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ADHC Update - July 13, 2017

ADHC Update - July 13, 2017

Dear ADHCC members,

Please note the following updates in the ADHC industry and Adult Day Health Care Council. ADHCC staff are available all summer to answer your questions or concerns.

  • Save the date: ADHC director and staff training to be held Oct. 24 at Wartburg (Mt. Vernon), Oct. 25 at LeadingAge NY/ADHCC offices (Latham), and Oct. 27 at The Highlands at Pittsford.
  • ADHCC to meet with DOH on MAS issues; send concerns to Meg (meverett@leadingageny.org) by Wed., July 19.
  • Federal Life Safety Code updates for nursing homes apply to ADHC programs.
  • DAL reminds health facilities that utilize certified electronic health record technology must become participants of a qualified entity to connect to the Statewide Health Information Network for New York (SHIN-NY).
  • Rep. Sanchez (D-CA) reintroduces Medicare Adult Day Services Act.
  • ADHC federal and state advocacy update. 

 

Save the date! ADHC director and staff training will be held Tues., Oct. 24 (Wartburg, Mt. Vernon), Wed., Oct. 25 (ADHCC office, Latham) and Fri., Oct. 27 (The Highlands at Pittsford, Pittsford). This intensive, full-day training opportunity is designed to provide program directors and staff with a comprehensive understanding of the regulations and procedures required to operate and work in an ADHC program. Training will also focus on day-to-day director responsibilities including leadership and management of interdisciplinary staff, documentation principles and working with managed care organizations. This program will be useful for any director or staff member with less than three years of experience in ADHC as well as individuals seeking to increase or refresh their knowledge of Part 425 regulations and/or program operations. Registration will open later this summer.

 

ADHCC staff will meet with DOH next week to address ongoing concerns with Medical Answering Services (MAS). During the budget season, we collected and shared with DOH several pages of complaints from ADHCC members, most of which centered around poor customer service, late or no-show drivers. ADHCC members expressed frustration with MAS’s confusing and unstandardized complaint process during the ADHC annual meeting in April. As a result, ADHCC developed a complaint form for ADHC providers to document and better manage complaints with MAS. This form is under review and will be posted for your use shortly.

If you have suggestions on how MAS can improve operations to better serve registrants and providers, please send an email to Meg at meverett@leadingageny.org detailing your ideas by Wed., July 19. DOH wants to know how MAS is managing Method 2 and other non-emergency trips to physician appointments in New York City since MAS replaced LogistiCare as the Medicaid transportation broker. New York City providers are encouraged to send positive or negative experiences to Meg. Please do not send us protected health information (no client name or Medicaid number).

 

ADHCC has learned that federal updates to the Life Safety Code apply to ADHC providers. Updates to the Fire Safety Requirements are very technical in nature. Program directors should speak to their Administrator about fire safety standards for ADHC program space when reviewing nursing home compliance. Click here for a summary of the federal fire safety rules prepared by LeadingAge national. Despite our advocacy, DOH has not offered guidance or education for providers. Please contact us with your questions.

 

ADHC providers that utilize certified electronic health record technology must become participants of a qualified entity (QE) or Regional Health Information Organization (RHIO). This requirement only applies to health care entities that utilize electronic health record technology under the federal Health Information Technology for Economic and Clinical Health Act (HITECH). Health facilities that can demonstrate hardship or technical limitations to connect to a QE may apply for a waiver through DOH. The DAL, which includes contact information for the eight QEs is here.

 

The Medicare Adult Day Services Act of 2017  HR 3098 was introduced in the U.S. House of Representatives by Rep. Linda Sanchez (D-CA) on June 28, 2017.* ADHCC is working with LeadingAge national and the National Adult Day Services Association to advance this bill. We praise the Congresswomen's ongoing support for adult day services, and her belief that adult day services play a critical role in helping older adults with chronic diseases remain in their own homes.

The measure was referred to both the U.S. House Ways and Means Committee and the Energy and Commerce Committee for consideration. In the partisan environment that exist in the House of Representatives, it will be difficult for this legislation to pass without Republican support. It is critical that we inform Republican representatives in Congress about the benefits of adult day services. Our colleagues at the national level continue to discuss ways adult day services could be covered under Medicare and Medicare Advantage that would improve quality of care and reduce costs.

If passed, the legislation would: 

  • Expand Medicare beneficiaries care options by adding skilled nursing, rehabilitation and social services in a Medicare Certified Adult Day Services Center.
  • Allow patients who qualify for home health services or nursing homes under Medicare to use a Medicare Certified adult day services center as an option for care. It does not expand eligibility. It simply allows qualified patients to choose a Medicare Certified Adult Day Services Center.
  • Save Medicare dollars, cover more services.
  • Not expand the number of people using Medicare services. Eligibility to use the services in a Medicare Certified Adult Day Services Center is the same as the eligibility criteria for Medicare certified home health.
  • Require Medicare Certified Adult Day Services Center to meet the standards of nationally recognized accrediting agencies.
  • Require Medicare Certified Adult Day Services Center services to be ordered by a physician who approves the plan of care.

The bill currently has six co-sponsors; one of the co-sponsors is Rep. Yvette Clarke (NY-9). Over the next several months, we will seek additional support from the New York State Delegation. *LeadingAge national contributed to this summary.

 

Advocacy Update: ADHCC is closely monitoring health care reform efforts at the national level. Senators Schumer and Gillibrand are vehemently opposed to the Senate Better Care Reconciliation Act (BCRA) which imposes Medicaid block grants or per-capita caps to states. We will continue to work with LeadingAgeNY and NADSA to communicate our opposition to any version of reform that will negatively impact Medicaid HCBS providers, such as ADHC. We will keep you updated on this issue as it unfolds.  

 

The best time to advocate for your ADHC program is during the summer and fall when your legislator is back home in their district office.

Invite your elected officials to a summer picnic, registrant birthday party or simply take a tour of your program. Explain how most of your registrants are Medicaid beneficiaries and what would happen to your program and sponsoring nursing home if New York State received significantly less federal dollars to pay for Medicaid. In addition, remember to thank your state legislator for protecting Method 1 transportation in the 2017-18 Executive Budget. Please tell your legislator the importance of safe, reliable and personalized transportation for your registrants and your experiences working with MAS. Last, invite the press! Legislators love seeing their picture in the paper with constituents. Click here to identify your state and federal representatives. If you have questions about effective advocacy, contact ADHCC.

Have a great summer!

 

Anne and Meg