All program transmittals: October 7 October 12, 2013

Transcription

1 All program transmittals: October 7 October 12, 2013 To go directly to the transmittal, mouse over the transmittal number (left column), hold down Ctrl, and click on the transmittal number. Transmittal # APD-AR APD-AR APD-AR Issue Subject/Topic date 10/14/13 Submit FY Are Plan Budget - Using the template provided in the link below, complete and submit the following fiscal pages for Year 2 (FY ) of your Area Agency on Aging Area Plan. See transmittal. 10/14/13 Request to Transfer OAA Funds and/or Expand Title IIIB Funds on Program Coordination and Development - Effective October 1, 2013, but not later than June 30, 2014, using the form linked in the transmittal, AAAs may request to perform the following transfer of funds: No more than 30% of the fiscal year appropriation from Title IIIB into Title IIIC1 and/or Title IIIC2 and no more than 30% of Title IIIC1 or Title IIIC2 into Title IIIB. No more than 40% of the fiscal year appropriation from Title IIIC1 into Title IIIC2 or no more than 40% from Title IIIC2 into Title IIIC1. Effective anytime during the fiscal year, AAAs may submit a request to use OAA Title IIIB funds for Program Coordination and Development. 10/14/13 Independent Choices Benefit Calculation form updated due to wage increase - Effective October 1, 2013 the ADL and IADL s increased to $13.00 and 24-hour availability increased to $6.50. A new 546IC form must be completed for every Independent Choices Program (ICP) case. A copy needs to be sent to the participant and the ICP Coordinator. Enter the new ICP grant amount from the 546IC into Oregon ACCESS by October 28 th to issue the accurate ICP grant. Complete a supple (SUPL) action back to October 1 st with the new benefit amount to send the difference.

2 APD-IM APD-IM The form has been updated with a wage increase for the ADL, IADL and 24-hour availability hours due to the HCW/PSW bargaining contract settlement. 10/14/13 Medicaid LTC Services Power Hour - Monday, October 21, 2013, APD Medicaid LTC Policy Unit is hosting a Power Hour to provide updates and check-in with local office staff. All managers and staff are welcome to join. Topics will include recent changes in the Collective Bargaining Agreements for Home Care Workers and Adult Foster Homes along with a check-in on Case Management Services. If you have a large number of staff interested in attending, please call in as a group and assign one staff person to be the representative for comments and questions from the group. See transmittal for details. 10/14/13 Request for Proposal(s) procurement beginning in Eastern Oregon and the Willamette Valley for Oregon Home & Community Based Care bed capacity expansion - Request for Proposals #3675 for Home and Community Based Care Capacity Expansion Regions 2 and 5 opened on the Oregon Procurement Information Network (ORPIN). This Request for Proposal (RFP) process is to expand placement options for persons transitioning out of nursing facilities in the following counties: Malheur, Harney, Grant, Baker, Wallowa, Union, Umatilla, Morrow, Douglas, Lane, Linn, Benton, Lincoln, Marion, Polk, Yamhill, Tillamook, and Clatsop. The proposal requests 30 slots or beds. The RFP will result in new Specific Needs contractors who will provide communitybased supports for person with complex behavioral or complex ADL needs. Final locations will be based on awarded proposals. The RFP is located in the file entitled Attachments Exist and is provided in a Word document format. The following is the link to the ORPIN website: All communications concerning this RFP must be directed to Sharon Landis. Unauthorized contact with other State employees or officials regarding this RFP may result in application rejection.

3 DMAP-IM SS-AR SS-AR SS-IM Questions regarding the roles of the local office staff or impact on services in your region or county can be directed to Roberta Lilly. 10/14/13 Non-emergent medical transportation FAQ updates - DMAP updated the non-emergent medical transportation (NEMT) frequently asked questions (FAQ), now posted at The FAQ now reflects recent changes in the NEMT program concerning the transfer of responsibility for non-emergent medical transportation and non-emergent ambulance authorizations from branch offices to brokerages. 10/15/13 OFSET Program Suspended - OFSET (Oregon Food Stamp Employment & Transition program) funding was suspended due to the federal government shutdown; OFSET services are suspended as of October 1, See transmittal for details. 10/15/13 Priority Splitting of TANF and Medical Cases - To support ACA implementation, some Office of Client and Community Service medical renewals have been deferred until In order to prevent redetermination paperwork from being mailed to clients, medical cases have been coded with a BED N/R that will prevent the case from closing. Cases are BED-coded the month prior to closure. The BED N/R will also prevent Temporary Assistance for Needy Family (TANF) cases from closing when a redetermination packet is due. See transmittal for details. 10/15/13 Decision Notices for Medical Programs - On September 24, the Application Processing Changes to Support ACA Implementation SS-IM transmittal was distributed. DHS/AAA eligibility workers have requested access to decision notices citing the 461 chapter rules for OCCS medical program (BCCTP, CEC, CEM, CHIP, EXT, MAA, MAF, OPC, OP6, OPP OPU and SAC) applications. For OCCS medical program decisions based on a date of request (DOR) prior to October 1, 2013: OCCS Medical Program Closure and Denial Notices See transmittal for the DHS 462A, 462R and 462C closure and denial notices with 461 Oregon Administrative Rules. OCCS Medical Program Approval Notices: OCCS medical

4 SS-IM SS-IM program approval notices will not be automatically generated by the CM system. The approval notices are tied to reporting requirements and benefit level; see transmittal for details. Reminder: For DORs established prior to October 1, 2013, the DHS/AAA eligibility worker will: Determine medical program eligibility using the eligibility methodologies and rules in place prior to October 1, 2013, including all applications the branch has in backlog and requests for retroactive medical; If OCCS medical benefits are approved by DHS/AAA the eligibility worker will open OCCS medical on a separate CM case. transfer to Branch 5503 and send an OCCS medical program approval notice from Notice Writer (FYI APD and AAA cannot send a notice via Notice Writer because the text is too small to meet our requirements - kg); OCCS medical program eligibility determinations completed after October 1, 2013, including those cases pended for the floating budget month information should be completed as soon as possible and transferred to Branch Note: When transferring a case to Branch 5503, do not send the client a transfer notice. 10/15/13 American Recovery and Reinvestment Act (ARRA) Sunset and Maximum and Minimum Allotment Changes - Sunset of the American Recovery and Reinvestment Act of 2009 (ARRA) Maximum Allotments: On November 1, 2013, maximum allotments will decrease. For example, a family of four receiving a maximum benefit amount of $668 will decrease to $632, a 5.4 percent reduction. Please see the tables in the transmittal for the new amounts. The changes will be reflected in FSUP, Family Services Manual, and APD Staff Tools effective November 1, The MSC 5530, DHS 221, DHS 853, DHS 854, FS Calculator, FS Benefits Estimator and Non-Citizen (NC1/NC2) Calculator will be updated. 10/15/13 SNAP Recert Mail out project is ending - In March of 2009 the SNAP Program launched a project to mail out recertification packets centrally to SS households. See transmittal for details.

5 SS-IM OPAR-IM OPAR-IM APD-AR /15/13 Shredding of Protected Health Information - Specific to Self- Sufficiency. See transmittal for details. 10/15/13 APD, SS and CW Regional Meeting Agenda: Curry County - Attached to this transmittal is the agenda for the APD/SSP/CW Regional Meeting in Columbia County held on Tuesday, October 22, These meetings are training and informational focused and are for field staff from SSP, APD/AAA and CW. They will be held at locations throughout the state between July and October (view schedule). Branch offices are encouraged to send front line staff and/or lead workers. Please note they are not intended for providers or external partners. Staff attending this meeting will receive important program updates and training on a variety of topics, receive useful tools, updates, resources and contact information. Handouts will be available at the meeting but are also be available on the Regional Meetings website. Pre-registration is not required. Please contact Carolyn at least 1 week prior to the meeting if V- con is needed to see if it s available in your area. 10/15/13 APD, SS and CW Regional Meeting Agenda: Coos County - Attached to this transmittal is the agenda for the APD/SS/CW Regional Meeting for Coos County held on Wednesday, October 23, See above. 10/17/13 Pay-ins Related to the Homecare Worker Rate Increase & In-Home Agency Rate Increase - The Collective Bargaining Agreement between the Oregon Home Care Commission and SEIU was ratified on October 3, Homecare worker service payment rates were increased retroactive to 10/1/13. APD-IM details the rate increase. In-Home agencies received a 3.5% rate increase effective 10/1/13. Pay-in changes based on the rate increase will be combined with other required end of year processes resulting in changes to pay-in amounts. Pay-in calculations will be based on the previous homecare worker and in-home agency rates until A modified pay-in worksheet has been created to assist in determining pay-ins; see transmittal. The Modified Pay-in Worksheet was created to calculate the

6 APD-AR consumer s pay in based on provider rates in effect prior to 10/1/13. The worksheet will calculate the temporary reduction based on the rate, FICA, and Workers Benefit Fund Assessment (WBFA) resulting in a modified pay-in. For current consumers who receive services from a homecare worker, In-home agency or through the Independent Choices Program and who have a pay-in: 1. Do not recalculate pay-in amounts nor update pay-in liability screens based solely on the rate increase. It is not necessary to issue a Notice of Increase in Service Payment (SDS 540P). 2. If a consumer s service hours change prior to 1/31/14, recalculate the pay-in using the rates in effect prior to the 10/1/13 increase (not the new rates), update the pay-in liability screens and issue proper notice. Use the Modified Pay-In Worksheet to determine the pay-in amount. For new in-home service cases between 10/1/13-1/31/14: For individuals who receive services from a homecare worker, Inhome agency, or through the Independent Choices Program and who will have a pay-in as determined on the CAPS 2 Pay-In Worksheet, you will need to calculate a modified pay-in amount using the rates in effect prior to the 10/1/13 increase and not the new rates. Use the Modified Pay-in Worksheet for pay-ins effective 10/1/13-1/31/14, update the pay-in liability screens and issue proper notice. For new in-home cases with a pay-in amount effective 2/1/14 (e.g. services began in January, but the pay-in won t begin until 2/1/14), use the CAPS 2 Pay-In Worksheet. Note: The homecare worker and In-Home agency providers will be paid at the higher rate and the increased rates will appear on the service plan, task list, and vouchers as they should. 10/17/13 Quality Control Case Request Procedure Changes - Effective immediately, there is a change to the way field offices should respond to a request for information from the Office of Program Integrity s Quality Control Unit. DHS/AAA procedure change: Please scan all materials related to the request and the file to the Office of Program Integrity: Quality-Control Unit in

7 APD-IM Outlook or must be sent securely with #secure# as the first text in the subject line; When material is scanned and ed the Office of Program Integrity will request a hard file be mailed only when the electronic version is insufficient to make an accuracy determination. Documents to scan. In response to an Office of Program Integrity request for information, staff must provide exactly what is listed in the request. Please do not provide more or less than requested; se transmittal for examples. Offices can choose to send hard files to the Office of Program Integrity via UPS or tracked USPS when needed. Please follow the procedures in the Support staff Assistance Manual, IV Case Records/Files. Medical reviews (MEQC): QC is waiting for more information from the Centers for Medicare and Medicaid Services (CMS) to determine what will be needed for future MEQC review pilots. SNAP reviews change: QC will request one year of documentation instead of the previous two year standard. Reason for Action: The increased availability of electronic documentation means fewer paper documents are needed, allowing for more an efficient review process. The cost of mailing hard files has increased and become prohibitive. Additionally, by scanning case file instead of mailing them, branch staff retains the hard file for better customer service. 10/17/ Updated Billing Codes for Gloves and Masks for Homecare Workers - The billing codes used to process invoices for gloves and masks for homecare workers have been updated: PCA code: Index code: AOBJ code: 4706 Additional information about gloves and masks for homecare

8 SS-IM workers can be found in the Homecare Worker Procedures Guide on the SPD Case Management Tools website. Please begin using the updated codes immediately. 10/18/13 ARRA Benefit Reductions - The American Recovery and Reinvestment Act (ARRA) funding will sunset on November 1, 2013; this is unrelated to the prior government. Please see SS-IM for more information about the reduction. All recipients were sent notices on October 15th. Staff does not need to send notices for the ARRA reductions November 1, See transmittal for the reference guide chart on how benefits will change for ongoing cases. For households currently receiving the minimum benefit amount ($16), their benefits will be reduced by $1 to $15. Staff completing certification or recertification actions on or after updates to the FSMIS system, noted below, will be able to let recipients know the amount they will receive. Staff will not be able to provide ongoing recipients the exact amount of the reduction until the system updates those cases at the end of the month. Please use the chart in the transmittal to estimate the potential maximum loss, but let recipients know they can access more information at This site contains a recipient focused FAQ about the ARRA reductions and resources. Due to the systems issues with implementation, no punitive action will be taken against recipients. Workers will not be required to take any additional actions. Please note: For recerts, or Interim Change Reports processed for November, the benefits recipients receive may be different based on their new eligibility and the ARRA changes. The chart is only for the ARRA reductions, not normal eligibility changes. Systems Information: The ARRA reductions will require FSMIS system changes. Currently the FSMIS system is not updated with the November 1, 2013 Thrifty Food Plan (TFP), also known as the maximum allotment, amounts. These changes are being put into place but

9 will take place over the weekend and be ready for Monday. Important things to remember: Updates will change TFP amounts for all households and the minimum benefit amounts for one and two person households. This change will affect most cases. In some cases, the benefit amount may not change. Reduction in benefits is based on specific household circumstances, such as income and deductions. The reduction will not be a standard amount. Please do not use any homegrown calculation sheets or forms. Until the FSMIS AUTORUN happens at the end of the month, the benefit amounts for ongoing recipients show. The exceptions will be cases certified for November on or after the date FSMIS system changes take place; these will show projected November benefits. The FS Calculator will be correct and ready to use once the FSMIS changes have been made.