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-Information courtesy Cardinal Innovations Healthcare
Cardinal Innovations County Action Plan
Cardinal Innovations Healthcare is wholeheartedly committed to helping the people we serve and are invested in supporting the counties and communities where our members live. In the spirit of transparency, ongoing improvement and partnership, and together with the NC Department of Health and Human Services, Cardinal Innovations has committed to a detailed plan of action, effective immediately.
Contained in this plan are concrete measures and specific steps for improvement to address county concerns and hold us accountable to our members and our communities.
Supporting Children Entering DSS Custody
• We recognize that even with all deliberate speed, change will take time and will not resolve all pain points overnight. For this reason, and in addition to the steps outlined in our plan of action, we plan to invest an additional $30 million to help our counties take care of children in foster care.
Effective immediately, Cardinal will enter into a subcapitation agreement with its county DSS partners to provide a Per Member Per Month (PMPM) payment for every Medicaid-eligible foster child in its care. Counties will be able to use these Medicaid funds to cover the cost of some preliminary or transitional care or to address social determinants of health (e.g., housing, transportation, food insecurity).
Payments will begin retroactively from March 2020 due to additional constraints caused by the pandemic and extend through June 30, 2022.
Access to Care
• Cardinal will remove authorization requirements for a broad category of outpatient and community-based services. For services that still require a Treatment Authorization Request (TAR), Cardinal will issue a decision within 72 calendar hours for foster children/juveniles and individuals with two or more occurrences in the Emergency Department within 60 days.
• Cardinal will co-locate Cardinal staff at county DSS offices to work directly with DSS staff to identify high-needs cases sooner, help to resolve emerging issues, and assist in identifying care needs earlier.
• To increase the availability of immediate access to care, Cardinal will partner with preferred Therapeutic Foster Care (TFC) providers to enhance the delivery of TFC by creating an emergency/transitional setting option, as well as pairing the service with evidence-based support and high-fidelity wrap-around services.
Emergency Department Utilization
• Cardinal will develop a transition of care program, which will include both hospital inpatient and ED discharge planning program with the goal of reducing the length of stay and improving access to services post-discharge
Improved Processes
• Effective immediately, Cardinal will eliminate site-specific contracting with TFC provider agencies
• Within 30 days, Cardinal will eliminate site-specific authorizations for TFC or Level II Family Type homes
• To increase provider accountability for timely authorizations, Cardinal will expand its provider monitoring activities to include tracking the length of time between a provider’s receipt of an assessment and the date the provider submits a completed TAR
Outreach and Education
• Cardinal will conduct in-depth trainings with DSS staff around the adult service continuum, including the state-funded registry, the Transitions to Community Living Initiative (TCLI), the Registry of Unmet Needs (Innovations waitlist), Medicaid services, (b)(3) services, and non-Medicaid services
• Cardinal will provide at least quarterly webinar trainings on the state-funded eligibility criteria and service array for DSS partners and other community stakeholders and will conduct pre/post surveys to assess the level of understanding pre/post to adjust content as needed
• Cardinal will develop updated member resources to improve ease of navigation and raise awareness of the service array offered by Cardinal
• Cardinal will begin implementation of a new service model that raises awareness of the Cardinal service array, simplifying the process for members to issue and resolve complaints and ensuring that members have access to services
For more information on Cardinal Innovations Healthcare, please visit www.cardinalinnovations.org.