The Awareness of Immigration Law

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1 Networking Collaboration Community Empowerment News from Council March 2013 Important Announcement: Please renew your annual member with us for Year 2013 if you have not done so. Our biannual Executive Board Election is coming up in April. Only current members may vote or be nominated, Your vote and Your voice are important to us! Organization Member: $100 Associate Member: $30 Please for further information The Awareness of Immigration Law Current Landscape of Managed Long Term Care (MLTC) and Adult Day Care: A Workshop for Providers On March 13, 2013, Asian Health and Social Service Council (AHSSC) co-organized its monthly meeting with the Chinese American Alzheimer s Coalition and Beth Israel Medical Center at the Philips Ambulatory Care Center in Union Square in Manhattan. The title of the presentation was Current Landscape of Managed Long Term Care and Adult Day Care: A Workshop for Providers. Selina Chan, Executive Director, Asian Services Center, Beth Israel Medical Center, provided an introduction followed by Dr. David Bernard, Chief Medical Officer, Beth Israel Medical Center, with a welcoming remarks. Pauline Yeung Ha, Esq, Grimaldi & Yeung LLP provided the conference outline. Valerie Bogart, Director, Evelyn Frank Legal Resources Program, Selfhelp Community presented the topic on Medicaid Redesign and MLTC updates. Valerie first gave an overview on the types of Medicaid plans, provided the definition of Medicaid managed long-term care and the services authorized by MLTC. Valerie then discussed how the mandatory MLTC enrollment has affected the clients. Valerie stated that current home care recipients who are dual eligibles, age 21 or older and receiving more than 120 days of community-based long term care services in NYC have already received notices giving them 60 days to select an MLTC, MAP or PACE plan before auto-assignment. In the next few months, these NYC duals receiving more than 120 days of CHHA services, private duty nursing will also receive notices and Lombardi recipients will receive notices upon CMS approval. Clients may enroll through the plan or through NY Medicaid Choice ( ). Valerie stated that there is no lock-in so members can switch to a different plan at anytime but cannot go back to fee-for-service Medicaid for long term care services. In general, if a member switches plans by the 20 th of the

2 month, the enrollment in the new plan will take effect the first of the next month. There are a few populations exempted from mandatory MLTC. Another important message was that the CMS Waiver approval requires plans to continue previous level of services for 60 days or until the plan s new assessment, whichever is later. By Day 30 of the 60-day period, Plan is supposed to assess client s needs and propose a new care plan, which could involve a reduction in hours or services. Valerie also stressed that MLTC plans are required to contract with all home attendant vendors which would ensure continuity of the client-aide relationship. The next speaker, Erin Purcell, Aging Services Representative, Bureau of Long Term Care Services and Caregiver Support, NYS Office for the Aging presented the topic on Social Adult Day Services and MLTCs. Eric discussed some NYSOFA Social Adult Day Care Regulations, participant eligibility, admission and discharge process and service plan. Erin stated that the core services should include socialization, supervision and monitoring, personal care services and nutrition along with other optional services. Erin stressed the importance of having policies and procedures in place which should include 1) participant eligibility, 2) admissions and discharge, 3) service plan, 4) staffing plan, 5) participant s rights, 6) services delivery, 7) annual program self-evaluation, 8) records, and 9) emergency preparedness. Erin also discussed in details about staffing and training. The third speaker, Sara E. Meyers Esq, Enea, Scanlan & Sirignano, LLP, presented the topic on Medicaid and the Appeal and Grievances Process. Sara explained that Grievances refer to complain to plan about quality of care or treatment but not about amount or type of service that was approved versus appeals refer to object to amount or type of service approved. Sara stated during the appeal process, that at least 10 days before the intended change in services, the plan must send a written notice to the member, containing: the action the plan intends to take, the reasons for the action, including clinical rationale, description of appeal rights, including how to request appeal and how to seek an expedited appeal, and if a reduction/ discontinuation, the right to aid continuing. Aid continuing means that plan must continue benefits unchanged if the appeal is timely requested, the appeal involves the termination, suspension, or reduction of a previously authorized course of treatment, the services were ordered by an authorized providers, the original period covered by the original authorization has not expired and the enrollee requests extension of benefits. The symposium was generously sponsored and support by Alzheimer s Association, NYC Chapter, Centerlight Healthcare, Grimaldi & Yeung LLP, Healthfirst, MJHS Hospice and Palliative Care, New York City Department for the Aging, and the Visiting Nurse Service of New York.

3 Executive Members Senior Advisors: Selina Chan, Chris Cho, Kenneth Lam, Edward Ma, Susan Wong President: John Tsoi Vice President: Maggie Wong Treasurer: An Hoang Secretaries: Teresa Lin Eva Wong Committee Chairs: Event Frank Liang James Leung Housing Rosie Wong Media Dan Liu Membership Fandi Moy David Chau North Star May Lai Research Kieu Loan Mia Social Service Jane Wong Serene Nie Website Hadrian Chan Trajan Chan Legal Consultant: Pauline Yeung Accountant: Michael Chan Understanding Your Survey Result of the Symposium: Current Landscape of MLTC and Adult Day Care & The Election of Council Board Members Date: Place: Next Monthly Meeting Agenda 4/19/13 (Friday) VNSNY Chinatown Community Center 7 Mott Street, New York, NY :00 Coffee/Networking 9:30 Welcome Remarks John Tsoi, President of Council Teresa M. Lin, Dir., Asian program, CHOICE Health Plans and Home Care, VNSNY Moderator: Maggie Wong 9:35 Presentation: Kieu-Loan Mai, Ph.D., Research Consultant and Psychologist 10:00 Proposal to revise the Bylaws & Election of Council Board Member 11:00 Closing Agenda Monthly Meeting Agenda Address: 39 Bowery, PMB 135 New York NY Tel: info@ahssc.org

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