H Procedure June 16, 2017

Transcription

1 STATE OF WASHINGTON DEPARTMENT OF SOCIAL AND HEALTH SERVICES Aging and Long-Term Support Administration Developmental Disabilities Administration PO Box 45600, Olympia, WA H Procedure June 16, 2017 TO: Area Agency on Aging (AAA) Directors Home and Community Services (HCS) Division Regional Administrators Developmental Disabilities Administration (DDA) Regional Administrators Residential Care Services (RCS) Division Regional Administrators Management Services Division (MSD) Staff FROM: Kathy Morgan, Acting Director, Home and Community Services Division Don Clintsman, Deputy Assistant Secretary, Developmental Disabilities Administration Candace Goehring, Director, Residential Care Services Division Chanh Ly, Director, Management Services Division SUBJECT: Contingency Planning for Possible Government Shutdown PURPOSE: To provide information and guidance to staff in the unlikely event of a temporary government shutdown effective July 1, BACKGROUND: On May 23, 2017, the Washington State Legislature adjourned their 30-day special session and entered a second special session on May 24, in an attempt to pass a final operating biennial budget. Our state s Constitution expressly prohibits the payment of treasury funds without an appropriation. This means that, without an approved budget, state government operations will partially shut down. There are limited exceptions in operations which include constitutional mandates and certain federal laws where continued service is required while the state takes measures to work with the federal government to withdraw from Medicaid. 1

2 A state budget must be enacted no later than 12:00 midnight on June 30, 2017 in order for the state to continue providing most services. WHAT S NEW, CHANGED, OR CLARIFIED: Impact on services: In the unlikely event that a state budget is not enacted by June 30, 2017, only the following ALTSA/DDA-funded services will be continued: Partial Adult Protective Services (abuse and neglect investigations that are federally required) Intake lines for APS/CRU and social services will continue to receive referrals and will triage to respond to the most urgent issues. RCS complaint investigations in community residential settings Federally-required nursing home and ICF/IID surveys and investigations Residential Habilitation Center (RHC) operations Consolidated Services (partial maintenance support to Lakeland Village) 1915(c) Medicaid waivers (COPES, New Freedom, Residential Support, CORE, Basic Plus, CIIBS, IFS, Community Protection) Medicaid State Plan (Nursing Facility, Community First Choice, Medicaid Personal Care, Private Duty Nursing, Program of All- Inclusive Care for the Elderly (PACE), Pre-Admission Screening and Resident Review (PASRR)) Roads to Community Living (RCL) Child Development Services DDA State Supplementary Payments (SSP) (payment may be delayed) Field and Headquarters staff (skeletal to support above activities) Maintaining these services is required by a state constitutional mandate or federal law. In the event the state goes without an enacted budget after July 1 st, continuation of Medicaid services may be impacted. The state will work with the Centers for Medicare and Medicaid Services to stop the Medicaid program and will provide adequate notice to Medicaid clients and providers. Client Assessments: Some clients will be scheduled for routine annual assessments during July In the absence of a budget, staff must contact those clients and reschedule those assessments, preferably at least one day in advance. Only Initial assessments and Significant Change assessments related to critical health and safety will be completed by the skeleton regional staff. See action section, below, for additional instructions. 2

3 Financial Eligibility: Financial staff should continue to process new applications and may continue to reinstate Medicaid cases. Staff will be able to process existing batch and late June reviews; however, the Document Management Services (DMS) and Hub Imaging Unit (HIU) will not have enough staff to keep up with scanning and indexing any new mail received after July 1, The following financial programs authorized by Economic Services Administration (ESA) will be suspended effective July 1, 2017: ABD cash payments (A01/A05 medical will remain open) Pregnant women s program FAP (state-funded food assistance) SFA (state-funded cash assistance) SSP payments (including issuance of the institutional CPI payment of $27.58) Ongoing Additional Requirements (AREQ) Cash AUs will remain active, but the grant amount will be set to zero. Clients on other programs that will be closing in the Automated Client Eligibility System (ACES) will receive a closure notice with the following text: This program ended 6/30/2017 because an operating budget for was not enacted prior to 7/01/2017. Clients do not have administrative hearing rights on these notices. The Health Care Authority (HCA) is notifying all providers to continue to provide services based on eligibility displayed in ProviderOne, including pharmacy point-of-sale transactions. Pharmacies have been notified on how to ensure needed medications can be provided in all cases, even where prior authorization is required. If financial staff are contacted by clients who cannot access needed medications, it is important to assist patients to locate a pharmacy that can comply with the requirements communicated by Medicaid. Impact on payments: In the absence of an enacted budget, payments to providers will be affected. ProviderOne and IPOne will be able to pay providers for services they provided on or before June 30, 2017, but will be unable to pay providers for services provided on or after July 1, Providers paid through Medicaid funding will be paid for services rendered during the absence of the budget, after a budget is enacted. It is possible that providers paid through state-only funding may not be reimbursed for services rendered during the absence of the budget. All medical coverage groups in ACES will continue. Benefits will be in 3

4 place but claims will not be paid to providers until a budget is passed. Notifications: State-only funded Clients: Clients receiving state-only-funded services from ALTSA and DDA will receive notification that their services will not continue after June 30, 2017 in the absence of an operating budget (see letters attached below). All authorizations that have been processed for services rendered on or after July 1 will be suspended. AAAs: If a budget is not enacted, DSHS will not be able to authorize AAAs to provide anything other than limited Medicaid-funded services after June 30, 2017 and will not be able to pay for other services that AAAs provide. Providing non-medicaid-funded services during any shutdown would be at the AAA s risk of non-reimbursement. If AAAs choose to discontinue non-medicaid services they must notify clients. Any contract between DSHS and the AAA covering SFY18, executed prior to July 1, will automatically go into suspension in the absence of a state operating budget. These contracts will immediately be resumed as soon as a state budget is in place. AAA Medicaid Case Management/Nursing Services will be funded at 25% of the typical monthly unit rate during a shutdown. This would fund only essential case management (such as Significant Change assessments and authorizing services), and nursing services. AAAs may use their discretion on whether they serve more than the minimal activities using accrued or local funding sources. The Asian Counseling and Referral Service (ACRS) and the Chinese Information and Service Center (CISC) will continue to complete initial assessments for emergent cases on a per-case reimbursement basis. Other AAA staff, including Core Service Contract Management, will not be considered essential. Any notices to AAA staff would be provided according to AAA policy. Providers: All contracted state-only providers have been notified of contract suspension (see attached letter). State staff: Non-essential state staff will receive layoff notices pending the potential government shutdown. These notices will be sent to each affected staff person via with information staff need to know regarding the layoff process. Staff on extended leave will receive notices via U.S. mail. 4

5 To deliver essential services, a small number of staff will not receive layoff notices and will be working during the partial government shutdown. Each Regional Administrator and Headquarters Office Chief has finalized a list of essential staff to continue critical work functions to support the essential services. Those employees will continue business as usual and will receive regular compensation. ACTION: If there is not an approved budget by close of business on June 30, 2017, field service and central office staff must: Assessments and authorizations: 1. Notify clients who are scheduled for annual assessments that the assessment will have to be rescheduled unless there has been a significant change in the client s condition. 2. Not create new state-only service authorizations for dates past July 1, If you must create an authorization that extends into July, you must send the client notification, attached below. Partial office closures: 3. Leave the following voice message on their phones: Hello and thank you for your call. You have reached [name] with the Department of Social and Health Services [name of administration, division, program]. As of Friday, June 30, 2017, a state budget has not been passed and state offices have been partially shut down. If this is a life-threatening emergency, please hang up and dial 911. If this is an issue that needs immediate attention with regard to services, please push 0 now and leave a message at the main desk. We will get back to you as quickly as we can. Otherwise, please remain on the line and leave a message and when I am able to return to work, I will call you back. Similar messages must be left on out-of-office automatic replies. 4. DSHS Employees who have received a temporary layoff notice should call the phone number listed on their layoff notice daily for information about when they should return to work. During the layoff day(s), employees must not come to their office or check work or voic . 5. Employees who have been identified to continue working during the shutdown will receive direction from the Regional Administrator, Director, or designee regarding their activities. Some of the anticipated activities and/or tasks that staff will be performing during the partial shutdown include but are not limited to: a. Retrieving voice messages that come in on the office s identified message line and responding to urgent issues that cannot wait; 5

6 b. Reviewing, entering, extending and terminating payment authorizations; c. Reviewing and submitting incident reports; d. Responding to emergent and/or crisis client situations, including Significant Change assessments, ETRs, and authorizing new essential services. 6. All offices should post a notice on doors, used by the general public, to indicate that the office is closed due to the partial government shutdown and that normal operations will resume after a state budget is approved. RELATED REFERENCES: Additional Staff Information: ATTACHMENT(S): DDA Client Letters: DDA Contractor Letter: Final DDA Contractor letter 06- ALTSA Client Letter: Final ALTSA 2017 contingency plan cli ALTSA Contractor Letter: Final ALTSA 2017 contingency plan Co CONTACT(S): DDA Contact: Debbie Roberts, Office Chief (360) Debbie.Roberts@dshs.wa.gov AAA Contact: Susan Engels, Office Chief (360) Susan.Engels@dshs.wa.gov 6

7 HCS Contact: Cathy Kinnaman, Chief of Operations (360) MSD Contact: Chanh Ly, Director (360) RCS Contact: Amy Abbott, Office Chief (360)