Tools and Solutions (Lake, Marin, Mendocino, Napa, and Sonoma)

View Best Practices and Layering Pain Points & Solutions for each step in the pre-contract, contract, and post-contract process.

Pre-Contracted Tools and Solutions

Step 1. What are Enhanced Care Management (ECM) & Community Supports (CS)?

1a. Self-Assess: Best Practice

  1. Connect
  2. Research
  3. Assess

1a. Self-Assess: Pain Points & Solutions
Should we contract?

Connect

Research

Assess 

Step 2. We’re exploring the contracting process.

2a. Estimate Costs: Best Practice
Before submitting interest statement to MCP, start to estimate cost and return on investment of program delivery.

CS Tool: Review the Non-Binding ILOS Pricing

2a. Estimate Costs: Pain Points & Solutions
Understanding VOI

Tools:

2b. Determine Pathway: Best Practice
Explore administrative and data collaboration opportunities in your local area.

2b. Determine Pathway: Pain Points & Solutions
Administrative Burden

Tools:

2c. Identify Resources Before Contracting: Best Practice

Contracting with MCP -> Funding Resources CITED, TAM, IPP, JUSTICE INVOLVED (County agencies).

Training and partnership resources: CPI, DHCS webinars, MCP trainings.

2c. Identify Resources Before Contracting: Pain Points & Solutions
Capacity Building & Contracting Knowledge

Funding Resources:

Operational Resources:

Step 3. We have started to work on the contract!

3a. Become a “Provider”: Best Practice
Obtain a National Provider Identifier number (NPI).

Tool: National Provider Identifier Application

3a. Become a “Provider”: Pain Points & Solutions
Who do I contact?

Lake, Napa, Marin, Mendocino, Sonoma: 
Lynn Scuri
Regional Director
(707) 863-4146
lscuri@partnershiphp.org

3b. Initiate Contract: Best Practice
Once NPI is received, express interest with Partnership by completing a readiness assessment.*

*Approval of assessment meets “in process of contracting with MCP” requirement for PATH CITED Grants.

3b. Initiate Contract: Pain Points & Solutions
Burdensome Process

Tools:
NEW DHCS Policies to reduce burden

3c. Fill Gaps: Best Practice
Leverage funding resources to fill the deficiencies plans have identified.

3c. Fill Gaps: Pain Points & Solutions
Upfront Costs

Key Actions:

  • Request an attestation to apply for funding during the contracting planning phase.
  • Explore the TA Marketplace for custom support.
  • Tips for the TAM-See TA Marketplace Links at bottom.

3d. Negotiate Rates & Contracts: Best Practice
Reference the initial self assessment your organization conducted.

3d. Negotiate Rates & Contracts: Pain Points & Solutions
Sustainability

Key Action:

  • Negotiate a rate that will sustain programming.
  • *Please note:  Partnership uses uniform fee schedule for all providers

Contract

Step 4. We have a contract!

Learn the Landscape

Tools:
Operation and Implementation:

Financial Considerations:

Post-Contracted Tools and Solutions

Step 5. We are testing the service delivery and billing system.

5a. Member Referred: Pain Points & Solutions
Understanding Member Network

Tools:
Network:

5b. Outreach: Pain Points & Solutions
Creative Outreach Opportunities

Tools:
MCP Referrals:

Internal referrals and Outreach:

Participate with your local Community Information Exchange, Accountable Communities for Health or other local cross-sector facilitator.

  • In-house outreach efforts:
    • Get example from Arcata house.
  • Utilize the Provider Portal to look up their members and see if they have an active TAR with another provider (from Issue Tracker)
  • Having a relationship with Collective Medical and uploading files more frequently can help tell you if people are getting services from other providers – helps determine potential clients. (from Issue Tracker)

5c. Enrollment: Pain Points & Solutions
Engaging Your Client

Tools:
Data Availability & Sharing

  • Contact PHC for monthly report of ECM members.
    • Partnership is working on enhancing the Collective Medical platform to allow providers to have direct visibility with ECM member enrollment information. Pending updates (from Issue Tracker)
  • Review Internal referrals and Outreach
  • TAR and Care Plan Policy Updates:
    • As of July 2023-process was revised that care plan is not required with TAR.. (from Issue Tracker)
  • Streamline your processes with help from the TA Marketplace

5d. Authorization: Pain Points & Solutions

Tools:
Administration Challenges

Step 6. We are making it work but…

6a. Render Service: Pain Points & Solutions

Tools:
Managing data with limited capacity

  • Quality Improvement tools for case management
  • Other tools for managing data or databases effectively, ETC.
  • Identify cross-sector facilitators in your region 

Care Coordination

  • Identify cross-sector facilitators in your region 

6b. Submit Claim: Pain Points & Solutions

Tools:
Administration Challenges