Calendar Year (CY) 2017 Older Americans Act (OAA) and ...



348615015240000STATE OF WASHINGTONDEPARTMENT OF SOCIAL AND HEALTH SERVICESAging and Long-Term Support AdministrationHome and Community Services DivisionPO Box 45600, Olympia, WA 98504-5600148590084455HCS MANAGEMENT BULLETIN00HCS MANAGEMENT BULLETINH20-26 Policy & ProcedureApril 1, 2020Amended April 3, 2020TO: Home and Community Services (HCS) Division Regional Administrators Area Agency on Aging (AAA) DirectorsFROM:Bea Rector, Director, Home and Community Services DivisionSUBJECT: Billing Process during the COVID-19 Outbreak for Community Choice Guiding, Client Training, Professional Support Specialists and Supportive Housing Providers Purpose:To notify the field and ALTSA contracted provider staff about temporary changes in client service provision during the COVID-19 Outbreak.Background:On February 29th, 2020, Governor Jay Inslee declared a state of emergency in response to the COVID-19 outbreak, directing state agencies to use all resources necessary to prepare for and respond to the outbreak. ALTSA staff have been in communication with the Centers for Medicare and Medicaid Services (CMS) to review the rules related to 1915(c) Waivers, 1915(k) CFC State Plan Services and the 1115 Medicaid Transformation Demonstration waiver, and to request exceptions to specific rules until the COVID-19 pandemic is contained. What’s new, changed, orClarified Most client services contracted providers are compensated solely for time spent working directly with a client through a face-to-face interaction. Other time is typically considered administrative and is not currently billable (this may vary by contract). To reduce potential spread of illness during the COVID-19 state of emergency, providers may utilize phone or other technology to substitute for in-person visits when the health and safety of the client and related care needs can be met this way. ACTION:Effective immediately and until further notice, phone or other technology may be substituted for in-person visits for providers with the following fully-executed contracts:Community Transition and Training Specialist (1072XP)Client Training (1073XP)Community Choice Guiding (CCG; 1071XP)Professional Support Specialist (1044XP)Supportive Housing (1070XP)When developing the person-centered care plan, the Case Manager should consider the circumstances of modified service delivery based on client health and safety. Note: There are no changes to current authorization procedures. Case Managers should continue to authorize services per policy.For existing authorized services, the provider should continue to document services provided to the client, in person and remotely, and submit to the case manager, consistent with current policy. Providers may only bill for hours provided, whether in-person, telephonic, or a combination of both.Special note regarding CCGs:Per their contract, qualified CCGs can be authorized to perform shopping tasks associated with the purchase of items necessary for transition or stabilization. Typically, this includes the purchase of household goods necessary for transition, specialized medical equipment and assistive technology. During the COVID-19 Public Health Emergency, if a contracted CCG has included the Purchasing subcode in their contract, a CCG may be authorized to perform routine, weekly shopping tasks on behalf of the client if the client’s caregiver or informal support is not available to complete that task. A CCG may not supplant the caregiver’s role in completing these tasks if a caregiver is available. ALTSA will compensate the CCG for the time spent shopping, but cannot reimburse the CCG for grocery or pharmacy purchases made. The CCG must come to an agreement with the client to determine how the client will pay for the groceries or pharmacy items before the shopping or purchasing occurs. Options may include (but are not limited to):The CCG assisting the client to create an online order using the client’s credit or debit card for either pick-up by the CCG or delivery. This assistance may occur over the telephone. The client reimbursing the CCG directly using cash or check.Appropriate social distancing should occur for shopping related tasks, including the exchange of EBT card, cash or check, and delivery of the groceries or items from the pharmacy.The CCG should be authorized service code SA266 (Shopping/paying no client present) at the standardized shopping rate of $8.00/OF. Select “[Community Setting] Stabilization” as the reason code. If a client is CFC-only this reason code is not available. If a CFC-only client is COPES eligible, create an interim and select CFC+COPES on the Care Plan screen. If a CFC-only client is not COPES eligible, assign the WA Roads RAC for a maximum of three months. WA Roads services can be extended if the public health emergency continues beyond the initial three month period. The CCG’s time shopping should be tracked on the Tracking Form and submitted to the case manager per MB H19-012. Following Basic Infection Control ProceduresInstruct providers to follow pre-screening procedures prior to delivering in-person services by calling and asking client/rep if they or household members have had symptoms of COVID-19 (such as fever, dry cough/shortness of breath (that is unusual to their typical respiratory condition) in the last 14 days. If the answer is yes, or they or household members have tested positively for COVID-19, encourage them to call their medical professional and advise their supervisor or client’s case manager. Follow the local health jurisdiction and Center for Disease Control’s (CDC) directives on how to safely provide care to those individuals.Providers providing in-person support should not work when they are sick. When providing services in-person, providers should follow standard infection control procedures including: Perform hand hygiene, prior to and after each visit, wash your hands with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer that contains at least 60% alcohol. Wipe all high touch surfaces with disinfectant at the beginning and end of every in-person visit. Avoid touching eyes, nose, or mouth with unwashed hands.Stay at least 6 feet away from client and others as much as possible. Limit close personal contact. Cover coughs and sneezes with a tissue and discard after each use. Ask client/others to do the same.If at any time during a face-to-face interaction, the provider becomes aware that a client has a fever, cough, and/or difficulty breathing (in the absence of another respiratory diagnosis), the provider should encourage the client to call their medical professional and notify the client’s case manager.Related REFERENCES:Governor Inslee Proclamation 20-16Department of Health: Community Health RecommendationsMB H19-012: Ancillary Service Approved for the COPES Waiver and New Service Authorization Reason CodesService Code Data Sheet SA266 (Shopping/paying no client present) You can find detailed Information for Potential Medicaid Contractors on DSHS. .ATTACHMENT(S): Client Training (1073XP)\sCommunity Choice Guiding (1071XP) \sSupportive Housing (1070XP)Professional Support Specialist (1044XP)\sCCG Activity Tracking FormCONTACT(S):For questions about the Client Training Contract:Jamie Tong, Waiver Program Manager (360) 725-3293Jamie.Tong@dshs. For questions about the Community Choice Guiding Contract:Debbie Blackner, Ancillary Services Program Manager(360) 725-3231BenneD@dshs.For questions about the Professional Support Specialist Contract:Julie Cope, Systems Change Specialist(360) 725-2529Julie.Cope@dshs.For questions about MAC or TSOA programs:Debbie Johnson, MTD Waiver Program Manager (360) 725-2531Debbie.Johnson2@ For general questions about contracting:Paula Renz, Program Manager/AAA Specialist(360) 725-2560RenzP@dshs.For general questions about Supportive Housing contracting:Liz Prince, RCL Project Director(360) 725-2561Elizabeth.Prince@dshs. ................
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