the uas-ny: abound in questions, challenges and change · 2013. 6. 18. · the uas-ny: abound in...

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The UAS-NY: Abound in Questions, Challenges and Change RECORDED AUDIO CONFERENCE Date Recorded: Tuesday, June 18, 2013 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 LeadingAge New York/FLTC 13 British American Blvd. Suite 2 Latham, NY 12110 518.867.8385 1

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Page 1: The UAS-NY: Abound in Questions, Challenges and Change · 2013. 6. 18. · The UAS-NY: Abound in Questions, Challenges and Change June 18, 2013 Diane Darbyshire, LeadingAge NY Senior

The UAS-NY: Abound in Questions, Challenges and Change

RECORDED AUDIO CONFERENCE

Date Recorded:

Tuesday, June 18, 2013

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

LeadingAge New York/FLTC 13 British American Blvd. Suite 2 Latham, NY 12110 518.867.8385

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Page 2: The UAS-NY: Abound in Questions, Challenges and Change · 2013. 6. 18. · The UAS-NY: Abound in Questions, Challenges and Change June 18, 2013 Diane Darbyshire, LeadingAge NY Senior

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

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Page 3: The UAS-NY: Abound in Questions, Challenges and Change · 2013. 6. 18. · The UAS-NY: Abound in Questions, Challenges and Change June 18, 2013 Diane Darbyshire, LeadingAge NY Senior

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 Allegany, Cattaraugus, Chemung, Erie, Genesee,

Livingston, Monroe, Niagara, Ontario, Orleans, Schuyler, Seneca, Steuben,

Wayne, Wyoming, Yates

May 1, 2013 Oct. 1, 2013

Region V Cayuga, Chenango, Cortland, Delaware,

Herkimer, Jefferson, Lewis, Madison, Oneida,

Onondaga, Oswego, St. Lawrence, Tioga, Tompkins

June 1, 2013 Nov. 1, 2013

Region IV Albany, Clinton, Columbia, Essex, Franklin, Fulton,

Greene, Hamilton, Montgomery, Otsego, Rensselaer, Saratoga,

Schenectady, Schoharie, Washington

July 1, 2013 Dec. 1, 2013

Region III Dutchess, Orange, Putnam, Sullivan, Ulster,

Rockland

Aug. 1, 2013 Jan. 1, 2014

Regions I & II Nassau, New York City, Suffolk, Westchester

Sept. 1, 2013 Feb. 1, 2014

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Page 4: The UAS-NY: Abound in Questions, Challenges and Change · 2013. 6. 18. · The UAS-NY: Abound in Questions, Challenges and Change June 18, 2013 Diane Darbyshire, LeadingAge NY Senior

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.

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Page 5: The UAS-NY: Abound in Questions, Challenges and Change · 2013. 6. 18. · The UAS-NY: Abound in Questions, Challenges and Change June 18, 2013 Diane Darbyshire, LeadingAge NY Senior

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

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Page 6: The UAS-NY: Abound in Questions, Challenges and Change · 2013. 6. 18. · The UAS-NY: Abound in Questions, Challenges and Change June 18, 2013 Diane Darbyshire, LeadingAge NY Senior

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

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Page 7: The UAS-NY: Abound in Questions, Challenges and Change · 2013. 6. 18. · The UAS-NY: Abound in Questions, Challenges and Change June 18, 2013 Diane Darbyshire, LeadingAge NY Senior

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

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Page 8: The UAS-NY: Abound in Questions, Challenges and Change · 2013. 6. 18. · The UAS-NY: Abound in Questions, Challenges and Change June 18, 2013 Diane Darbyshire, LeadingAge NY Senior

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

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Page 9: The UAS-NY: Abound in Questions, Challenges and Change · 2013. 6. 18. · The UAS-NY: Abound in Questions, Challenges and Change June 18, 2013 Diane Darbyshire, LeadingAge NY Senior

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

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Page 10: The UAS-NY: Abound in Questions, Challenges and Change · 2013. 6. 18. · The UAS-NY: Abound in Questions, Challenges and Change June 18, 2013 Diane Darbyshire, LeadingAge NY Senior

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)

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Page 11: The UAS-NY: Abound in Questions, Challenges and Change · 2013. 6. 18. · The UAS-NY: Abound in Questions, Challenges and Change June 18, 2013 Diane Darbyshire, LeadingAge NY Senior

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

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Page 12: The UAS-NY: Abound in Questions, Challenges and Change · 2013. 6. 18. · The UAS-NY: Abound in Questions, Challenges and Change June 18, 2013 Diane Darbyshire, LeadingAge NY Senior

DOH and LeadingAge NY webinars

• Participate

• Ask your questions – send to UAS-NY staff & copy LeadingAge NY

[email protected]

• 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

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Page 13: The UAS-NY: Abound in Questions, Challenges and Change · 2013. 6. 18. · The UAS-NY: Abound in Questions, Challenges and Change June 18, 2013 Diane Darbyshire, LeadingAge NY Senior

Resources

DOH UAS-NY Website:

http://www.health.ny.gov/health_care/medicaid/redesign/uniform_assessment_system/index.htm

LeadingAge New York site:

http://www.leadingageny.org/providers/home-and-community-based-services/best-practices-and-resources/uniform-assessment-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

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Page 14: The UAS-NY: Abound in Questions, Challenges and Change · 2013. 6. 18. · The UAS-NY: Abound in Questions, Challenges and Change June 18, 2013 Diane Darbyshire, LeadingAge NY Senior

Questions?

Contact LeadingAge NY:

Diane Darbyshire, [email protected], 518.867.8828

Anne Hill, [email protected], 518.867.8836

Linda Spokane, [email protected], 518.867.8857

Cheryl Udell, [email protected], 518.867.8871

Questions may also be emailed to:

[email protected]

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Page 15: The UAS-NY: Abound in Questions, Challenges and Change · 2013. 6. 18. · The UAS-NY: Abound in Questions, Challenges and Change June 18, 2013 Diane Darbyshire, LeadingAge NY Senior

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)

___________________________________

Education and Accreditation Administrator LeadingAge New York/FLTC 13 British American Blvd, Suite 2, Latham, NY 12110-1431

(518) 867-8383

Page 16: The UAS-NY: Abound in Questions, Challenges and Change · 2013. 6. 18. · The UAS-NY: Abound in Questions, Challenges and Change June 18, 2013 Diane Darbyshire, LeadingAge NY Senior

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)

___________________________________

Education and Accreditation Administrator LeadingAge New York/FLTC 13 British American Blvd, Suite 2, Latham, NY 12110-1431

(518) 867-8383