Aging and People with Disabilities October 1, 2017 Program Changes - PowerPoint PPT Presentation

Aging and People with Disabilities October 1, 2017 Program Changes Presented by APD Central Office Staff

Presentation Goals • This presentation is to provide a general overview of the changes that are scheduled to occur on October 1, 2017 • Consider how the changes will impact the work that is currently completed

List of October 1, 2017 Program Changes • Two Week Authorizations • Final Live-in to Hourly Services Transition • In-Home Hours Adjustments • Assessment Changes to the ADLs – Transition Services

Managing Change “Change is the law of life and those who look only to the past or present are certain to miss the future.” - John F. Kennedy “Without accepting the fact that everything changes, we cannot find perfect composure. But unfortunately, although it is true, it is difficult for us to accept it. Because we cannot accept the truth of transience, we suffer .” - Shunryu Suzuki

Why are all these changes occurring on October 1? • APD Budget is built on the changes occurring on October 1 st • IT staff and resources will be unavailable for major changes after October • Ease of transition for two week pay periods (October 1 st is a Sunday)

Two Week Authorizations • What: All HCWs will have vouchers authorized every two weeks (including In-Home Services, SPPC, and OPI).* • This will be implemented with the pay period starting October 1, 2017 • This does not impact other authorizations (i.e. CBC, Nursing Facilities, Adult Day Services, etc.) *This change also impacts In-Home Care Agency authorizations in MMIS.

Two Week Authorizations • Benefits: – HCWs and consumers will be able to better manage 40 or 50 hour weekly caps – The same number of hours will be authorized for the same number of days • Reduced branch voucher issues with HCWs working more hours than authorized • HCW scheduling is simplified for the consumer and HCW • Service Planning is easier • Expected Outcomes: – An adjustment period is anticipated as staff, consumers, and HCWs become accustomed to the changes

Two Week Authorizations • Please Note: – Service Planning must change. If a benefit ends at the end of the month, a voucher will not issue if the dates cross into next month. • For example, if the pay period spans from Oct 29 – Nov 11, and the benefit ends on Oct 31, a voucher will not issue until a new service plan is developed or the previous service plan is extended out. – The mainframe will convert the hours for each HCW prior to the October 1 pay period starting.

Two Week Authorizations • Please Note (continued): – When a service plan changes, it is possible that rounding in Oregon Access and the mainframe may have a slight difference in the number of hours authorized. Please avoid any accidental reduction in hours with service plan changes. – Some HCWs and consumers may think their hours are being reduced. The hours are lower because there are less days in a pay period. – There are currently 24 pay periods per year. This will change to 26 pay periods per year.

Live-in to Hourly Services Transition • What: The Live-in service option is no longer available (previously announced in APD-PT-17- 19). • Everyone receiving the live-in service option must have a different service plan in place by October 1, 2017. This does not pertain to OPI.

Live-in to Hourly Services Transition • Benefits: – Case Managers will no longer need to determine eligibility for the program – Easier to develop cost effective service plans • Expected Impact: – Approximately 300 consumers (combined in ICP and In-Home) will transition to a new service plan – Most HCWs working 7 days per week will transition to working 50 hours per week or into ICP, resulting in reduced overtime costs

Live-in to Hourly Services Transition • Please Note: – Consumers with live-in service plans will be approved for an exception of up to 12 hours per day (372 a month) for the first year – Exceptions above that limit or requests for exceptions to the 50 hour cap will be considered on a case by case basis by applying current policy – Service plans with exceptions must submitted no later than July 31, 2017. – Staff should initially offer plans to consumers that stay within limits of APD-PT-17-19 if it meets their needs – Consumers who do not want new HCWs should consider ICP

In-Home Hours Adjustments • What: – Maximum hours allowed in most ADL and IADL categories will be changed based upon APD analysis of time and motion study and other reports (this does not impact OPI or SPPC programs) • Implementation will occur on assessments w/ new service plans created on October 1, 2017 or later (please make sure the CA/PS is created if the assessment took place prior to implementation).

In-Home Hours Adjustments • Benefits: – Allows for more appropriate authorization of service hours – Balance service needs and ensure program integrity

In-Home Hours Adjustments • Expected Outcomes: – Hours will reduce for most in-home consumers. This will most likely result in increased administrative hearings. • Please Note: – Staff may be tempted to keep the hours the same as a previous assessment by requesting exception hours. Unless an exception is warranted, these exceptions should not be approved

Assessment Changes • What: The ADL rules are being changed • Why: – To better reflect individuals requiring nursing facility level of care. – Help CMs assess consistently – Make sure that assessment criteria meets policy intent – Address issues raised by hearings and QA

Assessment Changes • Specific Changes: – All ADLs will be updated. – Ensures terms are used consistently (i.e., tasks) – Physical ADLs will see an increase in the minimum frequency – Some tasks are being eliminated, moved or reworded – The eight Cognition components are being replaced by four new Cognition ADLs • Implementation will occur on assessments created on October 1, 2017 or later (please make sure the CA/PS is created if the assessment took place prior to implementation).

Assessment Changes • Benefits: – Better Cognition assessment – Tasks moved to areas for easier assessment flow (i.e. transferring off of Toilet considered in Transfers instead of Toileting) – Anticipated increase in assessment accuracy

Assessment Changes • Expected Impact: – An estimated 4% of current consumers will not meet new ADL requirements – Some consumers that have cognitive needs but did not meet Full Assist in Cognition criteria may meet new criteria • Please Note: – Consumers must be assessed accurately with these rule changes on or after October 1, 2017 – Transition services must be considered for consumers that do not qualify for services

Transition Services • Transition Services are being looked at for individuals that do not meet the new assessment criteria • They are currently being discussed with CMS. • Announcement of the available transition service options will be made soon

Next Steps • Training and additional communication will be provided on each topic • Conference calls will be scheduled to allow staff to ask questions and receive clarifications on the changes being made • Huddle topics will provided to discuss with staff • Additional conversation around these changes will occur at the Field Leadership meeting on July 27, 2017

Feedback • Please provide any feedback or questions regarding this change to your manager. Thank you for supporting these upcoming changes!