Aging and People with Disabilities July 19, 2017 OPI Power Hour - PowerPoint PPT Presentation

Aging and People with Disabilities July 19, 2017 OPI Power Hour October 1, 2017 Program Changes Created by APD and SUA 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.

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

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

Managing Change “The secret of change is to focus all of your energy. Not on fighting the old, but on building the new.” - Socrates

Why are all these changes occurring on October 1? • APD Budget is built on the changes occurring on October 1 st and the OPI program echo's APD for service eligibility and HCW payment means • IT staff and resources will be unavailable for major changes after October • Ease of transition for two week pay periods (October 1 is a Sunday)

Two Week HCW Authorizations • All HCWs will have vouchers authorized every two weeks (including In-Home Services, SPPC, and OPI)* • Work Week will always be Sunday at midnight to two weeks later midnight on Saturday • This will be implemented with the pay period starting October 1, 2017 • Moving from 24 pay periods a year to 26 pay periods a year • This does not impact other authorizations (i.e. CBC, Nursing Facilities, Adult Day Services, Home Delivered Meals, etc.) * This change also impacts Medicaid In-Home Care Agency authorizations in MMIS, but not OPI

Two Week HCW 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

Two Week HCW 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.

Two Week HCW Authorizations • Expected Outcomes: –An adjustment period is anticipated as staff, consumers, and HCWs become accustomed to the changes

Two Week HCW Authorizations • Please Note: – 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 (but more pay periods per year, 24 to now 26).

Two Week HCW Authorizations • Please Note (continued): – There are currently 24 pay periods per year. This will change to 26 pay periods per year. – The mainframe will convert the hours for each HCW prior to the October 1 st pay period starting. All HCW vouchers issued will for October 1 will be for the 1 st to the 14 th .

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.

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 or after October 1, 2017 (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 • Expected Outcomes: – Hours will reduce for most in-home consumers. This will most likely result in increased Medicaid hearings.

Assessment Changes • What: The Long-Term Service Priorities/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

Assessment Changes • Implementation will occur on assessments created on or later than October 1, 2017 (please make sure the CA/PS is created if the assessment took place prior to implementation) • 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 • Transition Services are being looked at for Medicaid service recipients 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

Feedback • Please provide any feedback or questions regarding this change to Sandy Abrams at sandy.h.abrams@state.or.us or 503-947- 2391 Thank you for supporting these upcoming changes!