In 1998, consumers, service providers and state agencies (DHS, DEA, MHRH and DOH) developed a shared vision for long-term care and action plans to help move toward that vision. In late 1999, the Department of Human Services put together an outline that consolidated the group’s efforts into an initiative called "Living RIte". A leadership team comprised of a community service provider (Robert Caffrey) and two senior representatives (Ann Gardella and Richard Ryan) has been charged with spearheading implementation efforts. Staffed by state agency representatives, the implementation task force will include people with disabilities, seniors, and service providers from the full continuum of long-term and acute care.
"Rhode Islanders will have a dynamic long-term care system that supports high quality, independence, choice, and coordination of services with the necessary public and private funding."
Living RIte is a complex interaction of medical services, service coordination, information and referral, and new benefits such as chore services. In the medical arena, clients will ultimately have the option of managed fee-for-service, managed care or integrated service delivery systems. DHS is working on a Managed Fee-For-Service program to ensure that everyone has the option of having a lead doctor who can monitor ongoing health status, and intervene as necessary. Coordination, Assessment, Referral, Reassessment and Evaluation will be offered by CARRE Centers available to anyone regardless of funding source. There will be linkages between these centers, physicians, and other medical services to offer consumers a seamless and efficient access point to any needed component of care. A key function of the CARRE center will be to leverage available funding streams (Medicare, Medicaid, etc.) for the services needed by an individual.
It is anticipated that many existing providers will link to form CARRE Centers. The Living
RIte Implementation Task Force will develop credentialing standards that will be monitored
by a state inter-agency team. Some centers may serve limited functions, such as Durable
Medical Equipment Evaluation and Provision, while others may develop into fully integrated
service delivery systems such as the Program of All-Inclusive Care for the Elderly (PACE).
The added value of Living Rite to the current system is as follows: (1) it develops
additional benefits and options for the elderly and people with disabilities, such as, a
"managed-fee-for-service" health plan, CARRE Centers, and new support services;
(2) it provides a framework for the development of a fully integrated delivery system; (3)
it streamlines the process to access needed services and medical equipment; (4) it links
Medicare and Medicaid clinical and financial information; (5) develops new outreach
materials, such as, hospital "welcome" and "discharge" kits and a
Web-site.
Workgroups have been established to cover the following areas:
- Finance and Delivery Systems
- Quality and Outcome Measurements
- Information and Referral
- Political Action and Advocacy
For questions answered or comments, please write to livingrite@rixix.sod.eds.com.