PCCM forum highlights DSS barriers to implementation

Friday the Appropriations Committee heard about DSS’ lack of progress in implementing the PCCM option for HUSKY passed into law three years ago. The panel included Dr. Patrick Alvino, a pediatrician practicing in Branford, who would like to participate but because PCCM is not statewide he and his 2,000 patients do not have the option. The committee also heard from Tawana Bourne, a HUSKY mom from Middletown who has struggled to access care for her family and would also like the option of receiving care though PCCM’s medical home model but it is not available in her town. Christine Bianchi of Staywell Health Center in Waterbury, a participating provider, talked about the lack of support or guidance she has received from DSS in trying to implement the program that started in Waterbury a year ago. Sabina Klein, a Yale senior and CT Health Policy Project Fellow, outlined to the committee the provider recruitment and public education activities she and other students/volunteers working with the Project and New Haven Legal Assistance have been providing in the absence of DSS efforts including phoning and visiting provider offices, putting up posters in schools, churches and health care sites, manning tables at community events, holding provider forums, and providing mass mailings to consumers and provider groups. Because DSS marketing guidelines prohibit providers from telling their patients about the PCCM option, but can answer questions if asked, the CT Health Policy Project purchased “Ask Me About PCCM” pins that the students/volunteers have distributed to hundreds of PCCM providers. The committee also heard from this advocate about PCCM experience in other states including OK where the shift from HMOs to PCCM saved $85.5 million in medical costs in the first full fiscal year, participating providers increased over 40%, outpatient visits went up, and ER visits went down. DSS responded that they believe the program is reaching its goals and they have no plan to improve enrollment or provider recruitment beyond what they are doing. The committee discussed advocate recommendations to hire an Administrative Services Organization to run the program for DSS and to appoint a Special Master to take over the program if DSS does not improve their efforts and performance.
Ellen Andrews