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State Senior and Disabilities Services takes steps to end federal moratorium on some Medicaid services

New project manager on the job; assessment backlog decreasing; assessors increasing

(Anchorage, AK) — The Alaska Department of Health and Social Services has taken several positive steps to decrease its backlog of reassessments for some Medicaid waiver programs and personal care attendant services, including the hiring of a project manager and completing hundreds of assessments.

The state Senior and Disabilities Services Division is addressing the federal concerns, and is working with the federal Centers for Medicare and Medicaid Services (CMS) to have the June 26 moratorium on new applications lifted.

“Our priority continues to be the health and welfare of Alaskans who need our services,” Health and Social Services Commissioner Bill Hogan said. “Compliance with rules and regulations is essential, of course, but we will not lose sight of individual needs as we work to restore full access to our services.”

Commissioner Hogan has been in constant contact with the Governor’s office on the situation, and is regularly updating Governor Parnell.

Accomplished to date:

  • A project manager was hired and has been on the job since July 16.

  • A total of 308 reassessments have been conducted since receiving the June 26 CMS review.

  • Four Provider and Family Suggestion Sessions — sponsored by Senior and Disabilities Services, the Alaska Commission on Aging, and the Governor’s Council on Disabilities and Special Education — are scheduled for Juneau (July 29), Fairbanks (Aug. 4), Anchorage (Aug. 5) and Kenai (Aug. 6) to discuss quality assurance, monitoring the health and welfare of waiver participants, improving provider oversight, and preventing conflicts of interest. Additional forums are planned for Bethel and Nome in August. For details, call 1 (907) 465‑4874.

  • The pool of assessors has been expanded to allow non-nurses to be hired, with 12 positions posted on Workplace Alaska.

  • Initial assessments and reassessments are being done methodically and more quickly with the newly approved Electronic Consumer Assessment Tool.

  • The Policy and Procedure on Critical Incident reporting has been implemented; over 100 providers have received training; and a mortality review has also been implemented.

Initial Assessments waitlist

As of the end of July, the waitlist for initial assessments, created since the moratorium was imposed, totals 524 applicants, and of that number 290 are already receiving needed services under another program, such as community developmental disabilities or senior grant-funded programs.

In the last month, assessors have completed a total of 308 reassessments, using an electronic assessment tool. “As we perfect this electronic database tool, the assessors’ productivity will steadily increase,” Senior and Disabilities Services Director Rebecca Hilgendorf explained. “The assessors have necessarily been doing duplicate paper and electronic assessments until the electronic system is tested and fully implemented, which takes additional time.”

Reassessment backlog

The most current numbers available show that as of July 24, 2009, there are 723 Personal Care Attendant reassessments due or past due. Three newly hired assessors have been trained and are working in the field as of Aug. 20, 2009. There are 412 waiver reassessments due for applicants to the Older Alaskans and Adults with Physical Disabilities services. In addition to 13 trained assessors, three newly hired assessors are now working in the field on these reassessments.

Improving death investigations

Another problem cited by CMS in its review of Senior and Disabilities Services’ waiver programs was its method of evaluating deaths occurring while individuals were receiving services. In April 2009, the department organized a workgroup with providers to develop a curriculum and policy for reporting critical incidents, such as deaths. Provider training started on June 5, 2009, and to date 94 providers have completed online training. An additional 14 education sessions are currently scheduled.

Working to lift moratorium

The department continues to work with CMS on having the entire moratorium lifted, or identifying exemptions to the moratorium for certain emergency or high-risk situations, Hilgendorf said.

Information related to the CMS review can be found at http://hss.state.ak.us/dsds/cmsreview.

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DHSS is now on Twitter. Follow CMS and other health updates at www.twitter.com/Alaska_DHSS.

July 30, 2009

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