DDD CHOICE PLANS – FREQUENTLY ASKED QUESTIONS
Question 1: Why is ADES/DDD limited in answering questions about the DDD Choice Plans?
The Integrated Health Care Choice Plan is a competitive solicitation (Solicitation ADES 19-00008322(link is external)) being administrated under the Arizona Procurement Code. The purpose of the Arizona Procurement Code is to ensure fair and equitable treatment of all persons who deal with the procurement of materials and services by the State and safeguard the State’s procurement quality and integrity. As such, during an active solicitation, ADES/DDD is not able to provide additional information outside the solicitation documents or to carry on individual discussion(s) which could result in or be perceived as, providing an unfair advantage to any possible bidder.
DDD remains committed to ongoing communication with members and their families, providers and other stakeholders. After the contracts are awarded, DDD will provide more detailed information about the implementation of the DDD Choice Plans and options for members in choosing how their care needs will be met.
Question 2: How are DDD Choice Plans different than DDD’s current health service delivery system?
Today DDD members have to navigate multiple systems to access physical health services, behavioral health services, long-term services and supports and support coordination. Members currently receive physical health care services from a DDD contracted health plan, behavioral health services from a Regional Behavioral Health Authority (RBHA) (also an MCO health plan) and long-term services and supports (LTSS), including support coordination, through DDD. Members with a Children’s Rehabilitative Services (CRS) designation receive CRS services through a separate MCO health plan.
DDD Choice Plans will make it easier for members to access services through an integrated care model. Members will choose and enroll with a single DDD contracted health plan, and will be able to choose from two different options to receive integrated physical (including CRS services) and behavioral health services, LTSS and support coordination. Those two DDD Choice plan options are called: the DDD Coordinated Plan and the DDD Direct Plan.
Question 3: What are the differences between the DDD Coordinated Plan and the DDD Direct Plan?
Under the DDD Coordinated Plan, members will receive all of their physical health services, behavioral health services, and the following LTSS: 1) Assistive Technology, 2) Augmentative Communication Devices and Accessories, 3) Augmentative Communication Evaluation and Training, 4) Emergency Alert Systems, 5) Occupational, Physical, and Speech Language Therapy and 6) Skilled Nursing Facilities) from a DDD contracted health plan of their choice. Support Coordination and all other LTSS will be provided through DDD and it’s service providers.
Under the DDD Direct Plan, members will receive all of their physical health services, behavioral health services, LTSS and support coordination through a DDD contracted MCO health plan of their choice.
Question 4: When will DDD Choice Plans go into effect?
The DDD Coordinated Plan will go into effect on October 1, 2019. The option to choose the DDD Direct Plan will be phased in across the State beginning October 1, 2020.
Question 5: Who will be eligible for DDD Choice Plans?
Members who are eligible for the Arizona Long Term Care System (ALTCS) and DDD services will be eligible for DDD Choice Plans.
Question 6: How will the new DDD Choice Plans benefit members?
Freedom to Choose: Members will be able to choose the type of DDD Choice Plan that coordinates and provides the integrated services in a way that works best for the member to have their care needs met.
Increased Efficiencies: DDD Choice Plans eliminate the need for members to go through multiple health plans to get the services and supports they need.
Improved Coordination: DDD Choice Plans will offer better coordination of care to improve whole health for members.
Trusted Guidance and Support: Experienced DDD team members will continue to be engaged and manage and oversee the health plans to ensure member needs are being met in a member-centered way. In addition to these responsibilities, under the DDD Coordinated Plan, DDD will continue to provide support coordination and LTSS.
Question 7: Will the services that are covered now for members still be covered under the DDD Choice Plans?
Yes. Members will still have access to the same covered physical health, behavioral health, and LTSS services as they do now.
Question 8: Will members be able to choose a new DDD contracted health plan?
Yes. All members enrolled in the ALTCS-DD program will be given an opportunity to select a DDD contracted health plan at least 30 days prior to contract start date. After a member is initially enrolled with a DDD contracted health plan, the member will have an additional 90 days to change health plans.
Members will continue to have the option to choose a different health plan on an annual basis.
Question 9: Will members be able to stay with the same health plan they are enrolled in now?
If a member’s current health plan for physical health services is awarded a new integrated contract, the member may choose to stay with the same health plan. If a member’s current health plan for physical health services is not awarded a new integrated contract, the member will need to select a new integrated health plan.
After the award of the contracts, DDD will provide members with information and assistance to make informed decisions about their health plan choice options.
Question 10: When the DDD Direct Plan is implemented in 2020, will members be able to choose one of the two DDD Choice Plans – DDD Coordinated Plan or the DDD Direct Plan?
Yes. When the DDD Direct Plan is implemented, members will be able to choose between the DDD Coordinated Plan and the DDD Direct Plan at least 30 days prior to implementation. After the member is enrolled, the member will have an additional 90 days to change DDD Choice Plans.
Members will also have the opportunity to select a different MCO health plan to provide services at that time.
Question 11: Will the DDD contracted health plans develop their own Provider Networks?
Yes. Each DDD contracted health plan will develop, maintain and monitor their own Provider Network to support the needs of their enrolled members.
Question 12: Will members be able to access the same providers as they do now?
As described in the answer to Question 11 above, each DDD contracted health plan will have their own Provider Network. Members may access the same providers if those providers are in the health plan’s network.
Each DDD contracted health plan will publish and provide members with a list of their providers (provider directory). This information can be used to assist members in selecting a DDD contracted health plan. Members who would like to continue with the same provider can review the health plan’s provider directory to see if that provider is in the health plan’s network.
After the award of the contracts, DDD will provide members with information and assistance to make informed decisions about their health plan choice options.
Question 13: What happens if the member’s provider is not in the DDD contracted health plan’s network?
Every effort will be made to ensure the continuity of care and consistency of providers for members throughout the DDD Choice Plans transitions.
There may be exceptional cases in which a member’s current provider is not contracted with the member’s selected health plan. In that case, the health plan will continue to maintain the member’s current providers and service authorizations for a period of at least 180 days to provide time to find an alternative provider and safely transition care. This time period can be shortened if the member agrees.
After the award of the contracts, DDD will provide members with information and assistance to make informed decisions about their health plan choice options.
Question 14: Will current members receiving Arizona Early Intervention Program (AzEIP) services need to change service delivery options and DDD contracted health plans?
Members who are ALTCS eligible and receiving AzEIP services are exempt from choosing the DDD Direct Plan. These members will, however, have a choice between DDD contracted health plans.
Question 15: Will current members receiving services in a State-operated Intermediate Care Facility (ICF), group home, or developmental home have a choice of DDD Choice Plans and DDD contracted health plans?
Members who are ALTCS-DD eligible and choose to receive services in a State-Operated ICF, State-Operated group home or State-Operated developmental home are exempt from choosing the DDD Direct Plan. These members will, however, have a choice between DDD contracted health plans.
Question 16: When will members receive information about the DDD Choice Plans?
Members will receive information about the DDD Choice Plans after the contract is awarded. Information will be provided to members well in advance of the change to allow time for members to make informed decisions about their health plan choice options.
Question 17: How many Health Choice Plan contracts will be awarded and when?
DDD anticipates there may be multiple health plan contracts awarded. The anticipated timeframe for awards is the beginning of 2019.
Question 18: How will DDD educate members, community stakeholders, providers, and advocates about the DDD Choice Plans?
DDD is dedicated to open and transparent communication and will use a number of methods to share information about DDD Choice Plans. Additional information, such as the Major Decisions for the IRFP and Community Presentation: Vision for the Future – New Health Care Options, can be located on the Department’s website at DDD Website – Integrated Health Plans. The solicitation can be located at Solicitation ADES 19-00008322(link is external).
DDD will be able to provide more information about DDD Choice Plans and how they will be implemented after the contracts are awarded.
Question 19: Will DDD provide training to the DDD Support Coordinators on the DDD Choice Plans so they will be able to assist members during this transition?
Yes. DDD has begun to provide training to Support Coordinators and will continue to provide in-depth training to all DDD team members after the contracts are awarded. DDD Support Coordinators and other DDD staff will assist members and their families to ensure a smooth and successful transition.
Question 20: Did DDD seek stakeholder input in the development of the Integrated Health Care Choices Plans, Request for Proposal (RFP)?
Yes. DDD engaged stakeholders and employees prior to the development of the RFP to obtain input. Information was gathered through statewide meetings, online surveys and through the State eProcurement System, ProcureAZ as indicated on the DDD website:
- Spring 2016 – Online survey posted for community and employee input.
- Spring 2016 – Six stakeholder and community meetings held across the state. Outreach sessions held in Tribal communities.
DDD is committed to continuing to engage and involve members, families and stakeholders throughout the implementation and term of the contract.
Question 21: When will DDD provide implementation information to providers to assist with the transition?
DDD will have and be able to share more information regarding the implementation of the DDD Choice Plans after the contracts are awarded.
Question 22: Do these changes mean that DDD is moving to the Arizona Health Care Cost Containment System (AHCCCS)?
No. The purpose of the changes and implementation of the DDD Choice Plans is to offer members and their families options for integrated health care.