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dialogue
24
NOV / DEC 2013
I
Healthcare Journal of NEW ORLEANS
Kathy Kliebert:
It’s a couple of things. One, we
keep our key principles always at the fore-
front, making sure that everybody under-
stands these are our key principles, some of
which are based on Centers for Medicare and
Medicaid Services.They’ve got key principles
for long term care. We have key values in
terms of people’s ability to live in their natu-
ral homes and their communities. We have
key values about person-centered services
and providing individuals what they need,
when they need it—the right services at the
right time in the right place.
This is a very diverse group. I think man-
aged long term care is so difficult because
probably with all of these people we have
on this advisory group, there’s not going to
be anybody that’s really for this. From com-
munity advocates to residential services,
nobody is really saying, “I’m a champion of
this.”However, I thinkmany of them see that
there are benefits that people gain, and that
our ability to serve more people in a way
that provides the quality of services is the
best benefit. If you keep that as the focus
you’ll go a long way towards taking some of
the adversity out of it for all those groups.
The other way we are going to manage
this is by really listening to every single
person, every individual that wants to give
us feedback. We’ll start with our advisory
group, which already has 28members and is
expanding. We can’t let every single person
that wants to participate be on our advisory
group, but we’re trying tomake sure we have
covered all the bases in terms of the different
kinds of stakeholders. Familymembers, indi-
viduals with disabilities themselves, commu-
nity advocates, residential providers, institu-
tional providers, making sure everybody has
a chance to say, “This is what’s important to
me as you design this system.” I don’t think
I’ll be able to get a true consensus in terms of
that diverse group, but I believe at the end of
the process we’ll be able to say we’ve listened
to everybody, we’ve heard everybody’s view-
point and taken that into consideration. A lot
of people are saying, “Are you going to take
the providers into consideration?”and abso-
lutely we will. We have to have an adequate
provider network to provide these services.
So we can’t destroy our provider network
and there is no intent to do that.
Again, it’s making sure we have all the
groups covered and making sure we have
given them the opportunities. That will be
done through our advisory group. We will
have set meetings on that as well as regional
stakeholder meetings throughout the state
to allow everybody the opportunity to ask
questions and give us feedback.
Editor:
Are youusing another state’smodel or is
this a CMSmodel?
Kathy Kliebert:
CMS actually does have an
advisory group and gives you recommenda-
tions for the people who should be on there,
so we are using some of that, but it’s mostly
just our belief that if you have a subject that
is so important to somany people you want
to get as much stakeholder engagement as
possible. There are 16 other states that do
some sort of managed long term care, but
we’re not following anybody’s model. This
will be what’s good for Louisiana. Louisiana
is very different in terms of how we deliver
services sowe are going to listen to the stake-
holders in Louisiana and design amodel that
works for us.
Editor:
I am curious. In terms of policy, how do
you strike that balance? With long term care
each case is so unique and yet you are charged
with setting the policy for all those different
cases.
Kathy Kliebert:
When we go out to stakehold-
ers and these advisory groups we are going
to be asking them what kinds of metrics do
they want us to look at. What’s important in
terms of what we are changing in the sys-
tem? What parts of the system do we want
to keep? We have good things that are now
working in our system, what parts of it do
we want to keep? Do we include the acute
portion and the long term care portion all
in one? Do we include all populations or do
we phase populations in?With those types of
questions, when we get feedback, it will help
us make those policy decisions.
Editor:
Can youanticipate that wehave anover-
supply in any one sector?
Kathy Kliebert:
You can look at our statistics
in terms of institutional services. We have
always been a highly institutional state. At
one point we were the highest ICF/DD (Inter-
mediate Care Facility for the Developmen-
tally Disabled) usage in the United States. I
think we are third now. Same thing in nursing