Conflict-Free Case Management and Person-Centered Planning (CFCM/PCP)

The Rhode Island Executive Office of Health and Human Services (RI EOHHS) is leading an interagency team to design and implement a statewide system for providing conflict-free case management (CFCM) for Medicaid participants who receive long-term services and supports (LTSS) in a home or community-based setting. RI EOHHS has three primary goals for CFCM:

CFCM Goals

WHY CFCM is needed:  

  1. The current service array of case management and planning services is not financed or delivered in accordance with the CMS’s HCBS Final Rule (42 CFR 441.301); therefore, the State is at risk of losing federal dollars if it is does not come into compliance with federal CFCM requirements.
  2. Conflict of interest exists for select providers including the State’s Developmental Disability Organizations (DDOs) and some community providers.
  3. The State’s HCBS programs continue to function in administrative silos where different State agencies maintain separate business processes, instruments, and IT systems for performing case management and planning tasks.
  4. The State uses different reimbursement rates and units of service (e.g., 15-minute increments v. monthly) for case management services.

WHEN CFCM will happen:

Contingent upon federal and RI legislative approval, the State will begin to enroll Medicaid HCBS participants into CFCM starting January 2024. Key milestones are shown below:  

  1. January 2023: RI EOHHS finalizes its CFCM strategic plan based on stakeholder input.
  2. March 2023: RI EOHHS will release a request for information (RFI) to identify interested CFCM bidders and to solicit feedback from stakeholders regarding the State’s proposed procurement strategy.
  3. July 2023: RI EOHHS implements a LTSS Consumer Information Management System (CIMS) to support CFCM activities.
  4. July 2023: RI EOHHS will conduct a pilot program to test CFCM tools and the State's LTSS CIMS. The pilot program will include several small HCBS programs currently receiving limited case management services.
  5. July 2023: RI EOHHS issues a request for proposal (RFP) for one or more vendors to provide CFCM statewide. It will take approximately six (6) months to execute contracts and prepare vendors to begin the gradual transition of new and existing participants.
  6. January 1, 2024: The State begins to enroll Medicaid HCBS participants into CFCM according to its participant transition plan. By January 1, 2025, all Medicaid HCBS participants have access to high quality CFCM from a conflict-free case manager that has met the minimum standards established by the State.

 

The materials posted below provide additional context and information regarding Rhode Island’s implementation of CFCM.

Upcoming Community Meetings

We are inviting you to participate in a virtual community meeting to learn more about the State’s design and implementation of CFCM.

Please register for one of the Community Meetings using one of the links below. The presentation materials/content will be the same at each meeting. All meetings will be conducted via Teams.

 Monday, December 12, 2022 3:00 PM-4:00 PM ET (click to register)

 Wednesday, December 14, 2022 3:00 PM-4:00 PM (click to register)

 Thursday, December 15, 2022 10:00 AM-11:00 AM ET (click to register)

 

After the last webinar date, a recording and PowerPoint presentation will be uploaded to this website.  

 

For questions regarding this effort, please email OHHS.LTSSNWD@ohhs.ri.gov.

Click here to view the 7.11.22 Conflict Free Case Management and Person-Centered Planning Community Meeting