STATE OF OKLAHOMA OKLAHOMA HEALTH CARE AUTHORITY

Transcription

1 JOEL NICO GOMEZ CH IEF EXECUTIVE OFFICER MARY FALLIN GOVERNOR STATE OF OKLAHOMA OKLAHOMA HEALTH CARE AUTHORITY LIVING CHOICE ADVISORY COMMITTEE AND LONG TERM CARE QUALITY INITIATIVES COUNCIL MEETING AGENDA 10 AM, JULY 24, 2014 TULSA COUNTY HEALTH DEPARTMENT 315 S. UTICA TULSA, OK Call to Order Rose Ann Percival, OUHSC 2. Welcome Erin Jackson, Money Follows the Person Program Director, OHCA Living Choice Tell Us Your Story Video 3. Approval of Meeting Minutes April 24, 2014 Meeting 4. Guest Presentations USDA 515 Direct Loan and Rental Assistance Program: Laurie Cobb-Lewis Volunteers of America Payee Services Program: Dave Goldman Lifespan Respite Grant Voucher Program: Al Ruble 5. Long Term Care Quality Initiatives Council (LTCQIC) Updates My Life; My Choice Program Update: Shakina Johnson Sooner Seniors Program Update: Beverly Couch Medically Fragile Program Update: Tatiana Reed 6. Long Term Care Waiver Operations (LTCWO) Quality Report David Ward, Quality Manager, OHCA (c) HCBS Final Rule Update LTCWO Staff, OHCA Conflict of Interest Person-Centered Planning 8. Announcements 9. Adjourn Next Meeting Scheduled for 10 AM, October 23 rd, 2014, Location: TBA 4345 N. LINCOLN BOULEVARD OKLAH OM A CITY, OK (405) CA.ORG An Equal Opportunity Employer

2 Living Choice Advisory Committee and Long Term Care Quality Initiatives Council Meeting Oklahoma Health Care Authority 4345 N. Lincoln Blvd Oklahoma City, OK Board Room April 24, :00 a.m. Meeting Minutes Attendees: Alisa Amiott-Kibois, Avis Hill-OHCA/LTCWO, Brian Kinkade-Oxford Health, Beverly Couch- OHCA/LTCWO, William Whited- LTC Ombudsman, Dave Goldman-VOA, David Ward- OHCA/LTCWO, Deborah Jenkins-OHFA, Deidra McCloud-DHS Aging Services, Erin Jackson-OHCA/Health Policy, Esther Houser-LTC Ombudsman, Essence McKnight-OHCA/LTCWO, Gayle Semtner-OHAI, Gina Fisher- OU College of Nursing, Grace Burke-Morton Comp Health Services, Irene Perez- OHCA/LTCWO, Jack Werner- A to Z Inspections, Joe Mecham-OHCA/LTCWO, Kailan Helm-VOA, Karen Poteet-Aging Services/DHS, Ken Jones-ODMHSAS, Kendra Orcutt-Home Mods by Therapists, Leah Medina-OIL, Lekenya Antwine- OHCA/Health Policy, Linda Shannon- Consumer Advocate, Loria Holleman-OU College of Nursing, Marisa New-OSDH-Health Equity, Megan Haddock- OKDHS, Mia Smith-OHCA/LTCWO, Patricia Linzy-OHCA/LTCWO, Princiss Rockmore-OHCA/LTCWO, Rose Ann Percival-OUHSC, Shakina Johnson-OHCA/LTCWO, Susan Roberts-KiBois, Tatiana Reed-OHCA/LTCWO, Trudy Johnson-OHCA/LTCWO. Meeting Call to Order/ Introductions Rose Ann Percival Approval of Quarterly Meeting Minutes from January 23, 2013 Presentations Certified Aging in Place Specialists (CAPS) Kendra Orcutt and Jack Werner Flyers and pamphlets describing the program were distributed - A program to properly remodel homes to accommodate people to remain home. - Partners include Certified Aging in Place Specialists (CAPS) and Universal Design and Build (UDB). - Information can be found through Jack Werner at Working on getting the company added as a provider CMS Guidelines for Person-Centered Thinking Rose Ann Percival - Oklahoma currently has seven certified Person-Centered Thinking trainers - Bios in Tulsa, OK has implemented this system wide and show millions of dollars in savings - Work group to be assemble that includes OHCA personnel to make a presentation at next meeting - CMS really pushing Person-Centered Thinking LTCQI Council Update Shakina Johnson The updated reports for the My life My Choice, Sooner Seniors and Medically Fragile waivers were distributed to the group. LTCWO Quarterly report - Avis Hill Avis distributed the 4 th quarterly report for all 4 Living Choice programs.

3 Living Choice Advisory Committee and Long Term Care Quality Initiatives Council Meeting Oklahoma Health Care Authority 4345 N. Lincoln Blvd Oklahoma City, OK Board Room April 24, :00 a.m. LTCWO Quality Report Department Update - David Ward David distributed copies of the Long Term Care Waiver Operations quality report. He states that the quality evaluation questionnaires are administered to the case management agencies. After reviewing the report, some of the first improvements to be made beginning 2014 include: 1. Finalized 80% of changes in procedures 2. OU pre-assessment team has been cleared to be utilized for training to do the pre-assessment for living choice. 3. Constructing automated systems through our IS and IT departments, to help streamline information and effectively communicate amongst each other as well as have everything centralized online. 4. Setting up web alerts to make people aware of upcoming changes forms per program have been converted to a single pdf fillable form that covers all four programs. 6. Adding 2 new forms in relation to the program with OU. A couple of members of Living Choice success stories to be published by the end of June 2014 and to present it at the Tulsa meeting on July 24 th, Will be accessing and processing SURS plans online. LCAC Committee Workgroups Erin Jackson and David Ward Marketing and Outreach group met March 22 nd, 2014, topics covered were: Radio time to be schedule some time around May-June Coordination with hospital discharge personnel Meeting again in June prior to the next LCAC meeting Quality review workgroup had no new topics to discuss Announcements Oklahoma Public Health Assoc. will have their annual conference May 8 th and 9 th Governor s Conference on Intellectual Disabilities will be May 28 th and 29 th at the Embassy Suites in Norman, OK Oklahoma is hosting the 2014 Self Advocates Becoming Empowered Conference. Cox Business Center and Renaissance Hotel in Oklahoma City, OK from October 9 th, 2014 through October 12 th, Application to MFP Tribal Grant from the fall of 2013 was awarded on April 6 th, 2014 to extend the program out to the tribes. Currently still in planning stages, however July 24 th, 2014 LCAC meeting will have more details on this topic. Currently Chickasaw Nation has partnered for this program. Living Longer, Living Stronger Program branched into southwestern and southeastern Oklahoma. It is a free 6-week workshop. May 8th, 2014 Oklahoma Health Literacy Summit integrated into Oklahoma Public Health Association Conference.

4 Living Choice Advisory Committee and Long Term Care Quality Initiatives Council Meeting Oklahoma Health Care Authority 4345 N. Lincoln Blvd Oklahoma City, OK Board Room April 24, :00 a.m. Oklahoma Aging Conference held May 20 th, 2014 May 22 nd, Ages 60 or above get free entry on May 20 th, Go to OKAgingConference.com for more information and to register. Next Meeting Date The next LCAC meeting will be: July 24 th, 2014 Time: 10:00 a.m. Tulsa County Health Department 315 S. Utica Tulsa, OK Adjournment Rose Ann Percival

5 USDA, Rural Development (RD) Multi- Family Housing (MFH) 515 Direct Loan and 421 Rental Assistance Programs MFH Income Based Rural Properties financed by RD: Adjusted Income Limits per State and County as revised 2/12/14: Link to USDA Rural Development MFH Handbooks, Unnumbered Letters (UL s), Forms, Administrative Notices (AN s), Instruction, etc.: Link to MFH Asset Management Handbook:

6 USDA, Rural Development (RD) Multi- Family Housing (MFH) 515 Direct Loan and 421 Rental Assistance Programs Definition of Elderly household: tenant or cotenant who is disabled or age 62 years or older. Persons with disabilities and their families are permitted to live in designated elderly and family housing. As soon as application is received, is required to be posted on Waiting List Most all Management Agents run a background and credit check upon receipt of a completed application If Applicant determined eligible, they are place on a Waiting List. If rejected Management will notify. Priority for eligible sized unit is: 1. very-low income and if not applicable, 2. then low income 2. then moderate

7 Rental Assistance (RA): USDA, Rural Development (RD) Multi- Family Housing (MFH) 515 Direct Loan and 421 Rental Assistance Programs The Section 521 Rental Assistance program provides assistance to individual residents of Agency financed multi-family projects. Rent subsidies under the Rental Assistance Program ensure that elderly, disabled, and low-income residents of multi-family housing projects financed by RHS are able to afford rent payments. With the help of the Rental Assistance Program, a qualified applicant/tenant pays no more than 30 percent of his or her income for housing. RD has some properties that have no RA. RA is not unit specific and each property has a maximum that can be utilized on any given day. Example: ABC Rentals is a 24 unit property however has only 18 RA units, therefore the maximum of 18 RA units can be utilized on any given day. RA remains at the property and does not transfer with any household to another property unless the transfer/move is related to a disaster Tenant and Co-Tenant are responsible and accountable for all guests and household members

8 USDA, Rural Development (RD) Multi- Family Housing (MFH) 515 Direct Loan and 421 Rental Assistance Programs Oklahoma USDA Rural Development Contact Information: Tom E Roberts, Acting MFH Program Director Laurie J Lewis, MFH Specialist, State Office, Stillwater OK Laurie.cobblewis@ok.usda.gov or by phone:

9 What is a Representative Payee? A person or organization appointed by the Social Security Administration to receive monthly Social Security and/or SSI benefits for beneficiaries who are unable to manage their own money or who need someone to assist them with money management. How does VOA Payee Services Program work? VOA becomes the representative payee for individuals who cannot manage their own money and/or the person who is supposed to be helping manage their money is taking advantage of them financially and fraudulently. VOA receives Social Security and/or SSI benefits directly from the Social Security Administration on behalf of each program participant. From that money, VOA pays each program participant s monthly bills, as well as providing them with weekly spending money for groceries and other items. In addition to providing basic representative payee services, the Payee Services staff will also provide light case management through the following services. Information and Referral Services- identify needs and assist the consumer with problem resolution by offering information and referral for services. Advocacy Services- interact with human service organizations, businesses, and other resources as needed to meet the needs of the consumer. Financial Counseling Services- provide direction and information to consumers to help best utilize their money. Benefits to Consumer Creates Stability Increases access to resources Decreases stress Decreases chances of being taken advantage of financially Increases quality of life Oklahoma City:1724 NW 4 th Street OKC, OK Phone: OR Tulsa: 9605 East 61 st Street Tulsa, Ok Muskogee: 3536 Chandler Road Muskogee, Ok

10 OAA National Family Caregiver Support Program Contacts Contact your local Area Agency on Aging to ask about services for caregivers. To apply for respite vouchers, call the Respite Voucher Program contacts listed below: Areawide Aging Agency (TDD) Canadian, Cleveland, Logan and Oklahoma counties Respite Voucher Program: Kathleen Wilson at ASCOG AAA or Caddo, Comanche, Cotton, Grady, Jefferson, McClain, Stephens and Tillman counties Respite Voucher Program: Tara Brown at COEDD AAA or Hughes, Lincoln, Okfuskee, Pawnee, Payne, Pottawatomie and Seminole counties Respite Voucher Program: Charlotte Blagg at EODD AAA Adair, Cherokee, McIntosh, Muskogee, Okmulgee, Sequoyah and Wagoner counties Respite Voucher Program: Kendel Dean at Grand Gateway AAA or Craig, Delaware, Mayes, Nowata, Ottawa, Rogers and Washington counties Respite Voucher Program: Mary Satterwhite at , ext. 31 INCOG AAA Creek, Osage and Tulsa counties Respite Voucher Program: Kathy Noojin at KEDDO AAA or (TDD) Choctaw, Haskell, Latimer, LeFlore, McCurtain, Pittsburg and Pushmataha counties Respite Voucher Program: Carla Brunson at or NODA AAA or Alfalfa, Blaine, Garfield, Grant, Kay, Kingfisher, Major and Noble counties Respite Voucher Program: Call or OEDA AAA or Beaver, Cimarron, Dewey, Ellis, Harper, Texas, Woods and Woodward counties Respite Voucher Program: Call or SODA AAA Atoka, Bryan, Carter, Coal, Garvin, Johnston, Love, Marshall, Murray and Pontotoc counties Respite Voucher Program: Paulette Blankenship at SWODA AAA or (TDD) Beckham, Custer, Greer, Harmon, Kiowa, Jackson, Roger Mills and Washita counties Respite Voucher Program: Call at or (TDD) You may also call 2-1-1, the Oklahoma Information and Referral Hotline to ask for respite services For information on the Lifespan Respite Grant Voucher Program, or to receive an application, call Al Ruble at (405) Vouchers will be provided for qualified caregivers as long as funds are available. OKDHS pub Issued 04/13 This publication is authorized by the Oklahoma Commission for Human Services in accordance with state and federal regulations and printed by the Oklahoma Department of Human Services at a cost of $ for 2,000 copies. Copies have been deposited with the Publications Clearinghouse of the Oklahoma Department of Libraries. OKDHS offices may request copies on ADM-9 (23AM009E) electronic supply orders. Members of the public may obtain copies by contacting OKDHS Design Services at (toll free), or by downloading a copy at RESPITE VOUCHER PROGRAM A Gift for You Your time is valuable AGING SERVICES DIVISION

11 Helping others by helping yourself, first What Respite Programs are Available? Lifespan Respite Grant Program Eligibility Where Can Respite Care Happen? Are you a primary caregiver? Do you take care of a family member or another person living in your home who is older and in need of full-time assistance or supervision during the day? Are you a grandparent, age 55 or older, who is raising a grandchild, or other child (as a parent)? Even though many families take great joy in providing care to their loved ones so that they can remain at home, the physical, emotional and financial consequences of caregiving can be overwhelming without some support. Everyone needs time for themselves to recharge their batteries time with a spouse or other family members, or just time to run an errand or go to the doctor. Respite services can provide you the much-needed, temporary break from the often exhausting challenges you face. With a respite voucher, you can bring another person into your home to take care of your loved one until you return. Two respite programs are available for caregivers. One is through the Older Americans Act (OAA) National Family Caregiver Support Program (NFCSP) operated through the Area Agencies on Aging (AAA). The other program is the Lifespan Respite Grant Program operated by the OKDHS Aging Services Division. OAA National Family Caregiver Support Program Eligibility You may be eligible for this program if you are: 1) A grandparent, age 55 or older, raising a grandchild or other child as a parent; or, 2) A primary caregiver who is caring for someone age 60 or older who needs assistance with at least two activities of daily living or who is limited by Alzheimer s disease or dementia. No income restrictions apply. For information on the OAA NFCSP or to apply, contact your AAA or the Respite Program Voucher contact directly. Contact information is on the back of this publication. You may be eligible for this program if the person receiving the primary or full-time care: 1) Needs assistance with activities of daily living in order to stay at home in the community; 2) Does not qualify for services of other respite programs such as the OAA NFCSP; 3) Does not receive services from a program with a respite component or receive in-home services paid by another program (Medicare, Hospice, ADvantage); and 4) Has a household income that does not exceed $90,000 per year. Who s Who? Caregiver The person providing primary or full-time care for a family member or another person living in their home. Care Receiver The person receiving primary or full-time care. Respite Care Provider The person chosen by the Caregiver to provide the care for the Care Receiver and who is paid by a voucher through the OAA National Family Caregiver Support Program or the Lifespan Respite Grant Program. Respite care can be provided in your home, someone else s home or a centerbased program or care center as long as agreed to by the caregiver and respite care provider. Who Can Be a Respite Care Provider? As the caregiver, you hire a person of your choice within program guidelines and negotiate the hourly wage the provider is paid, within funding limits. The Respite Care Provider must: Be age 18 or older Have a social security number and social security card Live outside of your (caregiver and care receiver s) home The respite care provider can be a family member, friend, church member or anyone you choose as long as they meet the above criteria.

12 ATTENTION CASE MANAGERS AND FAMILY CAREGIVERS Do you know someone who needs a temporary break from caregiver duties? The Lifespan Respite Grant Voucher program may be able to help! Respite service can provide a much-needed, temporary break from the often exhausting challenges faced by family caregivers. Respite vouchers let caregivers hire another person to temporarily care for their loved ones. The Lifespan Respite Grant Voucher program provides respite services for caregivers who do not qualify for other respite programs. Lifespan Respite Grant Voucher Eligibility Guidelines The Caregiver: Is age years old and is a full-time, unpaid caregiver to a person diagnosed with Alzheimer s disease or a related disorders with neurological and organic brain dysfunction (i.e. multiple sclerosis, muscular dystrophy, traumatic brain injury); or, Is 18 or older and is a full-time, unpaid caregiver for a person diagnosed with a condition(s) other than described above; or, Is a grandparent or other relative age 54 or younger raising a child as a full-time parent; and, Does not have annual household income over $90,000 (extenuating circumstances will be considered); and, Does not receive respite services or payments from other programs including, but not limited to foster care, Family Support Assistance Payment, ODMHSAS Systems of Care funding, or a DHS Child Care Subsidy. The Care Receiver is an Oklahoma resident: Age birth to 59 who needs help with activities of daily living (ADL) in order to stay at home in the community or who has neurological and organic brain dysfunction such as multiple sclerosis, muscular dystrophy or traumatic brain injury; and, 1/6/14

13 Does not qualify for respite services or payments through any other program including, but not limited to, DHS Developmental Disability Services, SSI-DCP, OAA Title III-E, ADvantage waiver program, Medicare-funded home health services or hospice. Where Can Respite Care Happen? Respite care can be provided in the caregiver s home, someone else s home, a centerbased program or care center, such as an adult day services center or nursing facility, as long as agreed to by the caregiver and respite care provider. Who Can Be A Respite Care Provider? The respite care provider can be anyone the caregiver chooses such as a family member, friend, church member, center-based program or care center. The respite care provider must: o Be age 18 or older; o Have a social security number and social security card; and o Live outside the caregiver and care receiver s home. How Does the Lifespan Respite Voucher Program Work? Caregivers contact Al Ruble at or al.ruble@okdhs.org to start the application process An application and pre-voucher survey are mailed to eligible caregivers Caregivers complete and return the application and pre-voucher survey to Al Ruble Eligible caregivers receive $400 worth of respite vouchers The caregiver negotiates the wage (within funding limits) and hires a respite provider of their choice (within guidelines) After respite care is provided, the caregiver and respite provider sign the vouchers and return in the envelope provided Payment is mailed to the respite provider The caregiver is asked to complete a post-voucher survey The caregiver may request vouchers every three months, if needed, and so long as funding is available For additional information on other caregiver support or respite voucher programs, call the Senior Info-Line at or the Oklahoma Information and Referral Hotline at The Lifespan Respite Grant Voucher program is funded by the ACL AoA and operated by DHS Aging Services 1/6/14

14 My Life; My Choice 2nd Quarter 2014 Apr-14 May-14 Jun-14 Totals Member Participation Number of Members Enrolled Number of Members Exits Death Loss of Financial Elig Improved Moved Re-institutionalizatized Withdrawn (after transitioning out into community) Transitioned from Another Program Transitioned into Another Program Withdrawn (before transitioning into community) End of Month Totals Complaints Received Number of Critical Incident Reports Received Service Plans Initial Service Plans Authorized Service Plan Addendums Authorized Reassessments Authorized Claims Issues Claims resolution requests received Claims resolution requests resolved Claims resolution issues pending CM/TC Trained Case Managers/Transitions Coordinators Supervisors Back-up Supervisors N/A = not available N/R = not reported The MyLife;My Choice waiver program had an enrollment of 74 members. For the second quarter ending June 30, 2014 the chart above highlights key waiver activities of enrollments, exits, the number of critical incidents reported, number of initital service plans authorized, number of reassessments authorized for the member who have completed more than one year in the program and the number of addendums (changes to service plans) authorized. Page 1 of 1

15 1 Sooner Seniors 2nd Quarter Apr May Jun Totals for 2nd Quarter Member Participation Number of Members Enrolled Number of Members Exits Death Loss of Financial Elig Improved Moved Re-institutionalizatized Withdrawn (after transitioning out into community) Transitioned into Another Program Withdrawn (before transitioning into community) End of Month Totals Complaints Received 23 Number of Critical Incident Reports Received Service Plans 37 Initial Service Plans Authorized Service Plan Addendums Authorized Reassessments Authorized Claims Issues 43 Claims resolution requests received Claims resolution requests resolved Claims resolution issues pending CM/TC Trained 48 Case Managers/Transitions Coordinators 49 Supervisors 50 Back-up Supervisors The Sooner Seniors waiver program has an enrollment of 38 members. For the second quarter ending June 30, 2014 the chart above highlights key waiver activities of enrollments, exits, the number of critical incidents reported, number of initial service plans authorized, number of reassessments authorized for member who have completed more than one year in the program and the number of addendums (changes to services plans) authorized. Since inception, (March 1, 2011) the program has enrolled a total of 69 members Page 1 of 1

16 Medically Fragile 2nd Quarter 2014 Apr-14 May-14 Jun-14 Totals Member Participation Number of Members Enrolled Number of Members Exits Death Loss of Financial Elig Improved Moved Re-institutionalizatized Withdrawn (after transitioning out into community) Transitioned from Another Program Transitioned into Another Program Withdrawn (before transitioning into community) End of Month Totals Complaints Received Number of Critical Incident Reports Received Service Plans Initial Service Plans Authorized Service Plan Addendums Authorized Reassessments Authorized Claims Issues Claims resolution requests received Claims resolution requests resolved Claims resolution issues pending CM/TC Trained Case Managers/Transitions Coordinators Supervisors Back-up Supervisors N/A = not available N/R = not reported Page 1 of 1

17 Quality Performances In every effort in continuing to grow and show viability for the longevity of the Living Choice Demonstration Model we have taken some measurable approaches that may perhaps grow our census and help market our program across this great State of Oklahoma. Here are some of our efforts: 1. Project Denials 2. Veterans Administration (Aug p) 3. Enhance Website Features a. The Provider Post Display Provider Letters, updates on Policy and changes with programs b. Members Montage Visual display (Video Commercial) of how the Living Choice Demonstration should work to include the Pre-Assessment Team and explain some program functionalities such as how an IDT works, roles and duties of a Transitional Coordinator/Case Manager, grievance procedures and Self-Directed goods and services. We feel that from a quality standpoint of view, our members should have some expectation from our services. c. OU PAT Will show our Pre-Assessment Team and a step by step process of Program Determination d. Participant Transition Planning Guide The feature will provide our members with helpful resources and assistance once transitioned back into the community e. Web Alerts Have all TCCM s, supervisors, managers and staff sign up for our web alerts to stay in the now of all changes in within the Living Choice and Waivers. 4. Eliminated Barriers for Assessment The MFP (Living Choice Demonstration) is and entitlement program therefore, any person(s) who meet the eligible requirements of: a. 90 day stay in Nursing Facility b. 1 day stay paid for my Medicaid Member has a right to be assessed. We will run all referrals (applicants) through Adult Protective Services (APS) to check for Legal Guardianship. 5. TCCM Application By the next meeting we will have implemented our new TCCM Application. The TCCM is designed for our Transitional Coordinators/Case Managers to actually create and input the service plan online through the Portal; even create the PA s for program services. After work is approved and recycled through our protocols, an approved 6g will be sent via Portal, no more faxing.