Hale Ola: Hawaii’s specialized health homes pilot concept

A key focus of Hawaii’s QUEST Integration Medicaid Managed Care RFP is increasing the level of care coordination for enrollees. One new component of this effort is Hale Ola – Hawaii’s specialized health homes pilot concept.

 

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As outlined in the RFP, the Hawaii Department of Human Services (DHS) will establish the Hale Ola pilot to provide comprehensive care and services to the “Special Health Care Needs Plus (SHCN+)” population. This includes individuals with a serious mental illness and/or substance abuse disorder, multiple chronic physical health conditions, or dual diagnoses of chronic conditions with impairments in an activity of daily living.

The purpose of Hale Ola is to combine community care teams with health homes to support individuals with complex health care needs.

“The goal of melding of these two concepts and creating the Hale Ola is to provide comprehensive, coordinated, and whole person care to individuals with complex conditions that results in improved outcomes and contributes to a more efficient use of health care dollars,” reads the RFP appendix detailing the pilot.

The Hale Ola will be charged with providing all care coordination services to the SHCN+ population. Services include integrated primary care and behavioral health services, care coordination and care planning, and connections to health-related social services. The Hale Ola will also place an emphasis on face-to-face interaction in the home and community through community care teams.

During the contract period, the pilot will be established in a minimum of three regions.

Health plans will be charged with ensuring that quality care is provided through the Hale Ola. Health plans will be responsible for monitoring and oversight, facilitating partnerships between the Hale Ola and community-based partners, and creating a process for assigning SHCN+ individuals to the Hale Ola. Health plans will pay the Hale Ola based on payment methodology developed by DHS.

The pilot will require collaboration among the plans and DHS to develop aligned information sharing and reporting standards.

Moving forward, DHS plans to seek input from stakeholders and community to develop the pilot’s program structure, performance milestones, reporting requirements, and payment distribution methodology. DHS will collect input from August 2019 – January 2020, with a target implementation date during 2020.