Wa
STATE OF WASHINGTON
DEPARTMENT OF SOCIAL AND HEALTH SERVICES
Aging and Long-Term Support Administration
Developmental Disabilities Administration
PO Box 45600, Olympia, WA 98504-5600
H17-049 – Procedure
June 16, 2017
|TO: |Area Agency on Aging (AAA) Directors |
| | |
| |Home and Community Services (HCS) Division Regional Administrators |
| | |
| |Developmental Disabilities Administration (DDA) Regional Administrators |
| | |
| |Residential Care Services (RCS) Division Regional Administrators |
| |Management Services Division (MSD) Staff |
|FROM: |Kathy Morgan, Acting Director, Home and Community Services Division |
| | |
| |Don Clintsman, Deputy Assistant Secretary, Developmental Disabilities Administration |
| | |
| |Candace Goehring, Director, Residential Care Services Division |
| | |
| |Chanh Ly, Director, Management Services Division |
|SUBJECT: |Contingency Planning for Possible Government Shutdown |
|Purpose: |To provide information and guidance to staff in the unlikely event of a temporary government shutdown effective|
| |July 1, 2017. |
|Background: |On May 23, 2017, the Washington State Legislature adjourned their 30-day special session and entered a second |
| |special session on May 24, in an attempt to pass a final 2017-2019 operating biennial budget. Our state’s |
| |Constitution expressly prohibits the payment of treasury funds without an appropriation. This means that, |
| |without an approved budget, state government operations will partially shut down. There are limited exceptions |
| |in operations which include constitutional mandates and certain federal laws where continued service is |
| |required while the state takes measures to work with the federal government to withdraw from Medicaid. |
| |A state budget must be enacted no later than 12:00 midnight on June 30, 2017 in order for the state to continue|
| |providing most services. |
|What’s new, changed, or |Impact on services: |
|Clarified: |In the unlikely event that a state budget is not enacted by June 30, 2017, only the following ALTSA/DDA-funded |
| |services will be continued: |
| |Partial Adult Protective Services (abuse and neglect investigations that are federally required) |
| |Intake lines for APS/CRU and social services will continue to receive referrals and will triage to respond to |
| |the most urgent issues. |
| |RCS complaint investigations in community residential settings |
| |Federally-required nursing home and ICF/IID surveys and investigations |
| |Residential Habilitation Center (RHC) operations |
| |Consolidated Services (partial maintenance support to Lakeland Village) |
| |1915(c) Medicaid waivers (COPES, New Freedom, Residential Support, CORE, Basic Plus, CIIBS, IFS, Community |
| |Protection) |
| |Medicaid State Plan (Nursing Facility, Community First Choice, Medicaid Personal Care, Private Duty Nursing, |
| |Program of All-Inclusive Care for the Elderly (PACE), Pre-Admission Screening and Resident Review (PASRR)) |
| |Roads to Community Living (RCL) |
| |Child Development Services |
| |DDA State Supplementary Payments (SSP) (payment may be delayed) |
| |Field and Headquarters staff (skeletal to support above activities) |
| | |
| |Maintaining these services is required by a state constitutional mandate or federal law. |
| | |
| |In the event the state goes without an enacted budget after July 1st, continuation of Medicaid services may be |
| |impacted. The state will work with the Centers for Medicare and Medicaid Services to stop the Medicaid program |
| |and will provide adequate notice to Medicaid clients and providers. |
| | |
| |Client Assessments: |
| |Some clients will be scheduled for routine annual assessments during July 2017. In the absence of a budget, |
| |staff must contact those clients and reschedule those assessments, preferably at least one day in advance. |
| |Only Initial assessments and Significant Change assessments related to critical health and safety will be |
| |completed by the skeleton regional staff. See action section, below, for additional instructions. |
| | |
| |Financial Eligibility: |
| |Financial staff should continue to process new applications and may continue to reinstate Medicaid cases. |
| |Staff will be able to process existing batch and late June reviews; however, the Document Management Services |
| |(DMS) and Hub Imaging Unit (HIU) will not have enough staff to keep up with scanning and indexing any new mail |
| |received after July 1, 2017. |
| | |
| |The following financial programs authorized by Economic Services Administration (ESA) will be suspended |
| |effective July 1, 2017: |
| | |
| |ABD cash payments (A01/A05 medical will remain open) |
| |Pregnant women’s program |
| |FAP (state-funded food assistance) |
| |SFA (state-funded cash assistance) |
| |SSP payments (including issuance of the institutional CPI payment of $27.58) |
| |Ongoing Additional Requirements (AREQ) |
| | |
| |Cash AUs will remain active, but the grant amount will be set to zero. |
| |Clients on other programs that will be closing in the Automated Client Eligibility System (ACES) will receive a|
| |closure notice with the following text: |
| | |
| |“This program ended 6/30/2017 because an operating budget for 2017 – 2019 was not enacted prior to 7/01/2017.” |
| |Clients do not have administrative hearing rights on these notices. |
| | |
| |The Health Care Authority (HCA) is notifying all providers to continue to provide services based on eligibility|
| |displayed in ProviderOne, including pharmacy point-of-sale transactions. Pharmacies have been notified on how |
| |to ensure needed medications can be provided in all cases, even where prior authorization is required. If |
| |financial staff are contacted by clients who cannot access needed medications, it is important to assist |
| |patients to locate a pharmacy that can comply with the requirements communicated by Medicaid. |
| | |
| |Impact on payments: |
| |In the absence of an enacted budget, payments to providers will be affected. ProviderOne and IPOne will be |
| |able to pay providers for services they provided on or before June 30, 2017, but will be unable to pay |
| |providers for services provided on or after July 1, 2017. Providers paid through Medicaid funding will be paid|
| |for services rendered during the absence of the budget, after a budget is enacted. It is possible that |
| |providers paid through state-only funding may not be reimbursed for services rendered during the absence of the|
| |budget. |
| | |
| |All medical coverage groups in ACES will continue. Benefits will be in place but claims will not be paid to |
| |providers until a budget is passed. |
| | |
| |Notifications: |
| | |
| |State-only funded Clients: |
| |Clients receiving state-only-funded services from ALTSA and DDA will receive notification that their services |
| |will not continue after June 30, 2017 in the absence of an operating budget (see letters attached below). All |
| |authorizations that have been processed for services rendered on or after July 1 will be suspended. |
| | |
| |AAAs: |
| |If a budget is not enacted, DSHS will not be able to authorize AAAs to provide anything other than limited |
| |Medicaid-funded services after June 30, 2017 and will not be able to pay for other services that AAAs provide. |
| |Providing non-Medicaid-funded services during any shutdown would be at the AAA’s risk of non-reimbursement. If|
| |AAAs choose to discontinue non-Medicaid services they must notify clients. |
| | |
| |Any contract between DSHS and the AAA covering SFY18, executed prior to July 1, will automatically go into |
| |suspension in the absence of a state operating budget. These contracts will immediately be resumed as soon as a|
| |state budget is in place. |
| | |
| |AAA Medicaid Case Management/Nursing Services will be funded at 25% of the typical monthly unit rate during a |
| |shutdown. This would fund only essential case management (such as Significant Change assessments and |
| |authorizing services), and nursing services. AAAs may use their discretion on whether they serve more than the|
| |minimal activities using accrued or local funding sources. The Asian Counseling and Referral Service (ACRS) |
| |and the Chinese Information and Service Center (CISC) will continue to complete initial assessments for |
| |emergent cases on a per-case reimbursement basis. |
| | |
| |Other AAA staff, including Core Service Contract Management, will not be considered essential. Any notices to |
| |AAA staff would be provided according to AAA policy. |
| | |
| |Providers: |
| |All contracted state-only providers have been notified of contract suspension (see attached letter). |
| | |
| |State staff: |
| |Non-essential state staff will receive layoff notices pending the potential government shutdown. These notices |
| |will be sent to each affected staff person via email with information staff need to know regarding the layoff |
| |process. Staff on extended leave will receive notices via U.S. mail. |
| | |
| |To deliver essential services, a small number of staff will not receive layoff notices and will be working |
| |during the partial government shutdown. Each Regional Administrator and Headquarters Office Chief has |
| |finalized a list of “essential staff” to continue critical work functions to support the essential services. |
| |Those employees will continue business as usual and will receive regular compensation. |
|ACTION: |If there is not an approved budget by close of business on June 30, 2017, field service and central office |
| |staff must: |
| | |
| |Assessments and authorizations: |
| |Notify clients who are scheduled for annual assessments that the assessment will have to be rescheduled unless |
| |there has been a significant change in the client’s condition. |
| |Not create new state-only service authorizations for dates past July 1, 2017. If you must create an |
| |authorization that extends into July, you must send the client notification, attached below. |
| |Partial office closures: |
| |Leave the following voice message on their phones: |
| |Hello and thank you for your call. You have reached [name] with the Department of Social and Health Services |
| |[name of administration, division, program]. As of Friday, June 30, 2017, a state budget has not been passed |
| |and state offices have been partially shut down. If this is a life-threatening emergency, please hang up and |
| |dial 911. If this is an issue that needs immediate attention with regard to services, please push “0” now and |
| |leave a message at the main desk. We will get back to you as quickly as we can. Otherwise, please remain on |
| |the line and leave a message and when I am able to return to work, I will call you back. |
| |Similar messages must be left on out-of-office automatic email replies. |
| |DSHS Employees who have received a temporary layoff notice should call the phone number listed on their layoff |
| |notice daily for information about when they should return to work. During the layoff day(s), employees must |
| |not come to their office or check work email or voicemail. |
| |Employees who have been identified to continue working during the shutdown will receive direction from the |
| |Regional Administrator, Director, or designee regarding their activities. Some of the anticipated activities |
| |and/or tasks that staff will be performing during the partial shutdown include but are not limited to: |
| |Retrieving voice messages that come in on the office’s identified message line and responding to urgent issues |
| |that cannot wait; |
| |Reviewing, entering, extending and terminating payment authorizations; |
| |Reviewing and submitting incident reports; |
| |Responding to emergent and/or crisis client situations, including Significant Change assessments, ETRs, and |
| |authorizing new essential services. |
| |All offices should post a notice on doors, used by the general public, to indicate that the office is closed |
| |due to the partial government shutdown and that normal operations will resume after a state budget is approved.|
|Related |Additional Staff Information: |
|REFERENCES: | |
|ATTACHMENT(S): |DDA Client Letters: |
| |[pic][pic] |
| |DDA Contractor Letter: |
| |[pic] |
| | |
| |ALTSA Client Letter: |
| |[pic] |
| | |
| |ALTSA Contractor Letter: |
| |[pic] |
|CONTACT(S): |DDA Contact: |
| |Debbie Roberts, Office Chief |
| |(360) 407-1556 |
| |Debbie.Roberts@dshs. |
| | |
| |AAA Contact: |
| |Susan Engels, Office Chief |
| |(360) 725-2527 |
| |Susan.Engels@dshs. |
| |HCS Contact: |
| |Cathy Kinnaman, Chief of Operations |
| |(360) 725-2318 |
| |FisheCL@dshs. |
| | |
| |MSD Contact: |
| |Chanh Ly, Director |
| |(360) 725-2339 |
| |Chanh.ly@dshs. |
| | |
| |RCS Contact: |
| |Amy Abbott, Office Chief |
| |(360) 725-2489 |
| |BeckeAmE@dshs. |
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