LTSS: No Wrong Door

The Rhode Island Executive Office of Health and Human Services (RI EOHHS) is leading an interagency team to redesign the State’s long-term care system to align with the person-centered principles of “No Wrong Door” (NWD) advanced by the Federal Administration for Community Living. The LTSS Interagency Redesign Team is an interagency work group that is comprised of EOHHS (the designated State Medicaid authority), the RI Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals (BHDDH), the RI Department of Human Services (DHS), and the RI Office of Healthy Aging (OHA). In tandem, these State agencies administer the delivery of Medicaid LTSS to Rhode Islanders with chronic illnesses or disabilities who meet the financial and clinical eligibility criteria. 

The State’s LTSS redesign efforts includes, but not limited to, the following: 

  1. Person-Centered Options Counseling (PCOC) (Complete): In August 2021, Rhode Island successfully implemented a PCOC program and network to assist consumers who are entering into or inquiring about the State’s system of publicly and privately financed LTSS. Additional information regarding the State’s PCOC program is available at myoptions.ri.gov.   
  2. Conflict-Free Case Management (CFCM) (Ongoing): The State is currently designing and implementing a statewide system for providing CFCM for Medicaid participants who receive LTSS in a home or community-based setting. The LTSS Interagency Redesign Team’s goal is to create a CFCM network that complies with federal requirements and aligns with RI EOHHS’s guiding principles regarding Choice, Equity, and Community Engagement. 
  3. LTSS Modernization (Ongoing): Rhode Island will become one of the first states in the nation to implement a single consumer information management system (CIMS) for Medicaid HCBS participants in which “information follows the person”. This project includes three key components: 
    1. Development of a single e-LTSS record housed on a cloud-based CIMS for ancillary functions that supports a person from the point of entry into the system 
    2. Reorganizing agency roles and responsibilities and associated business practices accordingly to eliminate silos and accommodate shifts in consumer demand; and  
    3. Investment in technology upgrades, interfaces and integration between the CIMS, Bridges (the State’s eligibility system) and the MMIS (the State’s claims payment system) required to support a full transition to a more person-centered quality driven and resilient LTSS system. 

 

Over the next several years, Rhode Island will continue to streamline access and transform its LTSS system into a model that is person-centered, coordinated, data informed, easily accessible and highly visible, and committed to quality. 

 

Archived Materials