the transmittal number. In-Home Support Adult In-Home Transmittal 22 not purchase or for details. See transmittal

Transcription

1 All program transmittals: June 27 July 03, 2014 To go directly to the transmittal, mouse over the transmittal number (left column), hold down Ctrl, and click on the transmittal number. Transmittal Issue Subject/Topicc # date APD-PT-14-6/27/ /14 Requirements for Signatures on In-Home Comprehensive 021 Individual Support Plan Budget Summary Pages - This policy outlines when and whosee signaturess are required for all DD 49 Adult In-Home Support and DD 151 Children In-Home Support Individual Support Plan (ISP) budget summary funding pages for contracting to the Office of Developmental Disability Services (ODDS). See transmittal for details. APD-PT-14-6/27/ /14 No Vocational Assessments in Sheltered Workshop Settings The Office of Developme ental Disability Services (ODDS) does not purchase or fund vocational assessments for individuals experiencing intellectual and developmental disabilities (I/DD) in sheltered workshop settings. See transmittal for details. APD-AR-14-6/27/ /14 Nominating HCR Trainers - Theree is limited availability of 035 trainers for Health Care Representative (HCR) Rule Training. To make this training more available, trainers willl be authorized to present this training. See transmittall for details. APD-AR-14-6/27/ /14 Request for ReBAR assessments - Reassessment requests may 036 be made directly to ReBAR by the CDDP or Brokerage. See transmittal for details. APD-AR-14-6/27/ /14 ANAA and CNA Version B - The Adult In Home Needs 037 Assessment (ANA) and Children s In Home Needs Assessment (CNA) are revised. The revised version of each assessment is identified as version B.. Everyonee must begin using version B, effective July 1, See transmittal for details. APD-IM-14-6/27/ /14 Attendant or Relief Care in a Camp Setting - To facilitate 030 access to provider organizations which provide attendant or relief care service in a camp setting for children and adults, ODDS is outlining how the servicee may be accessed for summer of See transmittal for details.

2 DMAP-IM APD-PT APD-AR /27/14 July 1 NEMT Changes: Talking points, letter, resources - Several changes are in store for the DMAP Medical Transportation Program, effective July 1, Last month DMAP notified 22,000 OHP members about Transportation Network assuming brokerage responsibilities for most of eastern Oregon; see DMAP IM This month, DMAP will notify 81,000 OHP members enrolled in Willamette Valley Community Health (WVCH) about a change in Marion and Polk counties. See page 6 for a copy of this letter. Note: DMAP has also extended the period beyond July 1, 2014, by which CCOs must integrate non-emergent medical transportation (NEMT). To help prepare for these changes, please review the July 1 talking points on page 3 and the updated protocol for handling NEMT requests on page 5. As CCOs assume responsibility for NEMT, DMAP will send notices to inform clients about changes impactiung how they receive NEMT services. OHA and DHS staff will also be notified on a similar time frame. 6/30/14 ReBAR Employment Rate Model, Day Support Activities Agency Rate Matrix, Interim Tier Assignments and Reviews - This transmittal is to communicate that effective September 1, 2014, the department will implement a new employment rate model. The ReBAR Employment Rate Model applies to all agency providers who provide employment services under the ODDS Comprehensive Waiver, Support Services Waiver and Day Support Activities (Formerly Day Habilitation, ATE, and Community Inclusion) under the Community First Choice State Plan Option (K-Plan). See transmittal for details. 6/30/14 Employment Service Utilization Survey - ODDS is publishing an Employment Service Utilization Survey along with a ReBAR payments calculator to employment and Day Support Activities providers. This Survey is to be completed with Employment Service utilization data from July 1, 2014 through August 31, 2014 and returned to ODDS. See transmittal for details.

3 DMAP-IM APD-AR /30/14 OHP Plan Service Area Changes - Effective 7/01/2014, Cascade Health Alliance CCOA (CCOA is mental, physical and dental) will close to new enrollment in Klamath (A435) County with a 30 day re-enrollment period. 7/2/14 Registry and Referral System Changes and Data Entry Requirements - The Oregon Home Care Commission (OHCC) has implemented a new Registry and Referral System (RRS) and homecare workers (HCWs) are now responsible to enter their own profile information. This was previously completed by the local office based on information gathered from the Homecare Worker Application (SDS 0355). HCWs are now responsible to complete the following tabs: Personal information; Preferences; Referral conditions; Services; Schedule; Phone number and address. In order for HCWs to be available for referral, they must update their availability in the RRS every thirty (30) days. There are tabs HCWs cannot edit and the local office will update this information in the RRS or Oregon ACCESS. This includes: Demographic information OHCC will continue to automatically transfer individual HCW demographic information from Oregon ACCESS to the RRS. HCWs will be able to update their address and phone number in the RRS, but not change their address; Training information CPR and First Aid expiration dates. Specific training courses will be entered by OHCC staff; Orientation dates Information under the Office Use tab assists local office staff in tracking HCW enrollment tasks; In addition, the local office must continue to do the following: Enter information into the RRS for applications received and not processed; Direct HCWs to complete the entire application;

4 APD-IM Document information under the Office Use section; Retain applications in HCWs provider files; Provide assistance, as needed, to providers who do not have access to a computer; During orientation, remind HCWs they must enter the information detailed above to be available for referrals. The RRS Staff User Manual is on the APD Case Management Tools webpage under the Homecare Worker program. 7/2/14 Specific Need Contract Facilities & ECOS COLA Increase - Effective 7/1/14, Specific Need contract facilities and Enhanced Care Outreach Services (ECOS) contracts will receive a 3.5% COLA rate increase. A new Specialized Services report will be posted under Case Management tools: scroll to Programs & Services and open Transition/Diversion. The purpose of the Specialized Services report is to provide the field with a list of specialized community based facilities and service options available to help support nursing home diversion and transition efforts. The report will include directions on preapproval from Central Office as required for admissions, the type of specialty, and the new reimbursement rate. For current 512s: For both facilities and ECOS payments, the new 7/1/14 rate has been added to the current 512, through the end of the current CAPS. For new and renewal 512s: Central Office will need to add the additional reimbursement on to the individual 512 each time a new CAPS is completed at review. For 512 renewal of payments, staff will need to complete the following steps: 1. Open the 512; 2. Contact Central Office via Specific Need Facilities: APD.Admissions@state.or.us. Include the name, prime #, effective date and provider #. ECOS: Send to Betew Hagos, betew.hagos@state.or.us. Include name, prime #, effective date and provider #.

5 APD-IM OPAR-IM Once the rate has been added by Central Office, an will be sent to you requesting you touch the 512 to pick up the added special need rate. Always compare the service payment printed on the 512 to the provider s service payment listed on the Specialized Service Report. A payment could be incorrect if an add-on is added or subtracted and Central Office was not notified to adjust the rate. 7/2/14 Mandatory Netlink Training: CAPS Assessment Versioning - Beginning August 4,2014, a new version of the assessment portion of the Client Assessment/Planning System (CAPS) will be implemented into the OACCESS system. The new version changes the question format to a statement format, includes some wording changes, and provides quick help tips for assessing various ADL and IADL needs in CAPS. Netlink training is being offered to: Demonstrate CAPS assessment changes; Demonstrate CAPS Quick Help header with tips; and Provide rule clarification on some of the SPL rules. Please register through the DHS/OHA Learning Center web site course # C This training is mandatory for all APD/AAA case managers. With supervisor approval, other local office staff is encouraged to attend. Due to limited registration slots and Netlink session availability, this training is restricted to APD/AAA staff. 7/2/14 Medicare Billings Sent Out in Error - During the week of June 14, 2014 and June 16, 2014, a system issue caused some Medicare A and B related claims to go out in error; it is being corrected. If you received billing(s) from OPAR s Medical Payment Recovery Unit, during those dates that are related to Medicare A and/or B claims, please disregard them. TPL (Third Party Insurance) ARs are not like Financial ARs in that they are not automatically recouped from the Provider s next payment so there should be no financial impact related to the system issue. After the system issue is corrected, we will rebill appropriate claims only.

6 SS-PT /2/14 JPI expanded to families in Change Reporting System (CRS) - Effective June 26, 2014, the JOBS Participation Program (JPI) has been expanded to include SNAP recipients in the Change Reporting System (CRS). Families in CRS must meet all JPI eligibility requirements to be eligible for the program. See transmittal for details. SS-AR APD-AR /2/14 Two parent JPI coding available - All coding for two parent JOBS Participation Incentive (JPI) families (J82) is available for field staff. The completed coding includes all UCMS, FSMIS and FSMIS JPI generated notices. See transmittal for details. 7/3/14 Nursing Facility Change of Ownership Avamere Transitional Care at Sunnyside Previous name: Kindred Nursing & Rehabilitation Sunnyside Previous provider Number ended 05/31/14: New provider number beginning 06/01/14: The current MMIS Plan of Care (POC) needs to close as of May 31, 2014 and a new POC opened June 1, 2014 with the new provider number.

7 APD-IM /3/14 In-Home-Care Agency (IHCA) Contracted Rate Structure - Beginning July 1, 2014, IHCA will be able to receive community transportation. Community transportation (non-medical) mileage is priorauthorized by the case manager (CM) for reasons related to an individual's service plan (OAR ). The CM, through service planning, will determine the number of miles to be authorized. This authorization follows the same process as determining HCW transportation needs and miles. IHCA do not drive the request of this service; Community transportation mileage will not be used to reimburse IHCA for employee mileage to and from the consumer s home; The IHCA will be reimbursed at $.48/mile; The 546n form can be used to communicate authorized miles as well as authorization for the plan of care in MMIS; Procedure code A0090 will be used to authorize the determined number of miles through MMIS. MMIS plan of care defines A0090 as non-emergency transportation, per mile-vehicle provided by individual with vested interest ; CM does not need to adjust the service plan immediately. The CM will discuss with the consumer the need for transportation service. If there is a transportation need through the IHCA, the CM will define the purpose of the transportation and prior authorize the mileage. IHCA providers do not provide this service without the CM prior authorization. Beginning July 1, 2014, IHCA will be reimbursed for completion of initial assessment. Licensing rules and Medicaid contract requires completion of an initial screening/assessment to evaluate a prospective consumer s needs prior to accepting them for services. The IHCA Medicaid contract requires the agency to be reimbursed up to three (3) hrs at the personal care hourly wage. Service assessment code T2024 will be used by the IHCA to bill through MMIS separately for the consumer s service plan. This assessment code will not be visible on MMIS to the CM. The CM will no longer add or subtract hours from the service

8 plan to cover the cost of the assessment. The IHCA will use assessment code T2024 defined as service assessment/plan of care development. Beginning October 1, 2014, IHCA will receive an increase in hourly rates. An IHCA single statewide reimbursement rate of $21.24 will be implemented for both personal care (ADLS) and in home care (IADLS). Through service planning, CMs will continue to authorize hours for both personal care (ADLS) and in home care (IADLS) In MMIS using units of 15 minute. This information will be added to the APD Case Manager Tools website.