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Implementation Key Responsibilities and Commitments
For purposes of this response, we are assuming that the winning
bidder will be announced on or about March 1, 2007.
bidder will be announced on or about March 1, 2007.
| Customer Service | ||
|---|---|---|
| Task | Targeted Completion | |
| Convene work group, review proposal, expand implementation plan | 03-08-07 | |
| Provide information to HR work group for CSR recruitment | 03-23-07 | |
| Network/Provider Services Manager hired and on board | 04-20-07 | |
| Customer Services Representatives hired | 05-15-07 | |
| Training of all CSR staff completed | 06-21-07 | |
| Live practice week | 06-29-07 | |
| Install and test 1-800 numbers | 05-16-07 | |
| Write and get necessary approvals for call routing, policies and procedures, and auto attendant scripts | 06-07-07 | |
| Finalize call routing, auto attendant scripts | 06-14-07 | |
| Test all call routing | 06-21-07 | |
| Participate in Readiness Review | Date TBD by SRS | |
| Determine reports required from Avaya call management system | 04/20/07 | |
| Program system for required reports; test programmed reports | 06/01/07 | |
| Provider Relations | ||
| Task | Targeted Completion | |
| Identify potential network providers | 01-07-07 | |
| Convene work group, review proposal, expand implementation plan | 03-02-07 | |
| Finalize provider communication materials (including cover letter, FAQ’s, application packet, rates and contracts | 03-07-07 | |
| Mail communication materials (including credentialing and contracting materials) and post FAQ’s to web-site | 03-10-07 | |
| Track returned applications through credentialing and contracting | All contract period | |
| Provide telephonic support through National Provider Service Line (included enhanced hours) and establish on-site support for Kansas providers having difficulty completing applications | 03-10-07 | |
| Develop training materials and schedule provider forums (both web-based and face-to-face) | 4-01-07 – 07-01-07 (and ongoing as needed) | |
| Assess network completeness and determine additional action steps if necessary to assure network adequacy for go-live | 04-16-07 (and monthly through implementation | |
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| Task | Targeted Completion | |
| Meet with SRS/AAPS to review provider handbook samples and determine format/content | 04-15-07 | |
| Present provider handbook draft to SRS and/or provider representatives for review | 05-01-07 | |
| Post handbook on Kansas Web site; print copies for distribution upon request1 | 05-01-07 | |
| Participate in Readiness Review | Date TBD by SRS | |
| In collaboration with SRS and RADACs, determine number of orientation meetings to be conducted and locations for each; book locations | 04-17-07 | |
| Prepare and distribute announcements about orientation meetings to providers, future members, and other interested parties (generally orientation for members and providers are held on the same day and location with the morning focusing on one group the afternoon on the other. However, anyone is free to attend either or both orientation program) | 04-17-07 – 07-01-07 (and ongoing as needed) | |
| In collaboration with SRS, provider and client representatives, finalize agenda and presenters | 05-15-07 | |
| Conduct orientation forums in multiple locations across Kansas | 06-15-07 | |
| Load provider files into management information system | 04-01-07 and throughout contract period) | |
| Schedule and conduct additional orientation sessions during first contract year | 06-30-08 | |
| Conduct provider forums at least twice annually | 07-08 | |
| Clinical / Quality Assurance | ||
| Task | Targeted Completion | |
| Convene work group, review proposal, expand implementation plan | 03-08-07 | |
| Provide information to HR work group for recruitment of staff for Clinical Dept | 03-23-07 | |
| Clinical Director hired and on board | 04-23-07 | |
| Intensive Care Managers hired and on board | 05-15-07 | |
| Utilization Managers hired and on board | 05-15-07 | |
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| Task | Targeted Completion | |
| Regional Representatives hired and on board | 05-18-07 | |
| Training of all staff in Clinical Department completed | 06-22-07 | |
| Live testing week | 06-29-07 | |
| Participate in Readiness Review | Date TBD by SRS | |
| Review proposed work flows with SRS and representatives of RADACs | 03-23-07 | |
|
Develop policies and procedures based on proposed work flows, including: • interface/information transfer between KCPC and CareConnect; • care coordination with MCOs and community mental health centers; mixed services protocols; • medical necessity criteria, level of care guidelines, treatment-based treatment guidelines; • authorization letter templates; and • clinical management reports, internal and external |
05-15-07 | |
| Customize clinical training for clinicians and SA-PIHP providers | 05-15-07 | |
| Complete initial memoranda of understanding with health plan, community mental health centers and other affiliated delivery systems that serve a high proportion of SA-PIHP clients | 06-15-07 | |
| Provide training to Northeast Service Center night staff and other service centers designated as emergency back-up | 06-20-07 | |
| Complete formal Utilization Management Plan for SA-PIHP | 08-31-07 | |
| Interview candidates for Medical Director consultant; present recommended candidate to SRS | 05-01-07 | |
| Training for selected consultant at other PSD Service Center and on-site in Kansas | 06-15-07 | |
| Identify SA-qualified Peer Advisors from interview pool and from VO contract; provide orientation to SA-PIHP | 06-15-07 | |
| (PE&O/Training Director) Implement outreach and communications efforts focusing originally on disseminating information about SA PIHP and 1-800 number | 05-31-07 | |
| Create two-sided one-page program information sheet for distribution at orientation meetings and other venues; get approval from SRS and client/family representatives | 04-16-07 | |
| Update one-pager | At least monthly during implementation | |
| Identify SRS staff and SA-PIHP clients/families to review drafts of Member Handbook | 04-30-07 | |
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| Task | Targeted Completion | |
| Provide initial Member Handbook for posting on VO-KS Web site2 | 06-01-07 | |
| With support of SRS, review and modify Member Rights statements, policies and procedures currently used by RADACs | 05-01-07 | |
| Finalize statement of Member Rights for SA-PIHP | 05-15-07 | |
| With support of SRS (and KHPA), clarify grievance and appeal process for both Medicaid and non-Medicaid SA-PIHP members | 04-06-07 | |
| Adapt policies and procedures to full compliance with Kansas regulations | 04-20-07 | |
| Submit policies for review and approval by SRS | 05-15-07 | |
| Program automated notices of action letters and other notifications for providers and clients to reflect approved policies | 05-31-07 | |
| Design training for staff on grievances and appeals; incorporate into orientation as well as ongoing training modules | 06-01-07 | |
| Adapt CareConnect complaint/grievance/appeal tracking module to support KS SA-PIHP processes | 06-18-07 | |
| Recruit and hire QM Director; QM Director on board | 04-27-07 | |
| Grievance/Appeal Specialist, PE&O/Training Specialist on board | 05-18-17 | |
| Review proposed QM committee structure with SRS; negotiate final structure | 04-16-07 | |
| Recruit members for committees | 05-18-07 | |
| Submit initial QM plan3 | 10-01-07 | |
| Convene Clinical Performance Committee to focus on policies and procedures and provider profiling | 04-08-07 | |
| Finalize Year #2 QM Plan for review by SRS/AAPS | 08-31-08 | |
| Identify reports required by SRS and required internal reports | 05-23-07 | |
| Submit recommended formats for SRS reports for approval | 05-31-07 | |
| Complete programming for reports | 06-22-07 | |
| Verify report accuracy | Ongoing | |
| Complete grid of contract deliverables | Ongoing | |
| Document delivery of contract deliverables | Ongoing | |
| Regular review of contract deliverable grid/ generate report | Oct & ongoing | |
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| Task | Targeted Completion | |
| Create training agenda for VO-KS staff and implement, including ttraining on cultural competency | Oct & ongoing | |
| Conduct member and provider satisfaction surveys | TBD | |
| Plan for and conduct Substance Abuse Summit | 05-08 | |
1
In many new programs, because policies and procedures are updated frequently in the early months of the contract period, printed copies of the Member Handbook are not made available until 90 days after go-live; the Handbook and revisions are available continuously on the website
2
In many new programs, because policies and procedures are updated frequently in the early months of the contract period, printed copies of the Member Handbook are not made available until 90 days after go-live; the Handbook and revisions are available continuously on the website, and one-page summaries or other handouts are made available to explain the most important program features including the 1-800 numbers, Member Rights, grievances and appeals, services and how to access them.
3
Many QM activities cannot be initiated until a sufficient body of data is collected to assure that reports are both reliable and valid. Therefore in most programs, finalization of the QM plan is delayed to provide state staff and other stakeholders the opportunity to participate in its development
| Task | Targeted Completion |
|---|---|
| Review proposal and contract for additional/changed requirements | 03-08-07 |
| Identify available appropriate properties; review and select | 03-23-07 |
| Identify and contract for temporary space/equipment/furnishings | 03-30-07 |
| Finalize build-out requirements and office configuration | 04-16-07 |
| Finalize and sign lease | 04-23-07 |
| Sign contract for build-out if necessary; begin build-out | 04-23-07 |
| Approve completion of build-out; move into permanent location | 06-01-07 |
| Verify office equipment needs; complete order | 05-01-07 |
| Install office equipment and furnishings | 06-08-07 |
| Establish office services including UPS and FedEx for temporary and permanent locations, post office box(es) | 04-03-07 |
| Determine supply needs; order supplies for temporary and permanent space | 06-01-07 |
| Information Technology | |
| Task | Targeted Completion |
| Included in dedicated IT implementation submitted in response to Section 5.7.16 of the proposal | Claims, Eligibility and System Configuration |
| Task | Targeted Completion |
| Convene work groups, review proposal, expand implementation plan | 03-08-07 |
| Request team members from SRS, KHPA, EDS and other agencies with whom interfaces will be established | 03-09-07 |
| Clarify processes required to provide to SRS information needed to support reimbursement of block-grant funded services | 03-16-07 |
| Receive list of approved services by funding stream and other information related to benefit design; load into BenefitConnect to support accurate claims payment, clinical and customer service | 05-16-07 |
| Identify all global configuration information critical to ensuring that all subsystems are appropriately linked within the system | 04-16-07 |
| Configure Connections Administrative System benefit designs for | 04-23-07 |
| Claims, Eligibility and System Configuration | |
| Task | Targeted Completion |
| each funding stream | |
| Identify format for Title XIX eligibility feeds | 03-16-07 |
| Program eligibility load program; configure eligibility client configuration and load sample eligibility tape | 05-16-07 |
| Claims model office testing to validate all sub-systems are fully and appropriately configured | 05-16-07 |
| Offer providers opportunity to submit trial claims as training/compatibility assessment | 06-01-07 |
| Provide telephonic and on-site support for providers | Ongoing |
| Participate in Readiness Review | Date TBD by SRS |
| Finance | |
| Task | Targeted Completion |
| Convene work group, review proposal, expand implementation plan | 03-08-07 |
| Request team members from SRS and KHPA with whom interface will be established | 03-09-07 |
| Provide information to HR work group for recruitment of CFO | 03-23-07 |
| CFO hired and on board | 05-22-07 |
| Determine any unique payroll requirements; set up VO-KS payroll | 03-08-07 |
| In collaboration with SRS, establish financial reporting requirements and implement any required changes to existing VO policies and procedures | 04-13-07 |
| In collaboration with SRS and KHPA, establish billing/ reimbursement process including wire transfer service | 05-15-07 |
| Set up internal general ledger accounts within ValueOptions for VOKS | 05-15-07 |
| Identify any special internal reporting needs and implement needed changes | 06-01-07 |
| Participate in Readiness Review | Date TBD by SRS |
| Prepare required audit information for SRS | TBD |
| Human Resources/Community Partnerships | |
| Task | Targeted Completion |
| Convene work group, review proposal, expand implementation plan | 03-08-07 |
| Gather job descriptions from all work groups; initiate recruitment efforts, including posting internal notices and advertising in selected media | 03-23-07 |
| Coordinate distribution of incoming resumes and scheduling of | 03-23-07 |
| interviews | > |
| Support Implementation Team, CEO and incoming new staff to complete processes required for filling VO-KS positions including background checks as necessary | Ongoing |
| Set up personnel files for all VO-KS positions | 04-06-07 |
| Establish internal P&Ps for personnel transactions that are compliant with VO and Kansas requirements | 04-30-07 |
| Recruit and hire Executive Assistant/HR Director; on board | 05-18-07 |
| Orientation and training complete | 05-31-07 |
| Post all required employee information posters relating to workman’s compensation, EEOC, VO Ethics Hotline | 06-01-07 |
| Participate in Readiness Review | Date TBD by SRS |
| Implementation Team/Service Center Leadership | |
| Task | Targeted Completion |
| Meet weekly with SRS/AAPS/KHPA staff for implementation updates | Throughout Imp period |
| Establish regular contract meetings at least monthly with SRS/AAPS/KHPA and/or other designated contract managers | 08-07-07 |
| Become active participant in existing meetings, such as Consortium meetings, at direction of SRS/AAPS or invitation of other groups | Ongoing |
| Join SRS effort to support treatment for co-occurring disorders | Ongoing |
| Complete letters of agreement with all major referral agencies outlining communication protocols | Ongoing |
