CILs and Pennsylvania Community Health Choices

Community HealthChoices (CHC) is a new initiative in Pennsylvania that will use managed care organizations (MCOs) to coordinate physical health care and managed long-term services and supports (MLTSS) for older persons, persons with physical disabilities, and Pennsylvanians who are dually eligible for Medicare and Medicaid.

PA CHC is expected to serve up to 420,000 Pennsylvanians.

According to the PA Office on Long Term Living, the goals of PA CHC are the following:

• Enhance opportunities for community-based services
• Strengthen health care and MLTSS delivery systems
• Allow for new innovations
• Promote the health, safety, and well-being of enrolled participants
• Ensure transparency, accountability, effectiveness, and efficiency of the program

PA CHC will cover the same physical health benefits that are currently available through the Medicaid Adult Benefit Package.

The current timeline for implementation of CHC is the following:

January 2018: Phase One (Southwest Region)
Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Fayette, Greene, Indiana, Lawrence, Somerset, Washington, and Westmoreland Counties

July 2018: Phase Two (Southeast Region)
Bucks, Chester, Delaware, Montgomery, and Philadelphia Counties

January 2019: Phase Three (Northwest, Lehigh-Capital, and Northeast Regions)
Adams, Berks, Bradford, Cameron, Carbon, Centre, Clarion, Clearfield, Clinton, Columbia, Crawford, Cumberland, Dauphin, Elk, Erie, Forest, Franklin, Fulton, Huntingdon, Jefferson, Juniata, Lackawanna, Lancaster, Lebanon, Lehigh, Luzerne, Lycoming, McKean, Mercer, Mifflin, Monroe, Montour, Northampton, Northumberland, Perry, Pike, Potter, Schuylkill, Snyder, Sullivan, Susquehanna, Tioga, Union, Venango, Warren, Wayne. Wyoming and York Counties

Consumers will be contacted prior to their region’s implementation date to select a participating MCO.

Pennsylvania CILs have had a major role in shaping the design and development of PA CHC through ongoing education, advocacy, and partnership with consumers, PA OLTL, MCOs, and other important stakeholders. CILs will continue to work and innovate to ensure that consumers receive choice of services and providers under PA CHC while retaining the ability to direct their own care in the community.