Transcript Slide 1

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
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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
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, DSS4449C
• 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
Broome, Chautauqua,
Otsego, Warren
March 2013
July 1, 2013
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
Nassau, New York City,
Suffolk, Westchester
Sept. 1, 2013
Feb. 1, 2014
Pilot
MLTC plans
Regions I & II
UAS-NY Overview
• Single record for
individuals in Medicaid
Long Term Care system
• Secure web-based
software application
• Role-based system
• Housed within NYSDOH 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.
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
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?
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Face-to-face meetings
Emails
Teaching labs
Timing – timing – timing – I wish I knew in advance……….
• What is effective external communication?
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Contractors – sub-contractors for assessments
Social service districts
DOH
LeadingAge New York
UAS-NY Roles
UAS Role Name
• UAS-15
• UAS-20
• UAS-30
• UAS-35
• UAS-40
• UAS-45
• UAS-50
Generally Intended For:
Administrative Staff
Review/Consult/OT, PT, ST
Social Assessors
Social Assessor Supervisors
Nurse Assessors
Nurse Assessor Supervisors
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
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
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
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
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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)
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
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
Resources
DOH UAS-NY Website:
http://www.health.ny.gov/health_care/medicaid/redesign/unifo
rm_assessment_system/index.htm
LeadingAge New York site:
http://www.leadingageny.org/providers/home-and-communitybased-services/best-practices-and-resources/uniformassessment-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
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]