According to a 2018 AARP survey, some 76 percent of LGBT adults are anxious about having adequate family and/or social supports to rely on as they age. Individuals attributed this to the fact they are likely to be estranged from family because of their sexual orientation or gender identity. Support networks will often include LGBT and straight friends rather than family.  LGBT individuals are also significantly less likely to have children and are more likely to be single. All of these social conditions present significant risks to the LGBT population as they age and demonstrate the vulnerability of this population especially as they progress to need any long-term services and supports.

Community HealthChoices, or CHC, is designed to support vulnerable populations such as those individuals in the LGBT community who are eligible for this program.  CHC is a Medicaid managed care program that will improve service delivery and offer better health care coverage for some of our most vulnerable friends, family members, and neighbors.  This program covers individuals who are 21 years of age or older and includes physical health benefits and long-term services and supports (LTSS). Care in CHC may be provided in the home, community, or nursing facility. When fully implemented on January 1, 2020, CHC managed care organizations (MCOs) will serve more than 450,000 Pennsylvanians.

CHC will enhance the quality, efficiency, and effectiveness of all services offered by the program as well as serve more people in communities, giving them the opportunity to work, spend more time with their families, and experience an overall better quality of life.  The program will work with eligible individuals and use a person-centered approach to identify their needs and preferences and design a service package that is appropriate to the person. Within the person-centered planning process, specific aspects of LGBT identity will be part of the discussion to articulate a plan for the future and help determine the services and supports that an individual needs to achieve their desired outcomes.

Additionally, the CHC-MCO agreement with the state requires the CHC-MCOs to address issues of cultural competency within their organization and among their network providers. It is imperative that racial, ethnic, linguistic, gender, sexual orientation, gender identity, and cultural differences between providers and participants do not present barriers to participants’ access to and receipt of quality services. For this reason, CHC-MCOs are required to have comprehensive provider education strategies and commit to cross-cultural training of staff to provide relevant, effective programs for the diversity of people served. Increased oversight and education of cultural competency among the CHC-MCOs and their network providers will increase access to high quality care, and expectantly lead to better health outcomes for the LGBT community.

The first phase of this program was implemented in the Pittsburgh area in January 2018 and thus far, the program has seen great success.  With about nine months completed of our Southwest zone roll out, nearly 80,000 Pennsylvanians have transitioned into the CHC program. DHS continues to support enrollees and providers as they adjust to this transition in the program.

The second phase is the Philadelphia area and will include approximately 128,000 individuals.  The launch date for this phase is January 1, 2019. In preparation of this launch, community sessions are taking place for eligible community members to learn more about this program, give them the opportunity to gather resources, and ask questions to choose a plan that will meet their needs (For a complete schedule of these CHC information sessions, visit healthchoices.pa.gov or call 1-833-735-4416).

CHC’s continued investment demonstrates a commitment to supporting elderly LGBT Pennsylvanians and individuals with physical disabilities every day.  The program represents an exciting time in the Commonwealth with the move towards managed care for hundreds of thousands of older Pennsylvanians and individuals with a physical disability. I encourage each of you to take some time to visit healthchoices.pa.gov to stay up-to-date on any and all information regarding Community HealthChoices.

Kevin Hancock is the Deputy Secretary for the Office of Long-Term Living in the Pennsylvania Department of Human Services.