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ADHC Update - March 24, 2017

ADHC Update

Emailed to ADHCC members March 24, 2017.

Below are several updates of importance to ADHC providers. Please forward this email to your Administrator or others in your organization as you see fit. As always, feel free to contact me directly if you have questions or concerns.

  • GuildNet MLTC pulling out of Westchester, Nassau and Suffolk counties effective June 1. Elderplan (HomeFirst) MLTC leaving Suffolk county ONLY, effective June 1.
  • ADHCC working hard to protect Method 1 transportation; final budget vote by April 1.
  • Federal advocacy update: House to vote on American Health Care Act today.
  • Looking for Licensed Nursing Home Administrator, social work or Recreation and Activities credits? Attend the ADHC conference!

This week, GuildNet MLTC plan members should have received a letter stating that GuildNet will no longer serve Westchester, Nassau and Suffolk counties effective June 1 and that the plan enrollee must select a new plan by May 18. You may recall that GuildNet attempted to limit the plan’s service area in November. DOH recently approved the transition plan for service area reduction for both GuildNet and Elderplan (Suffolk co. only).

ADHC providers in Westchester, Nassau and Suffolk counties should identify which registrants are enrolled in GuildNet and Elderplan and speak to the caregivers about alternative plans. The letter sent home to the plan member will include a list of other MLTC plans operating in the county. You may recommend specific plans with which you contract or have positive relationships with. If the registrant/caregiver does not make a selection by May 18, Maximus will auto enroll the member into a new plan.

Once your registrant is enrolled in a new MLTC plan, the plan must keep GuildNet or Elderplan’s plan of care for 90 days. On the 91st day, the new MLTC plan may change the plan of care. If the new MLTC plan decreases the number of days of ADHC, you have the right to appeal. The appeal must be made within 10 days of receiving the notice. It’s incredibly important for every ADHC program director and social worker to understand the continuity of care and fair hearing process. If you haven’t done so already, please listen to the free, member-only webinar specific to winning home care and ADHC fair hearings. Click here for an ADHCC memo on aid-continuing.

Please email me with any issues or concerns during this transition period. You may also send complaints to mltctac@health.ny.gov.

Budget negotiations are underway in Albany and we are working hard to protect ADHC Method 1 transportation. Thank you to all of the members who responded to our information requests earlier this week. We were able to pull together compelling arguments against mandatory Method 2 transportation quickly for our lobbyists at Greenburg Traurig. I expect transportation to be negotiated over the weekend or early next week. It should be noted that several other interest groups and their lobbyists are advocating on behalf of ADHC transportation and we are communicating daily about what we are hearing from DOH and the legislature. If you are a New York City provider that works with D&J Ambulette, please thank them for their advocacy.

The U.S. House of Representatives is expected to take a vote on the American Health Care Act this afternoon. ADHCC, LeadingAge NY, National Adult Day Services Association (NADSA) and LeadingAge national have opposed repeal of the Affordable Care Act and the severe cuts to Medicaid. We have conducted advocacy in the form of letters and phone calls to the New York delegation as well as face-to-face meetings in Washington, D.C. A letter from NADSA is attached to this email encouraging adult day services professionals to tell your Representative to vote “no.” Attached to this email are additional talking points should you decide to contact your representative.

Don’t forget to register for the ADHC conference April 20-21 and take advantage of 11.5 NAB credits, 9 social work contact hours and 11 clock hours (pending) for recreation and activity professionals. The conference marketing brochure is attached to this email. The schedule of events and online registration can be found here. First-time attendees can still register at a reduced rate.

Why attend the conference? You will:

  • Learn about new business opportunities for your ADHC program
  • Understand how Value-Based Payment will affect ADHC contracting and reimbursement
  • Implement new marketing strategy using social media platforms (and how to limit legal liability)
  • Hear directly from DOH about the Home and Community-based Services (HCBS) Settings Rule and how it will impact your program
  • Implement new strategies to better serve registrants with mental illness
  • Return to your program feeling motivated and inspired to work more effectively with your staff

Don’t forget to check out all of the great programming offered during the conference.