HLS 19RS-573 ORIGINAL
2019 Regular Session
HOUSE CONCURRENT RESOL UTION NO. 26
BY REPRESENTATIVE BACALA
HEALTH/LDH: Requests that the La. Department of Health resume implementation of a
Medicaid managed long-term services and supports system
1 A CONCURRENT RESOL UTION
2To urge and request the secretary of the Louisiana Department of Health to cause the
3 resumption of the department's effort to implement a Medicaid managed long-term
4 services and supports system and to report to the legislative committees on
5 appropriations, finance, and health and welfare by a certain date concerning the
6 status of this effort.
7 WHEREAS, managed long-term services and supports, commonly referred to as
8"MLTSS", are a means of delivering long-term care for persons with developmental,
9intellectual, age-related, and physical disabilities through a capitated Medicaid managed care
10program; and
11 WHEREAS, at least twenty-two state Medicaid programs currently feature an
12MLTSS system; and
13 WHEREAS, the primary benefits of Medicaid MLTSS, as evidenced in states that
14have implemented such a system, include improved quality of care and expanded service
15options for Medicaid enrollees; MLTSS systems also provide a valuable mechanism for cost
16containment in state Medicaid programs; and
17 WHEREAS, former officials of the Louisiana Department of Health (LDH) have
18indicated that implementation of an MLTSS system would result in considerable Medicaid
19cost savings by making less expensive, more widely preferred home- and community-based
20services increasingly available as an alternative to more expensive institutional care; and
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HCR NO. 26
1 WHEREAS, as indicated in House Resolution No. 224 of the 2017 Regular Session,
2the secretary of LDH has testified that savings from MLTSS implementation could be
3seventy million dollars "on the low end"; and
4 WHEREAS, in addition to the substantial savings in Medicaid expected to result
5from MLTSS implementation, according to the Legislative Fiscal Office, an MLTSS system
6would generate revenues to the state of up to one hundred million dollars annually through
7increased collections of premium taxes assessed on Medicaid managed care organizations
8pursuant to R.S. 22:842; and
9 WHEREAS, since the inception of Medicaid managed care in Louisiana in 2012,
10when only select groups of Medicaid enrollees were transitioned from a fee-for-service
11system to the insurance-based managed care model, the state has moved incrementally to
12institute managed care for additional populations and services; and
13 WHEREAS, as of the date of filing of this Resolution, the only Medicaid enrollees
14who remain excluded from managed care in this state are those receiving long-term care in
15institutional or home- or community-based settings; and
16 WHEREAS, in 2013 and 2014, LDH, following procedures and timelines
17recommended by the federal Centers for Medicare and Medicaid Services, engaged in an
18extensive planning process for including people with long-term care needs in Medicaid
19managed care through the creation of an MLTSS system for our state; and
20 WHEREAS, during this planning process, LDH officials stated all of the following
21to underscore the necessity of implementing an MLTSS system:
22 (1) As there are waiting lists for home- and community-based services numbering
23in the tens of thousands of people but no waiting lists for institutional care, the department's
24goal with system transformation in long-term care is to serve a greater proportion of people
25in the home- and community-based settings of their choice.
26 (2) While only ten to twenty percent of clients of the LDH office for citizens with
27developmental disabilities receive care in institutional settings, nearly half of that office's
28Medicaid expenditures go to institutional providers.
29 (3) From surveys and interviews with Medicaid enrollees with long-term care needs
30on what services would be most useful to them, the department found that transportation,
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1support for integration into the community, and employment support were the most
2requested services. None of these services are available in institutional settings, but all could
3be furnished through an MLTSS system serving people who choose to receive care in their
4own homes and communities; and
5 WHEREAS, based on its thorough planning and the significant amount of input it
6gathered from stakeholders across the state, LDH developed specifications for the MTLSS
7system and wrote these specifications into a request for proposals (RFP) for an MLTSS
8provider; and
9 WHEREAS, LDH announced that it would release the RFP for an MLTSS provider
10in April of 2015, then indicated in that month that the release of the RFP would be delayed;
11and
12 WHEREAS, the department ultimately announced in August of 2015 that it would
13not release the RFP for an MLTSS provider.
14 THEREFORE, BE IT RESOLVED that the Legislature of Louisiana does hereby
15urge and request the secretary of the Louisiana Department of Health to cause the
16resumption of the department's effort to implement a Medicaid managed long-term services
17and supports system.
18 BE IT FURTHER RESOLVED that on or before September 1, 2019, the secretary
19of the Louisiana Department of Health shall submit to the House Committee on
20Appropriations, the Senate Committee on Finance, the House Committee on Health and
21Welfare, and the Senate Committee on Health and Welfare a report detailing the actions the
22department has taken, or will take, to resume its implementation of a Medicaid managed
23long-term services and supports system.
24 BE IT FURTHER RESOLVED that a copy of this Resolution be transmitted to the
25secretary of the Louisiana Department of Health.
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HCR NO. 26
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
HCR 26 Original 2019 Regular Session Bacala
Urges and requests the secretary of the La. Department of Health to cause the resumption
of the department's effort to implement a Medicaid managed long-term services and supports
system.
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