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H15-025 – Policy and Procedure
April 20, 2015
|TO: |Area Agency on Aging (AAA) Directors |
| | |
| |Home and Community Services (HCS) Division Regional Administrators |
| | |
| |Division of Developmental Disabilities (DDA) Regional Administrators |
|FROM: |Bea Rector, Director, Home and Community Services Division |
| | |
| |Don Clintsman, Deputy Assistant Secretary, Developmental Disabilities Administration |
| | |
| |Chanh Ly, Director, Management Services Division |
|SUBJECT: | Agency Worker Health Insurance (AWHI) Update |
|Purpose: |To clarify changes of responsibility for the AWHI audit/review process. |
|Background: |The current home care agency vendor rate includes a designated portion, known as AWHI, which must be used |
| |solely to purchase health benefits for eligible workers directly providing home care to publicly funded |
| |consumers. This portion of the rate must be returned to the state if not used for this purpose. |
| | |
| |Some agencies purchase health benefits from the NW Health Trust. Those agencies may present a letter of good|
| |standing from the Trust that covers the appropriate timeframe to their AAA contract monitor in lieu of the |
| |steps described below. |
| | |
| |On October 20, 2011, MB H11-059, Additional Clarification of Agency Workers Health Insurance (AWHI) Billing |
| |and Individual Healthcare Reimbursements Accounts was released. This MB provided information on home care |
| |agency compensation for AWHI costs and distributed a revised AWHI billing form. |
| | |
| |On June 19, 2012, MB H12-041, Revised Standardized Home Care Agency Statement of Work and Monitoring Tool was|
| |released. This MB indicated that beginning September 1, 2013, AAA’s were to use the AWHI reimbursement |
| |calculation form when recovering unspent AWHI funds. |
| | |
| |On June 24, 2014, MB H14-036, Revised Standardized Home Care Agency Statement of Work & Monitoring Tool was |
| |released. This MB indicated that AAA’s are to review/monitor AWHI through service months ending June 30, |
| |2014. Service months after that date will have AWHI audited/reviewed by independent auditors/reviewers |
| |retained by the home care agency. It also stated instructions and forms for AWHI reconciliation would be |
| |forthcoming. |
|What’s new, changed, or |The new tool that is available for use by independent auditors/reviewers is titled “Agency Worker’s Health |
|Clarified |Insurance (AWHI) Monitoring Tool, Determination of Accurate AWHI Eligible Expenditures” and is attached. |
| | |
| |A copy of the AWHI Reimbursement Calculation form (see attached) must be completed and submitted with payment|
| |to ALTSA. For SFY 16 and beyond, the rate chart within this document will need to be updated with the correct|
| |rate for the review period. |
|ACTION: |AAAs are responsible to audit/review AWHI through June 2014. Service months beginning with July 2014 will be |
| |audited/reviewed by Independent Auditors/Reviewers retained by the home care agency. |
| | |
| |AAAs must distribute this MB to all home care agencies and make them aware that the AWHI tool is available |
| |for the agency’s auditor/reviewer to use as a resource to assist in their audit/review process. The tool is |
| |optional; however if not used, some form of work papers are expected. |
| |The AAA must verify that each applicable agency’s AWHI has been reviewed by an independent auditor/reviewer |
| |at least annually and obtain a copy of the auditor/reviewer’s report and/or, a copy of the AWHI tool if |
| |completed. |
| |AAA Contract Managers are required to include a copy of the agency’s SEIU Healthcare NW Health Benefits Trust|
| |Notice of Good Standing OR the auditor/reviewers AWHI report, and/or completed AWHI tool along with each AAA |
| |monitoring report sent to ALTSA. |
| |Home care agencies must reimburse ALTSA within 30 days if it is determined that an AWHI reimbursement is |
| |required. All reimbursements to ALTSA must be accompanied with a Reimbursement Calculation Form, see |
| |attached. |
| | |
| |Home care agencies that are directly contracted with DSHS will follow the same procedures, with state HQ |
| |staff playing the role of AAA indicated above. |
|ATTACHMENT(S): |Agency Worker Health Insurance Monitoring Tool: |
| |[pic] |
| |SFY15 AWHI Reimbursement Calculation Form: |
| |[pic] |
|CONTACT(S |Paula Renz, AAA Specialist |
| |State Unit on Aging |
| |(360) 725-2560 |
| |RenzP@dshs. |
| | |
| |Andrea Meewes-Sanchez, AAA Unit Manager |
| |State Unit on Aging |
| |(360) 725-2554 |
| |SanchAC@dshs. |
| | |
| |Jaime Bond, Interim State Plan Service Unit Manager |
| |Developmental Disabilities Administration |
| |360.725.3466 |
| |BondJL@dshs. |
| | |
| |Anna Glaas, Grants Unit Supervisor |
| |(360) 725-2374 |
| |GlaasAG@dshs. |
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