Quick Links. . .
• Alliance for Leadership & Education • CBAS • CCI / Cal MediConnect
• Legal • Member Associates (Vendors, Consultants, Health Plans, Networks)
Top-of-Mind . . .
CAADS FALL CONFERENCE -- THE QUALITY IMPERATIVE
NOV 16-18 | Anaheim Marriott Suites | Garden Grove, CA
HOTEL DEADLINE: 10/25/16. To book a room ($115, plus taxes), at the Anaheim Marriott Suites click here. Conference schedule and session details available in September.
CBAS CERTIFICATION FOR NEW ADHC CENTERS
The California Department of Aging (CDA) is accepting requests from prospective applicants to begin the process to be certified to provide Community Based Adult Services (CBAS). CAADS members click here and use Handouts from Events/Webinars Quick Link for NOV 18, 2015 course, Pre-Screening & Application Process for the Certification of New CBAS Centers. To learn about membership in CAADS, click here.
HELP II LOAN PROGRAM -- AFFORDABLE CAPITAL
The HELP II Loan Program, administered by the California Health Facilities Financing Authority (CHFFA) within the State Treasurer’s Office, offers low cost loans to assist eligible health facilities wanting to expand and improve services to their clients and the greater community. Learn more at www.treasurer.ca.gov/chffa/programs/help.
What's New . . . July 1, 2016
CCI COMPREHENSIVE STRATEGY UPDATE
July 1, 2016 | Health Care Delivery Systems, Department of Health Care Services
Earlier this year, the Department of Health Care Services (DHCS) shared for stakeholder comment a comprehensive strategy for the Coordinated Care Initiative (CCI). This strategy focused on improving the quality of care and care coordination beneficiaries receive through Cal MediConnect, ensuring that beneficiary satisfaction remains high and increases, and generating sustainability for the program. After considerable feedback from stakeholders, DHCS announced final policy decisions in May. Today, DHCS is sharing an update on these policy decisions, as well as an additional document for stakeholder comment.
Voluntary Enrollment Strategy
DHCS announced its intent to pursue a robust voluntary "opt-in" enrollment effort for the remainder of 2016. Today, DHCS is releasing its DRAFT Cal MediConnect Voluntary Enrollment Strategy for stakeholder comment. It is available here.
This strategy, designed to expand awareness of Cal MediConnect and encourage voluntary enrollment, builds on activities DHCS and its partners are already conducting. This strategy also incorporates many of the lessons learned about how best to reach and educate beneficiaries and providers about the CCI and Cal MediConnect. These strategies include streamlined enrollment and mandatory Medi-Cal plan enrollment for managed long-term services and supports (MLTSS).
DHCS is soliciting feedback from stakeholders on the activities included in this strategy, as well as additional activities Cal MediConnect partners can pursue. Feedback is due Thursday, July 14, 2016.
Standardized LTSS HRA Questions & Data Measures
DHCS announced that it would strengthen LTSS referrals and improve care coordination by standardizing the Health Risk Assessment (HRA) referral questions for LTSS to reflect the best practices developed over the early years of the program and expanding data collection and reporting. MORE
Special Report: Meeting the Legal Needs of LGBT Seniors
JUN 22, 2016 | Justice in Aging Health Network Alert
Legal services organizations play a crucial role in alleviating the effects of poverty for low-income older Americans. However, not all low-income older adults have the same legal needs, not all will seek out help on their own, and for diverse groups, culturally competent service is key to meeting their needs.
How Can Legal Services Better Meet the Needs of Low-Income LGBT Seniors? is a new Special Report by Justice in Aging, produced in partnership with Services and Advocacy for Gay, Lesbian, Bisexual, & Transgender Elders (SAGE). This report explains why LGBT older adults have higher rates of poverty, outlines how discrimination and other factors lead to unique legal needs, and provides practical tips for outreach, intakes, and providing culturally competent legal services to LGBT older adults.
STOP THE THREAT TO SHIP PROGRAM FUNDING
State Health Insurance Assistance programs provide local help for people with Medicare
JUN 21, 2016 | Justice in Aging Health Network Alert
The Senate Appropriations Committee shocked advocates last week by approving a bill that would entirely eliminate funding for State Health Insurance Programs (SHIPs). The Senate bill now goes to the House Appropriations Committee.
SHIPs in every state provide vital one-on-one benefit counseling to people with Medicare, helping them choose Medicare plans and navigate denials. They assist low income Medicare beneficiaries in accessing programs that lower their costs, such as Medicare Savings Programs and the Low Income Subsidy, and in using those programs effectively. For example, in 2015, SHIPs served over 1 million beneficiaries with one-on-one assistance during the Medicare Open Enrollment Period. Losing SHIPs would be a major blow to the people we all serve.
Now is a good time for your Senators and Representatives to hear from you. Use our Action Alert to contact members of the House of Representatives and urge them to reject the Senate proposal and invest in SHIPs. For more information, this Kaiser Health News article explains the potential consequences of a loss in funding, and The National Council on Aging (NCOA) also prepared an issue brief on SHIP funding.
Make your voice heard and let the House know how important SHIPs are for Medicare beneficiaries.
New Report: Moving Medi-Cal Forward on the Path to Delivery System Transformation
JUN 21, 2016 | California Health Care Foundation
Today the California Health Care Foundation (CHCF) released Moving Medi-Cal Forward on the Path to Delivery System Transformation. The report, commissioned by CHCF and written by Manatt Health, explores the reforms that are needed to ensure that Medi-Cal consistently delivers excellent access, quality, and patient experience while using resources efficiently.
Manatt conducted a landscape review and in-depth interviews with a diverse array of over 50 Medi-Cal stakeholders and thought leaders. The report assesses key challenges and opportunities in Medi-Cal, establishes a vision for delivery system reform, and articulates a path forward. Topics discussed include capitation rates, behavioral health, workforce shortages, access to providers, and more. See the report.
In the latest CHCF blog, Chris Perrone, director of Improving Access at CHCF, shares his key takeaways from the paper. Read the blog.
CHCF will hold a briefing in Sacramento on Wednesday, July 13 to discuss the report's findings. Register for the briefing.
LawHelpCA.org News Features Advance Planning, Scam Alerts
JUN 3, 2016 | LawHelpCA.org
LawHelpCA is a statewide resource for legal information and referrals. This issue of LawHelpCA.org News features:
Mental Health Access for Persons with Dementia
JUN 2016 | Prepared for the Alzheimer's Association by Cordula Dick-Muehlke, PhD, Cordula Cares
As this paper, Mental Health Services for Californians with Alzheimer's Disease, proposes, California has a number of timely opportunities to improve access to mental health services for people with dementia, beginning at the point of diagnosis. An urgent need exists to pursue such opportunities immediately to prevent the types of crises presented here, enable families to stay together, improve quality of life, and reduce the cost of care.
Investing in Patient Access, Improving Economic Productivity
JUN 2016 | Bay Area Council Economic Institute | Executive Summary | Full Report (PDF)
Medi-Cal is massive. It covers over 13 million people, more than the entire population of every state except Texas, New York, and Florida. As California’s state Medicaid program, it finances healthcare access for low-income children and adults as well as pays for a great deal of care for seniors and the disabled.
Because Medi-Cal is the provider of healthcare coverage for such a large percentage of the state’s population and the second-largest item in the state budget, it is critical to understand the growth of Medi-Cal over time, its economic and social benefits, and its strengths and weaknesses.
Suicide Safe Wins FedHealthIT Innovation Award
2016 | Substance Abuse & Mental Health Services Administration (SAMHSA) | Full Announcement
SAMHSA's Suicide Safe mobile app has won the FedHealthIT Innovation Award in the Mobile Category! This award recognizes an agency's efforts to solve some of the most pressing issues through innovative ideas and solutions.
The Centers for Disease Control and Prevention recently reported that suicide rates went up in almost every demographic category between 1999 and 2014. Overall, the age-adjusted suicide rate in the United States was 24 percent higher in 2014 than in 1999.
Medical professionals can play a critical role in connecting individuals to care if they are at risk of suicide. About 45 percent of people who die by suicide have visited a primary care provider in the month before their death, and 20 percent have had contact with mental health services.
Suicide Safe puts SAMHSA's suicide prevention resources at health care providers' fingertips through a free mobile app for mobile devices and optimized for tablets. The app helps medical professionals identify suicide risk factors in their patients and connect them with mental health care.
Download Suicide Safe Today
Free for Apple® and Android™ devices.
MOBILE RESOURCES TO SUPPORT BEHAVIORAL HEALTH
SAMHSA has free, mobile resources that can help address some of the toughest mental health and substance use challenges, including suicide prevention, bullying prevention, behavioral health following a disaster, and underage drinking prevention.
Learn More and Download SAMHSA's Free Mobile Apps
New Federal Regulation Enhances Protections in Health Care Services and Settings for Diverse Older Adults
JUN 2, 2016 | Justice in Aging Health Network Alert
After much anticipation, the U.S. Department of Health and Human Services (HHS) recently released final regulations that seek to transform care for underserved communities by ending discrimination in health care services and settings.
The regulations codify Section 1557 of the Affordable Care Act (ACA). In drafting the statute, Congress recognized the need to ensure all individuals have access to health services and insurance, regardless of their race, color, national origin, sex, age, or disability. It applies to every health program or activity that receives HHS funding, including Medicare and Medicaid managed care plans, aging network entities like home health care agencies, health clinics, community health centers, and most physicians. HHS itself and state Medicaid and public health agencies also are covered. The final rule is effective July 18, 2016, with additional time available only in limited circumstances.
The regulation will enhance protections for diverse older adults in several key ways, including:
- enhanced language access requirements,
- prohibits discrimination on the basis of sex, and
- ensures a private right of action for 1557 violations.
Read the full post with more insights on our blog.
Justice in Aging will be offering a webinar and publication on the new 1557 regulations in the coming months – stay tuned!
How SSA Can Improve the Representative Payee Program to Protect Vulnerable Seniors
JUN 1, 2016 | Justice in Aging Income Network Alert
Social Security’s Representative Payee Program is crucial to protecting the resources and economic security of vulnerable older adults who cannot manage their own finances. It is also inadequate to meet the growing needs of older adults and has a number of problems in both its capability determination process and in the way the overall program is administered.
This Issue Brief, How SSA Can Improve the Representative Payee Program to Protect Vulnerable Seniors, is the final paper in a series that Justice in Aging has produced with the support of a fellowship grant from the Borchard Foundation on Law and Aging.
This issue brief offers a brief explanation of the program, and outlines the major issues facing the program with recommendations for fixing those issues. The brief then talks about the more specific reforms needed and offers specific recommendations for advocates to use when pushing for reforms.
Justice in Aging will also be hosting a webinar on this topic in late July so stay tuned for that announcement. You can access the full toolkit of Justice in Aging resources on the Rep Payee program here.
Cal Duals Update
MAY 2016 Update (PDF) (Word) | CalDuals.org (5/25/2016)
Voluntary Means Voluntary: Coordinating Medicaid HCBS with Family Assistance
MAY 2016 | Issue Brief | Justice in Aging
When an older adult can no longer can live independently, and is eligible for Medicaid, he or she often qualifies for home and community-based services (HCBS) that enable the individual to stay at home, rather than move to a nursing facility or other health care institution. The same is true for persons with disabilities. HCBS are provided under a service plan; under federal Medicaid regulations effective since March 2014, those service plans cannot compel unpaid assistance by family members such as adult children. MORE
Just-in-Time Advocacy Convinces California to Adopt Voluntary Enrollment Strategy for Duals
MAY 2016 | Justice in Aging
Quick action by Justice in Aging prevented more than 100,000 low-income, high health need California dual eligibles from being passively enrolled in new health plans without their knowledge or consent. In May, the state proposed passively enrolling beneficiaries in six counties into California’s Coordinated Care Initiative (CCI). Though coordinated care shows great promise for dual eligibles, passive enrollment can cause beneficiary confusion and lead to service disruptions. We responded quickly by working with other advocates to propose an alternative, voluntary enrollment strategy and submitted comments to the state that were signed by more than 30 groups. The state reversed its policy and announced a voluntary strategy instead. California Healthline reported on the story. A shorter version of the comments can be found here.
New Regulation Prohibits Discrimination in Health Care: Key Highlights for Aging Advocates
MAY 31, 2016 | Faye Gordon, Staff Attorney, Justice in Aging
Aging advocates working to promote health equity got some good news and extensive summer reading last week. After much anticipation, the U.S. Department of Health and Human Services (HHS) released final regulations that seek to transform care for underserved communities by ending discrimination in health care services and settings. MORE
Meeting the Mental Health Needs of Dual Eligibles: An Opportunity for Advocates
MAY 24, 2016 | Denny Chan, Justice in Aging
The mental health needs of seniors and persons with disabilities who are dually eligible for Medicare and Medicaid are often overlooked in traditional medical settings, ramping up costs and leading to inadequate care. About 44% of dual eligibles have at least one mental or cognitive condition, while more than half of all Medicare inpatient psychiatric facility patients are duals. Stigma and inadequate screening mechanisms prevent beneficiaries from accessing behavioral health services. These needs affect some groups within the dual eligible population disproportionately. For example, nearly half of the under-65 dual eligible population have severe mental disorders, and this group’s health care costs are about double compared to young duals without severe mental health needs. MORE
New Federal Regulation Will Help Ensure All Older Adults and People with Disabilities Can Access Health Care and Services Without Fear of Discrimination
MAY 23, 2016 | Justice in Aging Health Network Alert
Last week, the Department of Health and Human Services (HHS) released the final rule implementing the non-discrimination provisions of the Affordable Care Act, otherwise known as Section 1557. This long-awaited regulation marks an important step in fighting discrimination in health care services for many different populations.
Both the statute and the rule interpreting it explicitly prohibit discrimination on the basis of race, color, national origin, sex, disability, and age. Section 1557 is the first federal civil rights law to prohibit discrimination on the basis of sex in health care, and the final rule interprets sex to include transgender individuals. Section 1557's protections apply to entities engaged in health services or health insurance coverage who receive funding from HHS. These include many who serve low-income seniors, like agencies within HHS - the Center for Medicaid and Medicare Services (CMS) - as well as Medicare and Medicaid providers and managed care plans.
Justice in Aging provided comments on the proposed regulation last year and will soon provide an analysis of the final rule from the perspectives of Medicare beneficiaries and those who serve older adults.
Expanded FLSA Overtime Standards to be Effective DEC 1, 2016
MAY 20, 2016 | National Adult Day Services Association (NADSA)
On May 18th the President and the Department of Labor announced changes to the Federal Fair Labor Standards Act (FLSA) regulations. Dubbed the “White Collar Overtime” rule, the new regulations will expand present overtime protections by increasing the salary levels under which they will apply. Initially, this expansion is expected to encompass approximately four-million employees nationally.
Generally, the Rule affects executive, administrative, professional, outside sales, and computer employees by raising the salary and compensation base under which these employees either must be paid overtime for more than 40 hours of work per week or must be given reduced hours.
The new base for most employees will be $913/wk (from $455/wk) and for Highly Compensated Employees it will be $134,004/yr (from $100,000/yr). The formal Rule is scheduled for publication in the Federal Register on May 23rd and will become effective on December 1, 2016.
Please visit the Department of Labor Blog for more information and to access additional links for specific information categories. If you are interested in how this rule effects non-profits, click here.
New Regulations Create Opportunity for Better Long Term Services and Supports: Medicaid Managed Care Regulation Review
MAY 9, 2016 | Faye Gordon, Staff Attorney, Justice in Aging
States and the federal government spend over $14 billion a year on Medicaid managed long-term services and supports—yet, there has never been an clear federal regulation defining state and managed care plan responsibilities in this massive enterprise. Until now. Last week, the federal Centers for Medicare & Medicaid Services (CMS) released a final regulation on Medicaid Managed Care. This new regulation details, among other things, the federal government’s expectations for states and managed care organizations (MCOs) that contract to deliver managed long-term services and supports (LTSS) for older adults and people with disabilities. MORE
Third Wave of National Study of Long-Term Care Providers to Begin Summer 2016: All ADS Centers are Invited to Participate
APR 26, 2016 | National Adult Day Services Association (NADSA)
Starting this summer, the U.S. Centers for Disease Control and Prevention’s (CDC) and National Center for Health Statistics (NCHS) will conduct the third wave of a biennial nationally representative survey of ADS centers, as part of its groundbreaking National Study of Long-Term Care Providers (NSLTCP). NSLTCP is an ongoing federally funded data collection effort to gather and report national and state information about the characteristics of ADS centers, other paid, regulated long-term care services providers, and the people they serve. MORE
Discovering What the ADS Financial Indicator Results Can Reveal About our Field
APR 26, 2016 | National Adult Day Services Association (NADSA)
NADSA, CARF International, and Reinsel Kuntz Lesher LLP are conducting the 2016 ADS financial indicators study in fulfillment of the goal to develop financial benchmarks for the Adult Day Services field. This is the 7th year of this study and NADSA offers Annual Meeting presentation to reveal the study findings as well as a webinar for members. ADS centers that participated in the study also receive complementary individualized reports with their benchmarking data.
If your organization is an Adult Day Services provider, you are invited to participate in this complementary study. Instructions for participation are included in this article along with why this is valuable for your organization, and highlights from last year’s study. MORE
DHCS Releases a New Provider Bulletin on Continuity of Care and Billing
APR 18, 2016 | California Department of Health Care Services (DHCS), Health Care Delivery Systems
In order to ensure that beneficiary transitions into Cal MediConnect are smooth and do not result in disruptions of care, the CCI continuity of care policy gives beneficiaries in Cal MediConnect plans the right to continue seeing non-participating physicians for a limited period of time.
DHCS has developed a Provider Bulletin which explains how current out-of-network physicians can continue seeing Cal MediConnect beneficiaries, and the process for billing the correct entity for payment. It also provides information to help combat balance billing.
More information and additional resources for providers can be found on CalDuals.org.
IHSS Workers Who Fail to Return Provider Enrollment Form by April 15 Will NOT be Terminated From Program
APR 11, 2016 | California Department of Social Services (CDSS)
The California Department of Social Services (CDSS) released a letter on April 8, 2016 to the County Welfare Directors and County IHSS Program Managers announcing that CDSS will NOT terminate IHSS providers (workers) from the program if they fail to return the “IHSS Provider Enrollment Agreement” form by the April 15th deadline.
However, all IHSS workers must submit the Provider Enrollment Agreement (SOC 846) form which was updated to include information regarding overtime and travel time pay, weekly hour maximums and the violations process.
Adult Day Services providers are urged to inform their center participants who have IHSS workers about this development, and refer them to the SOC 846 form and 7-page document “Important Information for the IHSS Provider.”
Urgent help is needed to reach our fundraising goal of $45,000 to support efforts to restore Medi-Cal Funds! DONATE NOW to the California Adult Day Services State Advocacy Fund. (Contributions are NOT tax deductible). Thank you!
California Association for Adult Day Services, a 501 (c) 6 non-profit grassroots-driven organization, advocates for the growth and development of adult day services in California and nationally. CAADS was the first state association formed in the United States for the purpose of advancing adult day services. Centers in membership with CAADS provide innovative day programs that support individuals with physical or mental disabilities and older adults with Alzheimer's disease and their families.
A nationally recognized leader in the field of aging, the Association is governed by the CAADS Board of Directors and provides timely information, analysis, advocacy, technical assistance, education, and networking opportunities for its members. CAADS members agree to abide by the Association's Bylaws, Code of Ethics, and Anti-trust Policy.
Board of Directors List | Bylaws | Code of Ethics | Anti-trust Policy | 2015 Annual Report
The CAADS Members Only page features information and technical assistance specific to Adult Day Services, as highlighted below. For membership information, click here.
- State Budget Proposals, Legislative Alerts & Advocacy
- CBAS Waiver
- Medi-Cal Issues
- Medicare and Medi-Cal Dual Beneficiaries News & CCI / CalDuals Updates
- Managed Care Health Plans & CA Dept of Managed Health Care Updates
- ADHC / CBAS Licensing & Regulations (DPH, DHCS, CDA)
- Adult Day Program (ADP) Licensing & Regulations (DSS, CCLD)
- Funding Sources
- Education & Training Materials / Webinar Recordings
- Membership Roster
The Alliance for Leadership and Education (A.L.E.) is a non-profit 501(c)(3) public benefit arm of CAADS. Its mission is to advance innovation and quality in Adult Day Service through research and analysis, education and training, and leadership for the benefit of consumers and their caregivers.
NATIONAL ADULT DAY SERVICES ASSOCIATION (NADSA)
CAADS is a proud member of the National Adult Day Services Association.
Three representatives from California currently serve on the NADSA Board of Directors:
Corinne Jan, RN, PHN (NADSA Treasurer)
CEO, Family Bridges / Hong Fook Centers
Lydia Missaelides, MHA
Executive Director, CAADS
Amanda Sillars, MSW, LCSW
CEO, Total ADHC Solutions, Inc.
CARING FOR A VETERAN?
For help, call the VA Caregiver Support Line (toll-free):
Mon - Fri 8 AM - 11 PM (EST) || Sat 10:30 AM - 6 PM (EST)
TO REPORT FRAUD AND ABUSE
Call DHCS Medi-Cal Fraud Hotline:
The call is free and you can remain anonymous.
BACK TO TOP
California Association for Adult Day Services
1107 9th Street, Suite 701 || Sacramento, CA 95814–3610
T: (916) 552-7400 || F: (866) 725-3123