ADHCC Update Oct, 24

ADHCC news:

Register today for the 2019 ADHC Director and Staff Training!
Run for office! ADHCC is looking for leaders to influence the direction of the association, strategize ways to strengthen the industry and support all ADHC providers.
HCBS Settings Rule Update audio conference posted on www.adhcc.org.

ADHC, nursing home and community-based services news and updates:

DOH issues new clarifications regarding cybersecurity event reporting requirements
New resources available for community services providers and managed care plans
DOH adopts regulations on nursing home discharges to the community
DOH suspends Consumer Directed Person Assistance Program (CDPAP) reimbursement changes
LeadingAge NY/ADHCC issues September ADHC “bed” census report
Cost-of-living adjustment (COLA) information for Social Security and Supplemental Security Income (SSI) in 2020

Free audio conferences of interest to ADHC providers (NOT sponsored by ADHCC); click on the links below to read more:

Registration is now open for our annual Director and Staff Training. The training will be held in three locations to accommodate member travel:

Dec. 2^nd at the Highlands at Pittsford, Pittsford;

Dec. 3^rd at Albany Guardian Society, Albany; and,

Dec. 5th at Wartburg, Mt. Vernon.

The full-day training is driven by lively attendee discussion and the real, day-to-day issues you face. We will cover a wide variety of topics including, the admission process, program director and staff responsibilities, census, managing staff, managed care and transportation. We will also discuss tips and strategies on how to comply with the HCBS Settings Rule. During the training you will learn from peers and experts in the field and come away with new ideas and a better understanding of how to manage your program.

This unique training experience is only offered once per year…register today!

ADHCC accepting nominations for 2020 Board of Directors! ADHCC is looking for leaders who want to influence the direction of the association, strategize ways to strengthen the industry and support all ADHC providers. Do you have what it takes to lead the organization in 2020? Nominate yourself or a colleague for one of the following postions:
Chairperson elect

Secretary

Treasurer

Regional Representative – ALL REGIONS, 1-8

To learn more about the positions, read the memo attached to this email or call ADHCC at 518-867-8836.

Did you miss the HCBS Settings Rule update audio conference on Oct. 7? Check out our website, www.adhcc.org, for the recording. This is a member only call and is password protected.

The Department of Health (DOH) Office of Health Information Management (OHIM) recently issued a Dear Administrator/Technology Officer Letter (DAL). The letter explains a new notification protocol that providers should follow to inform DOH when they experience a cybersecurity incident at their facility. The DAL includes a Frequently Asked Questions and poster with contact information for each DOH Regional Office. A reportable cybersecurity incident is any event that affects patient care, or represents a serious threat to patient safety, including intrusions whose intent appears to be breach or theft of protected health records. Click here to read the entire DAL; a pdf is also attached to this email. All nursing homes and ADHC programs must follow this new protocol.

Any questions regarding this DAL should be directed to DOH at ohim@health.ny.gov.

New resources are available to assist home and community-based services (HCBS) providers and managed care plans to identify and evaluate opportunities to address the non-medical needs of beneficiaries through Medicaid managed care social determinants of health (SDH) interventions and Medicare Advantage supplemental benefits.

Under New York State's Medicaid waiver and Value-Based Payment (VBP) Roadmap, Medicaid managed care plans are required to shift their provider contracts to Level 2 and 3 VBP arrangements that include approved SDH interventions and contracts with community-based organizations (CBOs) that do not bill Medicaid. The State Department of Health (DOH) recently published a list of the SDH interventions it has approved for managed long term care (MLTC) plans, Programs of All-Inclusive Care for the Elderly (PACE), and mainstream managed care. The MLTC and PACE SDH interventions are varied and address issues such as financial literacy and scam avoidance, asthma and diabetes self-management, social isolation, homelessness and housing instability, and advance care planning education. In addition, the Department's SDH web page offers a link to a Return on Investment Calculator for SDH interventions as well as an updated CBO Directory, webinars, and contract templates.

The Medicare Advantage program is also recognizing the importance of SDH and other non-medical supports by expanding the supplemental benefits that plans are authorized to offer. Additional detail on the expansion of supplemental benefits is available here and here.

ADHC providers may find opportunities to offer these types of services through contracts with both Medicare Advantage plans and Medicaid MLTC and mainstream plans.

The Department of Health (DOH) adopted regulations effective Oct. 9^th requiring nursing homes to provide information about home and community-based services (HCBS) and community transition programs to residents. The amendments to 10 NYCRR Sections 415.2 and 415.3 require that all nursing homes provide residents with information on services and programs that may be available to support the resident in returning to the community – including their right to live in the most integrated and least restrictive setting – upon admission.

DOH oversees and operates the federally funded Money Follows the Person program, which provides assistance and support to nursing home residents who wish to return to their community. Residents who express an interest are referred to the Local Contact Agency and connected with a transition specialist who can assist them with transitioning to community living. ADHC programs should be aware of this process and identify the transition specialist(s) in your community.

The adopted regulation is part of a series of actions aimed at promoting community living options for New Yorkers. It will require all nursing homes to adopt, and make public, a statement of the rights and responsibilities of residents and that residents are made aware of their rights prior to, or at, their admission to a nursing home.

The regulation requires nursing homes to:

advise all residents, upon admission, of their right to live in the most integrated and least restrictive setting, with consideration for the resident’s medical, physical, and psychosocial needs;
provide all residents, upon admission, with information on HCBS and community transition programs;
refer all residents to the Local Contact Agency, or a community-based provider of the resident or designated representative’s choosing, whenever the resident requests information about returning to the community, or whenever the resident requests to talk to someone about returning to the community during any State or federally mandated assessment;
post in a public area of the facility, at wheelchair height, contact information for the Local Contact Agency;
have staff available to discuss options for discharge planning, with consideration for the resident’s medical, physical, and psychosocial needs; and
ensure that all discharge activities align with resident transfer and discharge rights.

Advocates for fiscal intermediaries (FIs) and New York’s Consumer Directed Personal Assistance Program (CDPAP) obtained a favorable judgment late last week in an Article 78 proceeding challenging the Department of Health’s (DOH) reductions in administrative rates for FIs serving the CDPAP program. Judge Christina Ryba declared the Department's July 1^st Managed Care Policy containing the Per Member Per Month (PMPM) tiered reimbursement structure null and void. The court ruled that DOH must follow the State Administrative Procedure Act (SAPA) regulatory process before such an action may be taken.

Pursuant to the final 2019-20 State Budget, the State was seeking to implement a PMPM rate structure for CDPAP FI administrative services effective Sept. 1, 2019. DOH issued Managed Care Policy 19.01 providing guidance on the rate structure, along with requirements that plans must meet in assisting members who are transitioning from one FI to another (available here). Stakeholders voiced significant concerns regarding the timing and financial implications of the guidance. The Consumer Directed Personal Assistance Association of New York State (CDPAANYS), the New York State Association of Health Care Providers (HCP), and several organizations serving people with disabilities challenged the rate structure in an Article 78 proceeding.

The lawsuit’s main focus was CDPAP Fee-for-Service (FFS) rates (even though the policy referenced in the decision is entitled “Managed Care Policy”). To read the decision, click here.

Statewide median Adult Day Health Care (ADHC) occupancy was 72.5 percent in September 2019, up by nearly 5 percent since February, based on the most recently reported data analyzed by LeadingAge NY. The highest median occupancy was in the Rochester region (84.6 percent), which was the only region with an occupancy above 80 percent. In contrast, the lowest occupancy, 61.5 percent, was found in the New York City region. Since February, median reported occupancy has increased in four of seven New York State regions. The largest change in reported occupancy occurred in the Central New York region, where the rate increased by 12 percent.

Changes in occupancy have been influenced by more robust reporting, likely due to new regulatory requirements which no longer allow optional weekly bed census reporting.

To view reported capacity and availability data for each ADHC program statewide, click here.

Cost-of-Living Adjustment (COLA) Information for 2020- The Social Security Administration has announced that the Social Security and Supplemental Security Income (SSI) benefits will increase 1.6 percent in 2020. This cost-of-living adjustment (COLA) will begin with benefits payable to more than 63 million Social Security beneficiaries (nationwide) in January 2020. Increased payments to more than 8 million SSI beneficiaries (nationwide) will begin on December 31, 2019.

Thank you for your continued support and participation with ADHCC.