Conflict of Interest/Conflict Free Case Management

In the past few months you have probably heard the terms conflict free case management, or conflict of interest.  You may be wondering what this means.  

The Center for Medicaid and Medicare Services (CMS) is requiring New Hampshire to make changes in two areas of the service delivery system:

1.       Conflict of Interest in Case Management to be in compliance with the Home and Community Based Setting (HCBS) Regulations requiring the separation of Case management (Service Coordination) and direct service delivery; and

2.       New Hampshire’s Organized Health Care Delivery System, relating to the payment process for providers

There has been a stakeholder group looking at this process and how to move forward with these requirements.   BDS is currently working with agencies, stakeholders, providers and communities to map out the current system.  The goal is to fully understand the functions of the area agencies and the implications, cost, and practicality of splitting out direct service from the Area agency role. 

There is a desire to have input from families and individuals receiving services, and this is being done by completing this survey or attending on of the forums across the state being conducted by NH Family Voices. 

It is important to note that the term case manager and service coordinator can be used interchangeably.  Some agency’s may also use other titles for case managers. 

Some things to keep in mind as you take this survey:

·       The term Service Coordinator is defined in HEM 520 as a person who is chosen or approved by an individual and his or her guardian or representative to organize, facilitate and document service planning and to negotiate and monitor the provision of the individual’s services.

·       If you have more than 1 family member receiving services from the area agency please complete this survey with one particular individual in mind. 

If you would like more information please visit the corrective action plan website at:

https://www.dhhs.nh.gov/dcbcs/bds/hcbs-waiver.htm

If you have questions please contact NH Family Voices

Jennifer Pineo  jsp@nhfv.org  271-4525

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