UAS-NY Implementation Tips

On Tuesday, June 18, LeadingAge NY conducted a one-and-a-half hour audio conference entitled, The UAS-NY: Abound in Questions, Challenges and Change. During this presentation, LeadingAge NY staff provided background information regarding the implementation of the UAS-NY, and a panel of seven providers shared their personal experiences and lessons learned from their organization's transition efforts thus far.

The following tips were gleaned from the conference and provided some valuable "takeaways" for the participants:

General Tips

Getting started

READ THE DOH TRANSITION GUIDE CAREFULLY (most recent version dated 5/14/2013).
Establish HCS accounts for all staff who will have access to UAS-NY as soon as possible - it takes DOH time to process applications (up to 3-4 weeks).
Trust Level 3 assurance needs to be established for all UAS-NY users - HCS coordinator must ensure that UAS-NY users have proper NYS identification (driver's license or other NYS-issued ID). Make sure the staff name on the NYS-issued ID corresponds exactly with the HCS account name.
Educate your HCS coordinator on the UAS-NY process.
Identify a UAS coordinator as soon as possible to manage the new process; have the coordinator go through the training first.
Assigning UAS roles to your staff is a critical activity; roles must be assigned before staff can begin training.
Training is time intensive - plan accordingly.
As staff begins to go through training, the UAS Coordinator should be available to answer questions.
Recommended training modules (in addition to the mandatory modules) have been found to be very helpful.
Engage your IT department early in the process; assess your computer capabilities, make sure they meet minimum requirements to support the UAS-NY process (for both the online and offline application).
Make sure emails coming from DOH about UAS-NY are not going to your SPAM folder - talk to your IT staff if you are unsure.

Conducting Assessments

Verify case list - these are pre-populated by DOH but some clients may have missing data, contain inaccurate information, or are missing altogether.
Enlist an administrative assistant to assist with populating medication and diagnoses fields, if possible, since this can be done prior to completing first assessment.
Be aware that UAS-NY assessments require the client's physician's name and license number.
Completing the first few assessments may be very time intensive (3-4 hours) but after that, on average, the assessments have been taking about 1-2 hours to complete.
Since the assessment is very long, interruptions are common (e.g. client gets fatigued and asks to complete later) - plan accordingly if possible.
Non-Medicaid clients that require a UAS-NY assessment must sign a consent form (DOH 5032) which needs to be kept in the client's chart.
DOH has confirmed that there is no mandated timeframe established for completion of the UAS-NY, however they do encourage assessors to complete an assessment in a single visit or if that is not possible, within a few days.

General Challenges

Offline application glitches - some have experienced issues with uploading the offline application assessments from laptop to UAS-NY system. If this happens, call the DOH help line.

Program-specific challenges

ADHC:

Assigning HCS accounts have been difficult because HCS accounts are program-specific; many ADHC programs share the same PFI number as the nursing home. Therefore, the HCS recognizes the ADHC program as a nursing home which is not required to conduct a UAS-NY. Advice to members is to work with the nursing home AND with DOH (via the helpline) to resolve. DO THIS EARLY!!
There is confusion around who is responsible for conducting the UAS-NY and how this will change with mandatory enrollment into managed care. DOH stated on 6/20/13 that they are working with the program offices to clarify this.

LTHHCP:

Only one nurse can complete and sign off on the UAS-NY; however, there are times when a CASA RN and LTHHCP RN are involved in the process. Agreement needs to be reached over who will complete and sign the assessment and how conflicts will be resolved should disagreements arise as to how to complete certain UAS-NY questions.

ALP:

On the call, one of the panelists mentioned a possible delay in implementation of the UAS-NY for the ALP. LeadingAge NY has clarified with DOH that this delay applies only to private-pay individuals in the pilot counties. This delay does NOT apply to most ALPs, nor does it apply to most of the residents being assessed in those counties. ALPs should ensure that the individuals who conduct assessments (PRIs) in the CHHAs and LTHHCPs that ALPs contract with have HCS accounts so they can then be set up in the UAS-NY system. The UAS-NY staff can help ALPs and other providers determine how to set up contractors in the HCS's UAS-NY system.
If ALPs have the ability to conduct assessments in-house, they may want to consider which cases should be assessed by their own staff versus through the contracted CHHA or LTHHCP. For example, assessments that are likely to take longer might be better done in-house.
While the implementation of the UAS-NY does not change how the ALP Medicaid reimbursement is calculated, DOH has determined a mechanism to have UAS-NY RUG scores translate to PRI scores, which correlate with current reimbursement categories. It is possible that this will result in some outcomes that may be different than expected. For example, someone may score slightly higher or slightly lower than anticipated. It will be important for providers to keep us informed of their experience, to determine if advocacy for further adjustments to the RUGS crosswalk are necessary.

A recording of this audio conference is available and free to LeadingAge NY members. If you did not register for the audio conference, please register to obtain the recording. If you were registered for the live session, please contact Kristen Phillips to receive a link to the recording.

Contact: Kathy Pellatt, kpellatt@leadingageny.org, 518-867-8848