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CMS Review

Centers for Medicare and Medicaid Services (CMS) Focused Review of Senior and Disabilities Services Medicaid waiver and Personal Care Assistance programs

QA Reports

These documents contain the division’s first Quality Assurance Report on the SDS Performance Measures to CMS. This report will be submitted monthly until such time as CMS determines less frequent reporting is necessary. Additional refinements will be made to the reports in subsequent submissions.

CMS Review Correspondence

General Information

Resource & Referral Agencies

Provider Information

Press Releases

CMS Provider E-Alerts

SDS e-Alert

03/04/2010

Revised DRAFT Corrective Action Plan Submitted to the Centers for Medicare and Medicaid Services

The Division of Senior and Disabilities Services (SDS), in collaboration with technical assistance from National Quality Enterprise (NQE), resubmitted a revised Corrective Action Plan (CAP) to the Centers for Medicare and Medicaid Services (CMS) on January 15, 2010. This plan was created in response to feedback received from CMS requesting additional information and clarification.

Revisions to this draft action plan are anticipated and will evolve from ongoing discussion between SDS, CMS, and NQE technical assistants. It would be premature to comment on specific components of this document while formal discussions with CMS are ongoing. SDS will provide updates on the web and via SDS E-Alerts as matters are resolved and formalized with CMS.

Providers and Medicaid recipients with questions may contact Angela Salerno at 465-4874, or angela.salerno@alaska.gov

New DRAFT CAP

09/22/2009

Corrective Action Plan Submitted to the Centers for Medicare and Medicaid Services

The Division of Senior and Disabilities Services (SDS), in collaboration with technical assistance from National Quality Enterprise (NQE), submitted the initial Corrective Action Plan (CAP) to the Centers for Medicare and Medicaid Services (CMS) on September 3, 2009. This plan was created in response to preliminary findings outlined to the State of Alaska on June 26, 2009 regarding Quality Improvement Strategies and sub assurances found in Waiver Application Version 3.5. Revisions to this action plan are to be anticipated and will evolve from ongoing discussion between SDS, CMS, and NQE technical assistants.

The CAP submitted on September 3, 2009, is a preliminary document and will change significantly over the course of the next weeks and months. It would be premature to comment on specific components of this document while formal discussions with CMS are ongoing. SDS will provide updates on the web and via SDS E-Alerts as matters are resolved and formalized with CMS.

Providers and Medicaid recipients with questions may contact Angela Salerno at 465-4874, or angela.salerno@alaska.gov

Corrective Action Plan

09/16/2009

Legislative Hearing on Moratorium Rescheduled

Senator Bettye Davis, Chair of the Senate Health and Social Services Committee, has announced the rescheduling of a hearing on the CMS waiver moratorium. The hearing, originally scheduled for October 1st has been rescheduled for Tuesday, November 3rd from 1:00 until 5:00pm. A copy of the memo from Senator Davis’ office is attached.

Memo

8/28/09

– Moratorium on Home and Community-Based Medicaid Waiver Services Lifted by CMS–

On August 27th the Department of Health and Social Services received a letter from the Centers for Medicare and Medicaid Services (CMS) lifting the moratorium on Medicaid waiver services in the State of Alaska.

Attached are the CMS letter and a DHSS press release.

For questions call Angela Salerno at 465-4874 or angela.salerno@alaska.gov

8/27/09

– Emergency Consideration for Home and Community-Based Waiver Services –

The Centers for Medicare and Medicaid Services (CMS) has granted SDS request to allow an exception to the temporary hold for emergency cases. The attached Program Memo lists the approved emergency circumstances, timelines for processing an emergency request, the Request for Emergency Consideration for Home and Community Based Waiver application form, and a list of documentation requirements that must accompany the application. Also attached is a release of information form.

For questions or more information call Angela Salerno, 465-4874 or angela.salerno@alaska.gov

Program Memo

Release of Information

8/11/2009

SDS E-Alert — Changes to PCA Eligibility Criteria — 8/11/09

Today SDS released this Program Memo regarding changes to eligibility criteria for Personal Care Assistance services.

08/10/2009

  • Moratorium on PCA to be Lifted August 12th
  • Waiver Applicants Found Financially and Functionally Eligible Prior to June 27th to be Enrolled
  • SDS Program Memo: Updated Guidance for Providers
  • Clarification Regarding Adults with Physical Disabilities Waiver Transitions During Moratorium

The Centers for Medicare and Medicaid Services (CMS) moratorium on Personal Care Assistant (PCA) services will be lifted 8 a.m. Wednesday, Aug. 12. The update comes after DHSS and CMS collaborated on a thorough review of how Alaska runs PCA services. A DHSS press release is attached.

The temporary moratorium remains in place for the four Medicaid waiver programs. However, CMS clarified that individuals who were found to meet financial and functional eligibility prior to June 27th are actively enrolled in the program and are not affected by the moratorium. Please see the Aug. 7 program memo (attached) for more details.

People are encouraged to submit applications for Medicaid waiver programs so they will be ready to process as soon as the moratorium is lifted.

Waiver Transitions

Recipients that are currently receiving services via an Adults with Physical Disabilities (APD) waiver, but who will age out of the APD waiver, may apply for services to the Older Alaskans (OA) waiver.

While those individuals will not be affected by the CMS moratorium, the APD and OA waivers are separate programs and will not automatically shift from one program to another. The functional and financial eligibility for those two programs are the same and will not need to be redetermined during the transition year. However, effective immediately, one of two options must demonstrate that the planning team has discussed the transition between programs including the similarities and differences between programs as well as differentiate services to be provided.

Option #1: Transition plan year covered by a single level of care and one plan of care. The plan of care discusses the transition between programs including the similarities and differences between programs, the date of transition, and differentiates the services to be provided in each program. For example, the services are broken out separately for each waiver in the plan of care and on the cost sheet. The total duration of the transition plan year plan of care is no more than 12 months.

Option #2: Transition plan year covered by a single level of care and two plans of care. One plan of care describes the services to be provided under the APD waiver and ends the day before the recipient’s 65th birthday. The second plan of care describes the services to be provided under the OA waiver, begins on the recipient’s 65th birthday and ends so that the combination of the two transition plans does not exceed 12 months.

With either option, an amendment must be submitted if a change in the recipient’s condition warrants a change in service level mid-plan. At this time, the moratorium is still in effect for those individuals that are considered initial or new applications to the waiver programs.

Questions can be directed to Lynne Keilman-Cruz at 269-5606 or lynne.keilman-cruz@alaska.gov.

Please refer to our web site frequently for updates about the CMS review and related activities: http://hss.state.ak.us/dsds/cmsreview/Default.htm

Thank you.

7/27/2009

– Critical Incident Reporting Training Schedule for August, September and October –

SDS requires all Medicaid waiver service providers receive training on Critical Incident Reporting and Critical Incident Improvement Plans. This training will be offered via “GoTo Meeting” throughout August, September and October, 2009.

SDS assures the federal Centers for Medicare and Medicaid (CMS) that recipients of Medicaid waiver services are safe and healthy in their homes and communities. Critical incident reporting by providers of waiver services is one important way of carrying out this mandate. In addition, the collection and aggregation of critical incident data by SDS allows the agency to track trends and identify gaps in services. Also, critical incident reporting offers the opportunity for greater communication between providers and SDS as well as a channel for technical assistance.

Providers may train their staff. Provider agencies may choose staff to attend the online training, and then may train additional staff at their own agency. All CIR/CIIP learning materials are available to participants upon request, after attending the online class, to use for this purpose.

Training schedule: All trainings will be held at 2 - 3:30pm

August:
Aug 14 (Friday)
Aug 19 (Wednesday)
Aug 28 (Friday)

Each Tuesday in September:
September 1
September 8
September 15
September 22
September 29

Each Tuesday in October:
October 6
October 13
October 20
October 27

About GoTo Meeting
GoTo Meeting is very easy to use. Attendees will receive an email with instructions detailing how to join the meeting online, and a link to the scheduled meeting. To hear and speak during the class, attendees will need to use a computer headset with a microphone, or call in on the telephone and participate much like a teleconference. Upon joining the meeting, everyone will be able to view the learning materials on their computer screen right at their desk.

All trainings will be from 2 until 3:30 pm. The first 5-10 minutes of each training will be used to get connected and make sure all attendees are online and can communicate with each other in the online training space.

How to register
If you are working with an agency, please communicate with your supervisor about your plan to register. All attendees may register by sending an email to Kara Thrasher-Livingston, SDS Training Specialist at: Kara.Thrasher-Livingston@alaska.gov.

Please state the day you would like to attend in the email. Each class can accommodate up to 25 attendees. You will receive a confirmation email inviting you to the GoTo Meeting. You may want to choose a second class that would work for you in case your first choice is full.

7/22/2009

CMS Review Provider and Family Suggestions Sessions – Sponsored by SDS, Governor’s Council on Disabilities and Special Education and Commission on Aging

Providers and families affected by the Waiver & PCA moratorium:

We want your input as we work with the Centers for Medicare & Medicaid Services (CMS) on our plan to improve Alaska’s Medicaid waiver and Personal Care
Assistance programs. Help us brainstorm better systems for

  • Quality assurance
  • Monitoring the health and welfare of waiver participants
  • Provider oversight
  • Preventing conflicts of interest

Please join us in person… 10 am – Noon

  • Juneau - Wednesday, July 29- Assembly Chambers
  • Fairbanks - Tuesday, August 4 - Assembly Chambers
  • Anchorage - Wednesday, August 5 - 8th floor Frontier Building
  • Kenai - Thursday, August 6 - Kenai River Center (Soldotna)

You may also access the meetings by teleconference: 1-800-315-6338. Use pass code DSDS# (3737#)

- Additional forums are planned for Bethel and Nome in August –

For details: 1-907-465-4874, or www.hss.state.ak.us/dsds/cmsreview
If you cannot attend, please send us your comments at the new SDS Policy Mailbox

hss.dsds.policy@alaska.gov

FLYER

7/21/2009

Clarification Regarding CCMC Transitions During the Moratoruim

Senior and Disabilities Services has received clarification from the Center for Medicaid and Medicare Services (CMS) regarding the transition of recipients aging out of the Children with Complex Medical Conditions (CCMC) waiver. Recipients that are currently receiving services via a CCMC waiver, but who will age out of the CCMC waiver may apply for services to the Adult with Physical Disabilities (APD) waiver or the Mental Retardation and Developmental Disabilities (MRDD) waiver. Those applications can be processed and those individuals will not be affected by the CMS moratorium. The recipient must still meet functional eligibility criteria for the waiver that they are applying for.

At this time, the moratorium is still in effect for those individuals that are considered initial or new applications to the CCMC waiver and for others in transition situations. Senior and Disabilities Services continues to seek clarification from CMS on other circumstances related to the moratorium, and updates will be provided as clarification is received.

Please refer to our web site frequently for updates about the CMS review and related activities: http://hss.state.ak.us/dsds/cmsreview/Default.htm

Thank you.

Clarification RE: Accepting/Tracking Applicants during the Moratorium — 7/15/09

To ensure that SDS can track and refer applicants in need of services during the moratorium, SDS will accept completed new applications. However, except for tracking and reviewing for completeness, no action will be taken to process them during the moratorium.

Incomplete applications will be returned to the applicant. Applicants affected by the moratorium will be notified by mail. Those notices will begin this week. When an application is able to be processed, either upon clarification from CMS or a lifting of the moratorium, the applicant will be re-noticed with that information and the application processed. The care coordinator or PCA agency of record will be courtesy copied with those notices.

Please refer to our web site frequently for updates about the CMS review and related activities: http://www.hss.state.ak.us/dsds/cmsreview/Default.htm.

CMS Preliminary Report and SDS Response Available on DHSS WebSDS to Host Informational Teleconferences — 7/13/09

The Department of Health and Social Services has released the following press release along with the CMS Preliminary Report and the SDS response on the SDS website. For additional information, SDS will host two teleconferences on Tuesday, July 14th and Wednesday July 15th from 10:00 until 11:00 am. To reach the teleconferences: 1-800-315-6338. Use pass code DSDS# (3737#).

Temporary Moratorium on some Medicaid Applications and Enrollment — 7/1/09

The Department of Health and Social Services released the following press release today and SDS has issued the attached Program Memo.