In the new Long-term care 2.0 members receiving care will be able to pick between total self-direction or totally managed care for each service they receive.
In my opinion it shouldn’t be self-direction vs. total managed care for each service. It should be about people with disabilities and frail elderly being people not a number.
When I was looking for a massage therapist I was having a difficult time finding one. This is because I am self-directed on IRIS. Iris would not even give me a list of massage therapist vendors already signed up with IRIS. I did find a vendor eventually, that I Trust, after weeks of searching, emailing, and telephone calls. I imagine if I was on family care I would not have been able to choose the massage therapist because it would be totally managed.
In my opinion there is no reason care with regard to be able to choose or having no choice: the dynamic instead. It should not be total self-direction or total managed care. Instead the conversation should go something like this.
Care Team: You have been approved for massage therapy.
Member or Member Representative: That’s great.
Care Team: Do you have a massage therapist in mind?
(Member Can Yes or No)
Member: Responds Yes (care team says OK lets do the paperwork to see if they can be a vendor.
Member: Responds No (care team says OK we will work with you to find to you a massage therapist we can also give you a list of possible vendors that are already on our payroll for you to review. ) At this point, for any point, the member should be able to have any type of help in choosing the massage therapist.
By having this all or nothing self-direction or total managed care dichotomy it refuses to treat people with disabilities and frail elderly as actual people. Members shouldn’t have to decide one or the other, we should just be treated as individuals that might want to be involved and other times we just might need a little bit more help. There are all types of scenarios like I talk about above. I call this omni-direction at any time you can change how much self-direction based on conversations not paperwork. The whole process of directing a person’s life should be flexible enough to allow for anywhere between self-direction and total managed care depending on the persons needs and opinions.
Omni-direction would be much more simple than having to add two different processes for directing member cares. This dynamic process would most likely save even more money. Having a conversation instead of all or nothing regarding self-direction simplifies the process.