National Background Check Program for Long Term Care Opportunities & Challenges Centers for Medicare & Medicaid Services Survey and Certification Martin Kennedy, Director, Division of Continuing Care Providers Starr J. Brown Disabled and Elderly Health Programs Group Division of Long Term Services & Supports September 12, 2011
Affordable Care Act Section 6201 Offers federal 3 to 1 matching grants for States and Territories to enhance their criminal background checking systems For long term care providers/services For applicants, not current employees For any job with direct access to residents/clients not just nurse aides Each state may receive up to $3.0 million. 2
What Providers Must Be Included? Nursing homes Home health agencies Hospice care providers, ICF-IDs Long term care hospitals Providers of personal care services Adult day care and residential care, including assisted living 3
Non-Federal State Match CMS will generally apply the same criteria as is used in Medicaid, when judging the acceptability of the non-federal match Medicaid law and regulations permit a variety of options for use as the source of the non-federal share, such as: State tax revenue, Local tax revenue, Health care-related taxes, and Bona Fide Donations CMS has received questions regarding the use of fees as a source of non-federal match and has therefore included Appendix 9 in the third Solicitation to offer additional information, with regard to some of the options and limits that exist 4
Alaska California Program Update Connecticut Delaware District of Columbia Florida Utah Awarded States* Illinois Missouri New Mexico Oklahoma Rhode Island Kentucky North Carolina 5 *Applications from four additional States are currently being processed.
4 th Solicitation CMS released in June 2011 Posted on Grants.gov; and CMS website at https://www.cms.gov/surveycertificationgeninfo/04_backgroundcheck.asp Application deadline is October 31, 2011 CMS will review applications and make awards on a flow basis FBI continues to support panel reviews and implementation efforts Applicant States are invited to participate in communications and trainings 6
Barriers: Why States Have Not Applied Could not get State match money Had conflicting legislation political problems Did not want to explore State-level rap back when FBI is working on National system Did not see how enhancements could be sustained financially after grant period was over Some States notified us they were interested but could not meet deadline 7
Removal of Barriers: The Technical Support Contract CMS contracted with CNA to provide help to States, as requested with: System development Evaluation of equipment State legislation development Conferences and training Collecting evaluative information/data CNA technical assistance (TA) is available at no cost to States CNA Has completed most State assessments CNA Website: http://bgcheckinfo.cna.org/ 8
9 Training/Information Sharing CMS will host its 2nd National Conference for grantee and interested States Dates: September 13-15, 2011 Location: St. Louis, MO Topics include: Rap Back Update Program Sustainability Brief Grantee State Presentations Stakeholders group will discuss provider, residents and workforce concerns Grantee States are required to attend and utilize grant funds for travel expenses CMS invited all states to participate
Formation of the Long Term Care Criminal Convictions Work Group Office of Inspector General s (OIG) 2011 report, Nursing Facilities Employment of Individuals with Criminal Convictions recommended that CMS: Clearly define the employee classifications that are direct patient access employees, and; Work with participating States to develop a list of State and local convictions that disqualify an individual from nursing facility employment under the Federal regulation and periods for which each conviction bars the individual from employment. 10 CMS chose to form a Work Group of States to address these issues for all LTC provider types.
Workforce Work Group Mission The Work Group will review relevant State statutes, regulations, and other sources of information and provide CMS with recommendations on: Definitions of direct patient access employees for different provider types 11 State convictions that should disqualify individuals from direct patient access employment with long term care (LTC) facilities/providers, which conviction types should be considered for mitigation or rehabilitation, and the time period for which each conviction should disqualify individuals from employment.
Project Scope and Approach 12 The Work Group will develop recommendations to CMS for definitions of direct patient access employees, taking into account CNA s research on: The Affordable Care Act outcome-based definition; Duty-based and job title-based definitions; Statutes, regulations, and other sources of information for all States and U. S. Territories; and Other definitions identified by Work Group members and subject matter experts.
Questions & Concerns Any questions or concerns regarding this program can be sent to the CMS Background Check email account and the Core Team will respond to your inquiry Background_Checks@cms.hhs.gov 1314