Transcript State Home Per Diem Program Update

National Association of
State Veterans Home
State Home Per Diem Program Update
Cyndi Kindred, Acting Deputy, Chief Business Office for Purchased Care
February 2013
Agenda
• State Home Per Diem Program Overview
• Public Law 112-154, Section 105
• Implementation Plan
• VA Consults with State Homes
• January 2013 Milestones
• February 2013 Milestones
• FY 2012 State Home Expenditures
• FY 2013 Distribution of Facilities
• FY 2013 Budget Projections
• Accomplishments
• State Home Per Diem Program Future State
• State Home Per Diem Program Contacts
• Questions for State Homes
VETERANS HEALTH ADMINISTRATION
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State Home Per Diem Program
The State Home Per Diem Program is a health care
benefit administration and payment processing
program which is managed by the VHA Chief
Business Office for Purchased Care (CBOPC)
Responsibilities for managing the State Home Program
are shared by the following Veterans Health
Administration (VHA) Offices:
• Chief Business Office for Purchased Care
• Office of Geriatrics and Extended Care
• Office of Capital Asset Management and Support
VETERANS HEALTH ADMINISTRATION
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State Home Per Diem Program Cont’d
CBOPC is responsible for managing the State Home Per
Diem Program, which includes:
1. Regulatory and national policy development related to
eligibility and per diem payment methodologies
2. Oversight of State Home Per Diem eligibility, application
authorizations, and the per diem payment program
3. Operational oversight and training for VHA and Non-VA
Stakeholders
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State Home Per Diem Program Cont’d
4. Promoting collaborative relationships with VA and Non-VA
Stakeholders by maintaining communication and
networking with program leaders through interactive
forums, such as meetings, mail groups, and national
conference calls
5. Managing the state home budgeting process, the provision
of fiscal year per diem funds to the VA Medical Centers of
Jurisdiction based on projected needs, and the provision
of supplemental per diem funds (when required)
6. Compiling products/reports that depict State Home
workloads and expenditure trends
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Public Law 112-154, Section 105
August 6, 2012: President Obama signed the law that requires
VA to enter into contracts or provider agreements to reimburse
State Veterans Homes for nursing home care provided to
Veterans that have been rated by VA as one of the following:
• The Veteran has a service-connected disability of 70 percent or
greater and needs nursing home care; or
• The Veteran has a rating of total disability based on individual
unemployability and is in need of nursing home care; or
• The Veteran is in need of nursing home care for a VA
adjudicated service-connected disability.
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Public Law 112-154, Section 105 Cont’d
• To reimburse State Homes for the care provided under
the contract (or provider agreement), payment under
each contract (or provider agreement) will be based on
methodology developed by the VA Secretary in
consultation with State Veterans Homes.
• Effective February 2, 2013: All nursing home care
provided in State Veterans Homes for specific serviceconnected Veterans in need of nursing home care must
be paid for under a contract or provider agreement.
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Implementation Plan
• The State Home Per Diem Program Office executed
the following actions to meet the February 2, 2013
implementation due date:
 August 28, 2012: Established a VHA Implementation
Working Group and included subject matter experts
from:
•
•
•
•
•
VA Office of General Counsel
VHA Office of Regulatory Affairs
VHA Office of Procurement and Logistics
VA Office of Intergovernmental Affairs
VHA Office of Geriatrics and Extended Care
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VA Consults with State Homes
• September-December 2012: Launched the first series
of consultative meetings with State Veterans Home
Stakeholders and the VA Implementation Team.
• State Home Stakeholders included:
– State Veteran Home administrators
– National Association of State Veterans Home (NASVH)
– National Association of State Directors of Veterans
Affairs (NASDVA)
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January 2013 Milestones
• January 7, 8, & 11 2013: Provided five Public Law
Implementation training sessions for VAMCs of
Jurisdiction Per Diem Points of Contacts, Contracting
Officer Representatives (CORs), Provider Agreement
Coordinators (PACs), and separate sessions for State
Home Stakeholders.
– Over 1,100 attendees participated
– 92% overall satisfaction rating for the 6 training sessions
• January 14, 2013: Distributed the State Home Provider
Agreement to VISN Directors and Business
Implementation Managers (BIMs).
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February 2013 Milestones
• February 1, 2013: Confirmed that 133 of 134
State Veterans Homes had certified provider
agreements.
– One State Veterans Home declined to participate
• February 4, 2013: Written public comment
period closed.
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State Home Per Diem Program
FY 2012 Expenditures
The Grant Per Diem Program provides ear marked funds
to 97 VAMCs of Jurisdiction to pay per diem for State
Home Veterans
• 143 State Veterans Home Facilities
• Three programs:
• 134 Nursing home care programs (24,526 beds)
• 53 Domiciliary care programs (5,801 beds)
• 2 Adult day health care programs (85 slots)
• Costs:
• FY 2011: $823,693,587
• FY 2012: $851,046,624
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Bed Distribution FY 2013
Programs
1%
28%
24, 526 Nursing Home
5,801 Domiciliary
71%
VETERANS HEALTH ADMINISTRATION
85 Adult Day Health Care
State Home Per Diem
FY 2013 Budget Projections
SH Domiciliary (DOM):
SH Nursing (BASIC) NHC:
SH Nursing Higher (P1) NHC:
SH Adult Day Health Care (ADHC):
$57,534,147
$653,303,911
$269,358,375
$1,009,311
TOTAL :
$1,005,735,888
VETERANS HEALTH ADMINISTRATION
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Accomplishments
•
•
•
•
Educational Fact Sheets
Contract Solicitation
VAMC Training 2013
Monthly education conference calls (2011)
– Bi-monthly in FY 2013
• Customer Service Support (Ongoing)
• Field Assistance Visits/VAMC training calls
• Public Law 112-154, Section 105
– Contracts and Agreements
• Designation as State Home Program Liaison
• 2013 Per Diem Rates
VETERANS HEALTH ADMINISTRATION
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Future State: FY 2013 - 2014
• Revise State Home Per Diem Handbook
• VAMC training, State Home Procedure Guides, Desk
Procedures, and Quick Reference Guide
• Revised Regulation
– 12 calendar day admission rule
•
•
•
•
Revised VA State Home Memorandum of Understanding
Automated 10-10SH and 10-5588 forms
Revised 10-10SH, 10-5588, & 10-5588A (Retro Payments)
Electronic Invoicing
– New deadline of April 1, 2013
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State Home Per Diem Program
Contacts
Kelly J. Schneider
State Home Per Diem Program Manager
[email protected]
(308)389-5106 or (402)613-2379
Gloria J. Sanford
Deputy Program Manager
[email protected]
(303) 331-7856
Brenda Wiggins
Program Analyst
[email protected]
(202) 461-6757
Jeanne Crook
Program Specialist
[email protected]
(303) 398-5224
Gloria Testa
Budget Analyst
[email protected]
(303) 398-5573
Gus Harris
Program Specialist
[email protected]
(303) 398-4761
Stephanie Haddock
Administrative Support
[email protected]
(303) 331-7504
VETERANS HEALTH ADMINISTRATION
Michelle Slusser
Project Manager
[email protected]
(303) 780-4826
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Questions for State Homes
• Do you anticipate the number of highly serviceconnected Veteran admissions to increase
significantly over the next several years?
– What factors are driving the increased admissions?
• Do you anticipate State Homes to open adult day
health care programs in the next several years?
– What State Homes are interested?
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Thank You!
VETERANS HEALTH ADMINISTRATION