginia’s LTC Partnership June/August 2007: Finalize grassroots outreach campaign activities (public relations, www.valtcpartnership.org, development of materials, SHIP speakers bureau) www.valtcpartnership.org September 2007:  Program Launch  Governor’s “Own Your Future” Press Conference

15. Outreach Campaign Timeline DATEACTIVITY Fall 2006VDA Submitted Budget Request for Outreach Campaign February 2007Budget Request Denied by the General Assembly MarchPartnered with SHIP Program and Received CHCS Funding AprilFinalized Preliminary Outreach Documents MayTrained SHIP Counselors June/July/AugContinued Training and Developed Brochure and Website SeptemberLaunch! “Own Your Future” Press Conference OctoberRetrain SHIP Volunteers

16. Lessons Learned

17. Lessons Learned…so far… Good relationships are key! Keep it simple Use existing protocols when possible If it is their turf, let them figure it out Use established networks when available Keep stakeholders updated and onboard

18. www.valtcpartnership.org Teja S. Stokes, Sr. Policy Analyst (804) 786-0527 teja.stokes@dmas.virginia.gov