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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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