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2. Today's Topics. A recap on the AAL waiverWhere AAL is in the Legislative processEffects of budget cutsUpdate on results of QMR for last year Training on the provider enrollment processRoutine training resources available to providers . 3. Today's Topics. A recap on the AAL waiverWhere AA
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1. 1 Alzheimer’s Assisted Living Waiver Update LTC Network
Spring Conference
April 2010
2. 2 Today’s Topics A recap on the AAL waiver
Where AAL is in the Legislative process
Effects of budget cuts
Update on results of QMR for last year
Training on the provider enrollment process
Routine training resources available to providers
3. 3 Today’s Topics A recap on the AAL waiver
Where AAL is in the Legislative process
Effects of budget cuts
Update on results of QMR for last year
Training on the provider enrollment process
Routine training resources available to providers
4. 4 AAL Overview
Allows participants to:
Remain in a home-like setting for as long as possible
Maximizes their autonomy, privacy, and dignity, even if they require a high level of services
Provide relief for family caregivers
5. 5 Admission criteria
6. 6 Admission criteria Diagnosis Defined by:
A physician or psychologist for Alzheimer’s disease or related dementia (using the clinical guidelines) defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV)
Must not have a diagnosis of mental retardation /intellectual disability as defined by the American Association on Intellectual Disability or a serious mental illness as defined in 42 CFR 483.102(b)
7. 7 Reside in or be seeking admission to a safe, secure unit of a VDSS licensed assisted living facility, that has a DMAS provider agreement
Be eligible / receiving an Auxiliary Grant;
Qualifying Criteria
8. 8 Today’s Topics A recap on the AAL waiver
Where AAL is in the Legislative process
Effects of budget cuts
Update on results of QMR for last year
Training on the provider enrollment process
Routine training resources available to providers
9. 9 Summary of Proposed Changes
10. 10 Current Status of Proposed Regs
11. 11 Normal Regulatory Process Three significant steps
NORA
Proposed
Final
Items effecting Process
General Assembly session
New Administrations
Typical time Line 18-24 months
NOIRA ended 7/8/09
Started Proposed August 2009 got to Governors desk and back to Secretaries desk
Current goal for completion
12/10
12. 12 Today’s Topics A recap on the AAL waiver
Where AAL is in the Legislative process
Effects of budget cuts
Update on results of QMR for last year
Training on the provider enrollment process
Routine training resources available to providers
13. 13 Medicaid Funding for AAL It was a difficult time for maintaining funding
FMAP funding had significant impact
How long will it last ?
Auxiliary Grant Funding was effected
Details from DSS
14. 14 Budget Reductions: Long Term Care FMAP Delayed proposed cuts in:
Reduce rates for Home and Community-Based Care (HCBC) waiver services by five percent
Freeze enrollment in HCBC waivers for one year, beginning
Jan 1, 2011
250 new ID Waiver slots added
Reduce allowable hours for respite services from
720/year to 240/year
Assistive Technology (AT) and Environmental (EM) will be reduced to $3,000 per year from $5,000 per year.
Allowable monthly income for waiver eligibility would be reduced to 250% of SSI.
Current monthly income allowed is $2,022 (300% of SS).
Reduced to $1,685 ($250% of SSI).
15. 15 Budget Reductions: Long Term Care Continued Non FMAP Related Reductions
Maintain nursing facility rates at FY 2010 level (no inflation)
Eliminate Intensive & Regular and Assisted Living Programs
3.1 million DMAS administrative reductions
16. 16 Today’s Topics A recap on the AAL waiver
Where AAL is in the Legislative process
Effects of budget cuts
Update on results of QMR for last year
Training on the provider enrollment process
Routine training resources available to providers
17. 17 Results of 2009 QMR’s
Three out of four providers required a corrective action plan due to lack of staff training and staff license issues.
18. 18 AAL Cycle of Documentation
19. 19 Top (10) Technical Assistance Areas: Staff working in secured unit who had not received or completed the 12hr dementia-specific training within 30 days of their hire date.
Staff working in secured unit who had not received eight hours of dementia-specific training annually.
Staff working with AAL waiver participants on the secured unit who were not (CNA) certified nurse aide.
Some Participants did not have a UAI completed annually.
ISP (Individualized Service Plan) not reviewed quarterly.
Some participant’s therapeutic and recreational objectives were not individualized.
Some of the ISP’s did not contain the one to one activity
The Comprehensive assessment was not completed by an RN
One participant had a diagnosis of MR.
Some AAL waiver participants did not receive their one hour per week of one to one activities.
20. 20 Discharge Notice New form
Key Area’s
Name of resident
Medicaid number
Date of Discharge
Reason for discharge
Signature of ALF Employee
21. 21 Today’s Topics A recap on the AAL waiver
Where AAL is in the Legislative process
Effects of budget cuts
Update on results of QMR for last year
Training on the provider enrollment process
Routine training resources available to providers
22. 22 Path to Becoming AnAlzheimer’s Assisted Living Waiver Provider Be enrolled with the Department of Social Services to participate in the Auxiliary Grant Program
Contact
Virginia Department of Social Services Division of Finance 7 N. Eighth Street Richmond, VA 23219 (800) 726-7252
Visit http://www.dss.virginia.gov/family/as/auxgrant.html
Become a Medicaid Assisted Living Facility Provider if not one already
Click on www.dmas.virginia.gov and go to Provider Enrollment for an enrollment package or
Call 888.829.5373
23. 23 Path to Becoming AnAlzheimer’s Assisted Living Waiver Provider (continued) Be designated as a Safe and Secure unit by the Department of Social Services
Contact your Local DSS Licensing Division to obtain criteria and procedure required to obtain the designation
Complete and submit the DMAS-482 Request to be Screened as a Provider for the Alzheimer’s Assisted Living Waiver
Can be obtained from forms section at www.dmas.virginia.gov
Can be requested by calling 804.225.4222
Call 804.225.4222 to schedule a conference call to review your packet.
Call 804-225.4222 should there be any questions during the process
24. 24 What can delay your Participant enrollment
Submission of incomplete packages (use the Alzheimer’s Waiver Participant Application Package check-off sheet)
Not calling Long Term Care Division with questions before you mail your enrollment package.
Failure to watch the Alzheimer’s documentation Web-Ex training.
25. 25 Today’s Topics A recap on the AAL waiver
Where AAL is in the Legislative process
Effects of budget cuts
Update on results of QMR for last year
Training on the provider enrollment process
Routine training resources available to providers
26. 26 Training resources Your State Association
Department of Social Services
Licensing
Auxiliary Grants
Department of Medical Assistance Services
Web site
Learning Network (Long Term Care)
Helpdesk
Division of Long-Term Care
Technical Assistance
27. 27 DMAS Training Resources As of October 2009 providers can go to https://dmas.webex.com, click on recorded session. Scroll down to Alzheimer’s Assisted Living (AAL) documentation. This Web-Ex will give provider information regarding AAL waiver criteria, and forms needed to enroll participants into the AAL Waiver.
Providers can also go to www.dmas.virginia.gov , click on Long Term Care – Waiver Services on the left side of the screen. Click on Waiver services at the top of the page. Providers will see an overview of the AAL Waiver and a link to the current AAL Waiver Regulations.
Providers receive training during their (QMR) quality management review as needed or requested.
All New AAL Waiver Providers will receive AAL Waiver Regulations training at the time of the initial on-site visit prior to enrolling participants, or prior to Provider Enrollment if needed.
Up Coming Training Resources:
Web-Ex training on how to complete the annual level of care (LOC) form is scheduled for April 2010
28. 28 Contact InformationDivision of Long-Term Care
Division Director
Terry Smith
804-371-8490
Alzheimer’s Waiver Program Manager
Steve Ankiel
804-371-8894
Supervisor AAL
Deborah Pegram
804-371-2912
Lead AAL Waiver Analyst
Thelma Thomas
804-786-0167
Long-Term Care
Phone 804-225-4222 Fax number 804-612-0050
29. 29 Alzheimer’s Assisted Living Waiver Thanks for your time and your interest in the Alzheimer's Assisted Living Waiver
30. 30 Alzheimer’s Assisted Living Waiver
Any
remaining questions?