Frequently Asked Questions

What are long-term care services or long-term services and supports?

Long-Term Supports and Services (LTSS) refer to assistance given over a sustained period of time to people who are experiencing long-term inabilities or difficulties in functioning because of a disability.  LTSS can be provided in facilities, institutional settings or in the home and community.

What are managed long-term services and supports?

According to the Centers for Medicare and Medicaid Services (CMS), "[Managed Long-Term Supports and Services] MLTSS refers to the delivery of LTSS (including both home and community-based services (HCBS) and institutional-based services) through capitated Medicaid managed care programs. These programs can be operated by a variety of health plans, including managed care organizations." There has been a growing movement in this direction across the nation, from eight states in 2004 to 15 in 2013 implementing managed LTSS programs.

Why move long-term care services to a managed-care model?

We believe that a move to managed care is the next logical step in our long-term supports and services transformation. We believe that a move to MLTSS will help ensure that we are able to more effectively meet the needs and improve the health outcomes of the residents of Louisianans who need long-term supports.

How many people are currently receiving long-term care services from DHH?

During the last fiscal year, over $2 billion was spent to serve over 73,000 recipients of long-term supports and services in Louisiana.

What are your goals for this new service delivery system – MLTSS?

The key objectives of restructuring LTSS to a system of managed care are to:

  1. Improve the quality of services and health outcomes;
  2. Decrease fragmentation and improve coordination of care;
  3. Create a system that utilizes proven and/or promising practices;
  4. Refocus the system in order to increase choice and provide more robust living options for those who need LTSS and their families; and
  5. Rebalance the system in order to meet the growing demand for services within the existing level of expenditures for the LTSS population.

Is this another budget-saving measure by the state?

No, we have not built any savings or adjustments into the next fiscal year budget for MLTSS.

How have stakeholders been involved in the process?

We have made a concerted effort to involve stakeholders in the process of restructuring LTSS to a system of managed care and gather their feedback, including:

  1. Release of an Request for Information (RFI) in 2012 to gather information about the capabilities of possible companies with whom the Department could work on managed care;
  2. Release of a concept paper with specific requests for stakeholder feedback;
  3.  Formation of an advisory group of stakeholders, which has met frequently to provide input on MLTSS;
  4. Public forums held across the state; and
  5. Public webinars.

Will you be closing any intermediate care facilities for the developmentally disabled (ICF/DDs)?

At this time we do not anticipate closing any facilities. One point of our focus will be ensuring that individuals continue to have the option to choose the setting that best meets their needs, including services in a facility.

What is your timeline for implementation?

There is no set timeline for implementation. We anticipate the earliest implementation would be is July of 2015.

When will you issue a Request for Proposal (RFP)?

The Department, based on feedback from the advisory group, may issue two RFPs - one for individuals with developmental disabilities and one for individuals with age-related disabilities. Our goal is to release both RFPs by late summer or early fall of 2014.