The UAS-NY: Abound in Questions, Challenges and Change AUDIO CONFERENCE Date/Time: Tuesday, June 18, 2013, 1:30 3 p.m. Speakers: Diane Darbyshire, LeadingAge NY Senior Policy Analyst Anne Hill, Adult Day Health Care Council Policy Analyst Linda Spokane, Director of Research & Analytics Cheryl Udell, LeadingAge NY Community Services Policy Analyst Panelists from LeadingAge NY/ADHCC member organizations Packet Contents: Handout ACF/AL Certificate of Attendance Generic Certificate of Attendance Dial-In Instructions: Conference Phone Number: 866-380-9615 Participant Access Code: 364514# You may dial the toll-free number no sooner than five minutes prior to the program. LeadingAge New York/FLTC 13 British American Blvd. Suite 2 Latham, NY 12110 518.867.8385 1
The UAS-NY: Abound in Questions, Challenges and Change June 18, 2013 Diane Darbyshire, LeadingAge NY Senior Policy Analyst Anne Hill, Adult Day Health Care Council Policy Analyst Linda Spokane, Director of Research & Analytics Cheryl Udell, LeadingAge NY Community Services Policy Analyst Panelists from LeadingAge NY/ADHCC member organizations Today s Agenda Introductions Provide brief overview of UAS-NY project Discuss recommended transition activities Review IT requirements Discuss offline and paper-based assessment process Review UAS-NY Readiness Survey results Discuss LeadingAge New York advocacy efforts to date Panelist discussion Questions and Answers 2
Programs Required to use UAS-NY and the Assessment Instruments Being Replaced Adult Day Health Care - RAI Assisted Living Program PRI, DSS-4449B, DSS-4449D, DSS- 4449C Care at Home I/II Waiver DSS-4362, DSS-3139 Consumer Directed Personal Assistance Program DMS-1 Long Term Home Health Care Program DMS-1, DSS- 3139 Managed Long Term Care plans - SAAM Nursing Home Transition and Diversion Waiver PRI, Screen Personal Care Services Program - M27-R Traumatic Brain Injury Waiver - PRI, Screen Region Counties Begin Transition Implementation deadline Pilot Broome, Chautauqua, Otsego, Warren March 2013 July 1, 2013 MLTC plans Statewide June 1, 2013 Oct. 1, 2013 Region VI Region V Region IV Region III Regions I & II Allegany, Cattaraugus, Chemung, Erie, Genesee, Livingston, Monroe, Niagara, Ontario, Orleans, Schuyler, Seneca, Steuben, Wayne, Wyoming, Yates Cayuga, Chenango, Cortland, Delaware, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, St. Lawrence, Tioga, Tompkins Albany, Clinton, Columbia, Essex, Franklin, Fulton, Greene, Hamilton, Montgomery, Otsego, Rensselaer, Saratoga, Schenectady, Schoharie, Washington Dutchess, Orange, Putnam, Sullivan, Ulster, Rockland Nassau, New York City, Suffolk, Westchester May 1, 2013 Oct. 1, 2013 June 1, 2013 Nov. 1, 2013 July 1, 2013 Dec. 1, 2013 Aug. 1, 2013 Jan. 1, 2014 Sept. 1, 2013 Feb. 1, 2014 3
UAS-NY Overview Single record for individuals in Medicaid Long Term Care system Secure web-based software application Role-based system Housed within NYS- DOH HCS Off-line application available Ad hoc reporting capabilities Community Health Assessment (for adults over the age of 18) includes two supplements: Functional and Mental Health Program regulations not subject to change How does MLTC fit into the picture? For MLTC enrollees: MLTC plan will conduct assessment in the home, determine a plan of care, and prescribe community-based services. Downstream provider will fulfill care plan and MLTC plan will conduct reassessment every 180 days. MLTC plan may contract with downstream provider to conduct UAS-NY and/or reassessments using a Care Management Administrative Services (CMAS) contract. For Medicaid recipients NOT in enrolled in MLTC plan: Program is responsible for conducting assessment and reassessment by appropriate staff and within the timeframe as reflected in regulation. 4
UAS-NY Training Environment All training is web-based and self-paced Training modules contain fundamental (required), intermediate and advanced courses Training is classified as either mandatory or recommended based on assigned role(s) Staff will not be allowed to access the UAS-NY application before completing mandatory courses Training for certain roles may take at least 10 hours to complete At our urging, DOH is developing a test environment Transition Activities Establish HCS User Accounts Time consideration Trust Level III assurance for all UAS-NY users is required Establish a UAS-NY workgroup within your organization Appoint UAS-NY Coordinator(s) Thoroughly review the most recent version of the UAS-NY Transition Guide (dated 5/14/2013) Establish an internal and external communication plan Establish UAS-NY roles - authorize access Participate in DOH and LeadingAge NY webinars Assess staff computer literacy and provide additional training as needed 5
Organizational Considerations Leadership team UAS-NY workgroup UAS- NY Coordinator Point person to facilitate the change to UAS-NY within your organization Point person for internal and external communication Administrative activities Back-up Internal and External Communication Plan Consider how your organization/staff responds to change and plan accordingly What is effective internal communication? Face-to-face meetings Emails Teaching labs Timing timing timing I wish I knew in advance. What is effective external communication? Contractors sub-contractors for assessments Social service districts DOH LeadingAge New York 6
UAS-NY Roles UAS Role Name Generally Intended For: UAS-15 Administrative Staff UAS-20 Review/Consult/OT, PT, ST UAS-30 Social Assessors UAS-35 Social Assessor Supervisors UAS-40 Nurse Assessors UAS-45 Nurse Assessor Supervisors UAS-50 Managers Source: DOH Transition Guide (page 41), dated 5/14/2013 IT Specifications Remember that ALL users of the UAS-NY must have an HCS account Time considerations Includes contractors Page 38 of the Transition Guide provides the technical requirements for using the UAS-NY Online Application Page 39 provides technical requirements for the Offline Application 7
IT Considerations Be sure to review IT specifications in Transition Guide carefully before investing in new equipment DOH does NOT recommend the use of tablets The system does not run on MAC-based products Ensure that hardware settings, operating systems, supported browsers, settings and software requirements are per specification to ensure proper functioning LeadingAge New York can help Offline Use When using the offline application, there are steps the assessor must take, while still connected to the internet (i.e. in the office prior to going into the field): Start the UAS-NY Offline Application and log into the HCS Select individuals you will be assessing and synchronize the data (placing case files on assessor s laptop) After conducting the offline assessment and returning to a site that is internet accessible, the assessor must start the Offline Application and again synchronize, updating the system with the new assessment data Signature of assessment can only occur when online 8
Offline Use Considerations Offline use may be necessary if there is no internet access at time/place of assessment Assessor will be storing HIPAA and HITECH protected data on their computer (e.g. laptop). Your organization is responsible for data stored on your organization s computers; you must take additional steps to protect it The UAS-NY Offline Application requires the installation of the software application on the computer (e.g. laptop). Installation instructions are available with the installation program Conducting Paper-based Assessments Under certain circumstances, you may need to complete the assessment on paper. However, paper use is NOT recommended. If a paper-based assessment is conducted, additional supplements (i.e. Mental Health assessment, Functional assessment) will not be triggered automatically. Assessors must be aware of this and conduct the additional assessments, if required Assessment data must ultimately be entered into the online system You are responsible for the protection of health information 9
UAS-NY Readiness Survey In late-april, a survey was sent to all LeadingAge NY members with ADHC, ACF/AL, LTHHCP, MTLC, and TBI programs Purpose was to evaluate readiness of members to implement UAS-NY, determine barriers to implementation, and gauge interest in additional education 83 respondents Pilot: 2 Region VI: 15 Region V: 23 Region IV: 8 Region III: 2 Regions 1&2: 33 Survey Results Identifying HCS and UAS Coordinators 78% of respondents had identified their HCS Coordinator 12% have begun the training modules 61% of respondents had identified their UAS Coordinator 24% have begun the training modules IT Proficiency Proficiency was rated based on a 1-10 scale, with 1 being not proficient at all and 10 being highly proficient On average, HCS and UAS Coordinators are moderately proficient (7.3 and 6.5, respectively) Lower levels of proficiency reported for staff responsible for conducting and reviewing assessments (<6 out of 10) 10
IT Infrastructure 78% of respondents have a dedicated IT staff Not necessarily located on site Some organizations contract out IT Several noted the limited number of IT staff available compared to size of organization (e.g. 1 IT staff for 500 employees) 82% of respondents have an adequate number of computers to conduct onsite assessments but only 33% indicated they have an adequate number for offsite assessments Additional Education/Training Primary challenges/concerns Understanding the getting started process (i.e. appointing coordinators, assigning roles, completing training modules) Preparing and training staff Having enough IT resources TIME! Overwhelming majority (87%) indicated interest in a half-day in-person UAS Readiness Workshop led by LeadingAge IT staff Stay tuned for more information about the workshops 11
DOH and LeadingAge NY webinars Participate Ask your questions send to UAS-NY staff & copy LeadingAge NY uasny@health.state.ny.us Keep us informed of your experience-good and bad! Advocacy Advocacy April Meeting with DOH regarding ALP Medicaid rate crosswalk and general concerns May 28, 2013 Webinar Program specific webinars LeadingAge New York Letter to DOH requesting delay with implementation 90 day delay implementing the UAS-NY for Managed Long Term Care (MLTC) plans Meeting again with DOH in July 12
Resources DOH UAS-NY Website: http://www.health.ny.gov/health_care/medicaid/redesign/unifo rm_assessment_system/index.htm LeadingAge New York site: http://www.leadingageny.org/providers/home-and-communitybased-services/best-practices-and-resources/uniformassessment-system/ Panelists Kathy Norsen, Clinical director, Schofield Adult Day Health Care, Buffalo Kathy Swezey, Executive Director of Good Shepherd-Fairview Home, Binghamton Phyllis Dailey, Office Manager and UAS Coordinator, UHS Home Care/Senior Living at Ideal, Binghamton Danielle Tierno, ACF/ALP Case Manager, Good Shepherd-Fairview Home, Binghamton Cindy Steele, Director of Clinical Services Hultquist Place, Jamestown Sharon H Phipps RN, BSN, Senior Director, UHS Home Care at Ideal - LTHHCP and LHCSA DPSm, UHS Senior Living At Ideal - ACF and ALP Administrator Barb Travis, Broome County CASA, Broome County Local Department of Social Services 13
Questions? Contact LeadingAge NY: Diane Darbyshire, ddarbyshire@leadingageny.org, 518.867.8828 Anne Hill, ahill@leadingageny.org, 518.867.8836 Linda Spokane, lspokane@leadingageny.org, 518.867.8857 Cheryl Udell, cudell@leadingageny.org, 518.867.8871 Questions may also be emailed to: uasny@health.state.ny.us 14
Certificate of Attendance ~ This Certificate of Attendance is presented to ~ Participant received 1.5 hours of continuing education credit for Adult Care Facility (ACF) and Assisted Living (AL) Administrators The UAS-NY: Abound in Questions, Challenges and Change Audio Conference June 18, 2013 1:30 3 p.m. ~ sponsored by ~ The Foundation for Long Term Care (the educational affiliate of LeadingAge New York) LeadingAge New York/FLTC 13 British American Blvd, Suite 2, Latham, NY 12110-1431 (518) 867-8383 Education and Accreditation Administrator
Certificate of Attendance ~ This Certificate of Attendance is presented to ~ ~ for participating in ~ The UAS-NY: Abound in Questions, Challenges and Change Audio Conference June 18, 2013 1:30 3 p.m. ~ sponsored by ~ The Foundation for Long Term Care (the educational affiliate of LeadingAge New York) LeadingAge New York/FLTC 13 British American Blvd, Suite 2, Latham, NY 12110-1431 (518) 867-8383 Education and Accreditation Administrator