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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