As a Service Facilitator since 2012 I've watched this program go through many changes.  I've watched the families adjust to and adapt to changes that were difficult to comprehend but they eventually adjusted over time.

However, eliminating the one person who knows the member and their family is a major mistake that will have a negative impact on the families.  My role is not just doing the routine visits and renewing authorizations.  This is what my typical week consists of as a service facilitators under the CCC+ Waiver:

Conducting the 90 day home visit and listening to what their needs are since we last spoke

Reading the mail that they have received from DSS or the MCO that they don't understand

Contacting DSS to check the status of Medicaid renewal paperwork that was sent 2 months ago only to find that additional information is needed. Faxing that additional information to DSS as the member lives off the beaten path with no access to a fax to prevent lapse in coverage

Contacting Home Care Delivered to reduce the shipments as they have a wall lined up with incontinent supplies as they are receiving too many.

Contacting CDCN for new enrollment paperwork update - background checks not checked off and the Virginia State Police has sent the results in 2 weeks ago.  Proving to CDCN that the documents for the EOR were emailed to them along with the attendant packets which I personally send for the members.  I conduct a three way call with the EOR or attendant and CDCN to verify that what CDCN's customer service rep has told them is incorrect - more like a plain lie. CDCN does not process the attendant pkts promptly within the 30 day time frame and refuses to correct the issue timely. The attendants are losing weeks of pay and cannot enter time past 30 days even though it's CDCN's fault.  Customer service reps that work from home with kids crying and people talking in the background when discussing the members enrollment. 

I speak with the MCO's to find out which care coordinator is assigned to this member as they have received several letters over 6 months introducing a new care coordinator but no one has met them yet.  Some members have not had a visit with a care coordinator in over a year but yet ICT meetings results are done.  Of the 45 care coordinators that I communicate with only 10 are top notch and knows that member and will advocate for them as hard as I do.

I handle the appeals when the hours are reduced. I have to get permission forms signed by the member for both Medicare and Medicaid to represent them in the appeal at the MCO level.

When the aide is suffering with burnout he/she can call me and talk about it just to have a sympathetic ear.  These caregivers work around the clock with a total care family member or a parent with dementia.  They need words of encouragement as they are only paid for 7 hours of the 18 hours they are working.  They will never consider facility placement as this program allows them to remain in their homes.  There are families that I assist with finding a respite caregiver for them to interview - matching the caregiver to their home environment and the member's needs.  It feels good to see a revised plan provide the relief that they need.

I make the APS reports for those consumers that don't lack capacity but the member is not receiving the proper care. They will not turn on a family member but observation in the home shows that they are afraid to speak up.

I report fraud when there is solid proof that the aide is not providing care and billing for it.  Even the EVV doesn't stop that from happening.  

There are facilitators that don't do their jobs and yet there are those of us who do.  Since the announcement of our roles being eliminated the service facilitators have communicated with each other daily about the changes.  We are not in competition with each other and we support each other emotionally knowing that our work is overshadowed by a huge company that has many complaints.  As one comment stated "throwing the baby out with the bath water" sums it up. As of today, we still have no answers from DMAS but we're patiently waiting for our turn to speak with them.

These families deserve to have a choice and not be forced to have no one to advocate for them.  I can't see CDCN providing the service broker services as they cannot do what they're currently contracted to do.  

I encourage DMAS to provide more oversight of our roles and address those Service Facilitators that have numerous complaints from the families.  No one is perfect and we all make mistakes.  However, we shouldn't be allowed to participate if we are not doing our jobs and providing a positive service to the members.  I know my members and their families and it hurts to hear them upset that I may not be here to service them after April 1, 2027. We can only hope that DMAS reads all of these comments and reconsider their decision.