CAADS - California Association for Adult Day Services

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Community Based Adult Services (CBAS)

Updated MARCH 9, 2017


CA Dept of Health Care Services (DHCS)

Website (CBAS/ADHC Information) | Email (Comments/Questions)

Medi-Cal Managed Care Enrollment: Health Care Options

Website (General informing materials, enrollment forms, plan comparison charts, etc.)
Call Toll-Free 1-800-430-4263 or write to DHCS, Health Care Options, P.O. Box 989009, West Sacramento, CA 95798-9850

CA Dept of Aging (CDA)

Website (CBAS Providers)

New CBAS Certification Process for Prospective ADHC Applicants

For the first time since August 2004, the California Department of Aging (CDA) is accepting requests from prospective applicants to begin the process to be certified to provide Community Based Adult Services (CBAS). CAADS members, click here and follow the Quick Link to "Handouts from Events/Webinars" for the November 18, 2015 course, Pre-Screening & Application Process for the Certification of New CBAS Centers.



CBAS Updates

MAR 9, 2017 | California Department of Aging CBAS Branch

Don’t Miss Upcoming Training Opportunities for CBAS Providers and Managed Care Plans!

  • California Association for Adult Day Services (CAADS) Spring Conference, “Transforming the Continuum of Care”, April 25-27, 2017, at the Doubletree Berkeley Marina Hotel, Berkeley, CA.
  • Justice in Aging webinar, “Older Adults and Health Care Decision-Making in Clinical Settings”, Wednesday, March 22, 2017, 10a.m. to 11a.m. PDT

CAADS Spring Conference & Membership Meeting - REGISTER NOW!
Early Registration Ends March 15th

Registration is underway for the CAADS Spring Conference 2017, scheduled for April 25-27, 2017 at the DoubleTree Berkeley Marina Hotel, Berkeley, CA. Hotel and conference registration information is posted on the CAADS website or call/e-mail CAADS: 916-552-7400; info@caads.org.

The conference theme is Transforming the Continuum of Care. Kevin Prindiville, Executive Director at Justice in Aging, will provide the keynote address, “High Stakes for Older Adults in 2017.” A range of practical workshops will be offered for both Adult Day Programs and ADHC/CBAS centers including motivational interviewing, mindfulness based dementia-care, meaningful activities for persons with a dementia, honoring choice in dementia care while mitigating risk, high-risk medications and interactions in the elderly, quality measures and metrics for CBAS centers, and more. A panel of managed care plan partners will end the conference discussing innovative practices and partnerships to improve services for persons needing long term services and support.

The California Department of Aging (CDA) CBAS Branch staff will facilitate a workshop on the new ADHC/CBAS Individual Plan of Care (IPC) and Participation Agreement, and lead a general session on ADHC/CBAS Compliance with the Home and Community-Based (HCB) Settings Regulations.

The CAADS Spring Conference provides a unique, collaborative opportunity for CBAS providers and managed care plan partners to learn about best practices, network with colleagues, hear presentations from the State to stay informed about program requirements, and much more.

Justice in Aging Webinar, Older Adults and Health Care Decision-Making in Clinical Settings – Wednesday, March 22, 10a.m. – 11a.m. PDT
Register Here

The following webinar description was distributed by Justice in Aging:
When older adults lack the capacity to make important health care decisions for themselves and have nothing in writing naming a person to make decisions for them, how can the right health care decisions be made in clinical settings? Over the past 40 years, nearly every state has passed statutes on health care decision-making. The laws vary from state-to-state, from authorizing living wills or powers of attorney for health care to defining the conditions when withholding or withdrawing life sustaining care is permitted for patients who lack capacity.

Despite years of legal guidance, questions remain regarding the statutory applicability in clinical practice. In 2016, the American Bar Association Commission on Law and Aging (ABA COLA) initiated a national survey to explore health care clinicians’ perspectives on questions regarding capacity and decision-making. Findings explore instances when the law and clinical practice clearly align, when there are consultation differences between lawyers and clinical providers, and outline the areas that still present the greatest challenges for health care decision making in clinical settings.

In this webinar, David Godfrey, Senior Attorney to the American Bar Association Commission on Law and Aging, will detail the survey findings and implications for the health and aging network working with older adults with diminished capacity. The webinar will be accompanied by an Issue Brief that highlights the survey findings and provides recommendations for the field. This webinar is free.

CDA’s Webinar Training on the CBAS Individual Plan of Care (IPC) and Participation Agreement (1/24/17) – Slides and Recording are Now Posted!

On January 24, 2017, CDA provided training via webinar on the new CBAS IPC and standardized ADHC/CBAS Participation Agreement. The webinar slides and recording are now posted on the CBAS Training webpage (click “Eligibility”.)

As indicated in the CBAS Updates newsletter distributed February 14, 2017, the new IPC is being reviewed by DHCS along with revisions to the CBAS section of the Medi-Cal Provider Manual which includes the IPC instructions. We are uncertain when DHCS will complete its review but do not expect implementation of the IPC before June 2017.

Therefore, CBAS providers are required to continue using the current IPC until DHCS has approved it along with revisions to the CBAS section of the Medi-Cal Provider Manual. Once approved, CDA will post the new IPC and instructions on its website and notify CBAS providers about the implementation of the IPC via an All Center Letter (ACL) and CBAS Updates.

CBAS providers are required to begin using the new Participation Agreement (CDA 7000) for new and continuing CBAS participants as of March 1, 2017, and to replace all non-standardized participation agreements in participants’ health records with form CDA 7000 on a rolling basis as participants’ IPCs are developed and reauthorized. For new participants, use the CDA 7000 starting March 1, 2017. For currently enrolled participants, the CDA 7000 applies to anyone whose TAR period is up for renewal beginning April 1, 2017 through April 30, 2017. Prior to implementation of the new Participation Agreement, CBAS providers must have assessment and care planning policies and procedures in place to ensure proper implementation.

The new standardized ADHC / CBAS Participation Agreement CDA 7000 and instructions are now posted on the CDA website. Please contact the CBAS Branch at the California Department of Aging (CDA) if you have any questions about the CBAS IPC and/or ADHC / CBAS Participation Agreement: (916) 419-7545; cbascda@aging.ca.gov

 

CBAS Updates

FEB 17, 2017 | California Department of Aging CBAS Branch

Key CBAS Program Accomplishments and Priority CBAS Activities for 2017

The beginning of a new year is a time to reflect on what we’ve accomplished and what lies ahead.

As a result of extensive stakeholder processes initiated by the California Department of Aging (CDA) and Department of Health Care Services (DHCS), the CBAS Branch in collaboration with stakeholders developed the following documents that will guide CBAS program activities in 2017:

  • CBAS Home and Community-Based (HCB) Settings Transition Plan (November 23, 2016)
  • CBAS Quality Assurance and Improvement Strategy (October 2016)
  • Revised CBAS Individual Plan of Care (IPC)
  • New standardized ADHC/CBAS Participation Agreement

CDA and DHCS developed these documents in response to directives by the Centers for Medicare & Medicaid Services (CMS) in the CBAS provisions of the 1115 Demonstration Waiver. Refer to Special Terms and Conditions/STC 44(c) and 45(c) which requires CBAS settings to meet federal Home and Community-Based (HCB) Settings regulations, 42 CFR 441.301(4), and Person-Centered Planning requirements, 42 CFR 441.301(c)(1)(2)(3). To meet the directive in STC 45(c) the CBAS program needed to revise the IPC and develop a standardized Participation Agreement. Refer to STC 49 which requires the State to develop a CBAS Quality Assurance and Improvement Strategy to assure the health and safety of Medi-Cal beneficiaries receiving CBAS. This newsletter provides a status report on each of these documents.

CDA thanks all CBAS providers, managed care plan representatives, provider associations, advocates and other partners who participated in the stakeholder meetings and webinars to develop these work products. This includes the California Association for Adult Day Services (CAADS) who convened webinars and a Pre-Conference at its November 2016 Fall Conference, facilitated by CDA, which generated helpful feedback from attendees on the draft IPC and Participation Agreement.

In 2017, CDA in collaboration with our stakeholders will focus on implementation of the CBAS Transition Plan’s “Milestones & Timelines”, the CBAS Quality Assurance and Improvement Strategy’s “Goals”, the new standardized Participation Agreement and the revised CBAS IPC. Together we will continue to promote quality CBAS services and CBAS center compliance with HCB settings and person-centered care requirements to meet the needs of CBAS participants.

Information about all CBAS stakeholder activities including the CBAS IPC Revision and Quality Workgroups is posted on the CDA website.

Status Report on the New CBAS Individual Plan of Care (IPC) and ADHC / CBAS Participation Agreement

On January 24, 2017, the California Department of Aging (CDA) hosted a webinar to provide training on the new CBAS IPC and the new standardized ADHC/CBAS Participation Agreement. If you missed it, please visit the CDA website to access the webinar slides. We will post the webinar recording after it has been transcribed to meet Americans with Disabilities Act (ADA) requirements.

IPC Update

The target date for implementation of the new IPC will not be March/April 2017 as indicated in the December 27, 2016 CBAS Updates newsletter. The new IPC is being reviewed by DHCS along with revisions to the CBAS section of the Medi-Cal Provider Manual which includes the IPC instructions. We are uncertain when DHCS will complete their review, but do not expect implementation of the IPC before June 2017.

Therefore, CBAS providers are required to continue using the current IPC until DHCS has approved the new IPC and revisions to the CBAS section of the Medi-Cal Provider Manual. Once approved, CDA will post the new IPC and instructions on its website and notify CBAS providers about implementation of the new IPC via an All Center Letter (ACL) and the CBAS Updates newsletter.

ADHC / CBAS Participation Agreement Update

The new standardized ADHC / CBAS Participation Agreement (CDA 7000) provides evidence of consent by the participant (or participant’s authorized representative) to attend the ADHC / CBAS center and receive services identified in the participant’s IPC.

CBAS providers are required to begin using the new Participation Agreement (CDA 7000) for new and continuing CBAS participants as of March 1, 2017, and to replace all non-standardized participation agreements in participants’ health records with form CDA 7000 on a rolling basis as participants’ IPCs are developed and reauthorized. Prior to implementation of the new Participation Agreement, CBAS providers must have assessment and care planning policies and procedures in place to ensure proper implementation.

The new standardized ADHC / CBAS Participation Agreement CDA 7000 and instructions are now posted on the CDA website. Please contact the CBAS Branch at the California Department of Aging (CDA) if you have any questions about the CBAS IPC and/or ADHC / CBAS Participation Agreement: (916) 419-7545; cbascda@aging.ca.gov

CBAS Home and Community-Based (HCB) Settings Transition Plan News

The State submitted California’s Statewide Plan (STP) to CMS on November 23, 2016. The Revised Draft CBAS HCB Settings Transition Plan (CBAS Transition Plan) is an attachment to the STP. Although CMS has not yet approved the STP or CBAS Transition Plan, the State including CDA is implementing the activities and commitments described in these plans to comply with the federal HCB Settings requirements.

All CBAS centers must comply with the HCB Settings requirements by March 17, 2019, and thereafter, or risk losing their CBAS Medi-Cal certification. CDA is evaluating each CBAS center for compliance with the federal requirements during its certification renewal survey process every two years. Regardless of when a CBAS center’s certification is up for renewal between now and March 17, 2019, all CBAS providers are required to implement person-centered planning requirements now.

The CBAS Transition Plan (Section 3) describes the process that CDA is using to determine CBAS providers’ initial and ongoing compliance with the federal regulations during the State’s onsite certification renewal survey. This process requires CBAS providers to complete a Provider Self-Assessment (PSA) Survey tool as part of their Certification Renewal Application (posted on the CDA website along with instructions) as described in their certification renewal notification letter sent by CDA. The CBAS Transition Plan (Section 4) describes the CMS directive regarding person-centered planning requirements and an overview of person-centered care planning with a link to guidance for implementing the federal standards for person-centered planning.

CDA surveyors will validate the CBAS center’s PSA responses during the onsite certification renewal survey visit via observations, review of records, and interviews with CBAS staff and CBAS participants. The CBAS Transition Plan describes the process if a CBAS provider is non-compliant or is in partial compliance with the federal requirements, including the heightened scrutiny process if a CBAS center is presumed to be institutional.

CBAS providers should review the CBAS Transition Plan and the CBAS “Are You Ready?” toolkit posted on the CDA website to prepare for their CBAS certification renewal to ensure compliance with the federal requirements. Please contact the CBAS Branch if you have any questions: (916) 419-7545; cbascda@aging.ca.gov.

Status Report on the CBAS Quality Assurance and Improvement Strategy

The CBAS Quality Assurance and Improvement Strategy (CBAS Quality Strategy) is a five-year plan to assure CBAS participant health and safety by addressing the following:

  • The quality and implementation of the CBAS beneficiary’s person-centered IPC
  • Provider adherence to state and licensure and certification requirements
  • Quality metrics for person-centered care/continuity of care
  • Clinical and program outcome measures/indicators
  • CBAS center staff training on best practices and quality improvement
  • Improved use of existing enforcement provisions for CBAS centers that do not meet licensing or certification standards.

The CBAS Quality Strategy is designed to assure federal partners, beneficiaries and the public that CBAS providers meet program standards while they continue to develop new approaches to improving service delivery. CDA and DHCS will implement the goals and objectives within specific timeframes in partnership with CBAS providers, managed care plans and advocates. The short-term objectives identified in Goals I and II will guide CBAS program activities for 2017.

California Association for Adult Day Services (CAADS) Spring Conference 2017 “Transforming the Continuum of Care” – Save the Date (April 25-27, 2017)

April may seem far away but it’s never too early to “Save-the-Date” for the California Association for Adult Day Services (CAADS) Spring Conference, April 25-27, 2017, at the DoubleTree Berkeley Marina Hotel, Berkeley, CA. The conference theme is “Transforming the Continuum of Care.” The CAADS Spring and Fall Conferences provide a unique opportunity to learn about best practices, network with colleagues, hear presentations from the State to stay informed about program requirements and much more. As always, CDA will participate in the Conference by providing program updates and facilitating workshops. At the Spring conference, CDA will facilitate a workshop on the new ADHC/CBAS Participation Agreement and CBAS IPC, and compliance with the HCB settings and person-centered planning requirements. Watch for conference registration details coming soon on the CAADS website or call/e-mail CAADS: 916-552-7400; info@caads.org.

 

CA Department of Public Health Announces Centralized Processing
of Licensing Applications and Report of Change Requests

OCT 20, 2016 | Karen L. Smith, MD, MPH, Director and State Public Health Officer
California Health and Human Services Agency, California Department of Public Health

All Facilities Letter (AFL) 16-15

The California Department of Public Health Licensing and Certification Program (L&C) is consolidating the processing of licensing applications and report of change request to the Centralized Applications Unit (CAU) in Sacramento. On July 1, 2015, the California Department of Public Health Licensing and Certification Program’s (L&C) began centralizing the processing of licensing applications and report of change requests to CAU in Sacramento. CAU is centralizing one district office per month with complete centralization by February 1, 2017.

As of October 20, 2016, CAU has assumed the application and report of change request workload for the following district offices:

  • Los Angeles (four offices)
  • San Francisco
  • Chico
  • San Jose
  • Fresno
  • Riverside
  • Santa Rosa
  • San Bernardino
  • East Bay
  • Bakersfield

CAU will assume the remaining application and report of change request workload as follows:

          District Office and Start Date
          Ventura:   November 1, 2016
          Orange:   December 1, 2016
          San Diego North & South:   January 1, 2017
          Sacramento:   February 1, 2017

CAU will review and process the following for all facility types:

  • Initial/Renewal Applications
  • Change of Administrator or Designee
  • Change of Ownership (CHOW)
  • Indirect Changes in Ownership
  • Change of Location
  • Change of Stock
  • Change of Mailing Address
  • Change of Officers
  • Change of Name
  • Change of Beds
  • Adding/Deleting Services
  • Change of Director of Patient Care

Services (DPCS) Designee

CAU will review applications, assist facilities through the application approval process, and complete application approvals. Once CAU approves the licensing application and receives notification of the facility’s successful completion of the licensing survey (if applicable), CAU will issue the license to the facility. CAU will also forward the original application and a copy of the facility license to the appropriate L&C district office for final processing. L&C district offices will continue to perform any required licensing and certification surveys.

Please refer to application checklists for assistance in completing application packages. Checklists and required forms are available on L&C’s website:
          http://www.cdph.ca.gov/pubsforms/forms/Pages/HealthFacilities.aspx

Once CAU assumes the application and report of change workload for your designated L&C district office, please submit all requests to the following address:

California Department of Public Health
Licensing and Certification Program
Centralized Applications Unit
P.O. Box 997377, MS 3207
Sacramento, CA 95899-7377

For additional questions regarding the application approval process, contact CAU by phone at (916) 552-8632 or by email at CAU@cdph.ca.gov.

 

CBAS Updates October 2016

OCT 7, 2016 | California Department of Aging CBAS Branch

Upcoming Training Opportunities!

  • Mark your calendars for the California Association for Adult Day Services (CAADS) Fall Conference, The Quality Imperative, November 16-18, 2016, at the Anaheim Marriott Suites in Garden Grove, CA.
  • Participate in the Pre-Conference Intensive, The New CBAS Individual Plan of Care (IPC), November 15, 2016, presented by the California Department of Aging (CDA) CBAS Branch in collaboration with CAADS providers.
  • Access the CAADS website for registration, conference, pre-conference and hotel reservation information. Contact CAADS if you have any questions (916) 552-7400 or info@caads.org. Please Note: The hotel reservation deadline is October 25th.

The CAADS Fall Conference provides an important opportunity to learn about best practices, network with colleagues, hear presentations from the State about program requirements, and much more. CDA encourages all current and prospective CBAS providers to attend.

CDA will participate throughout the conference—during the general membership meeting; in breakout sessions on CBAS documentation, quality improvement, and the certification process for new centers; and in a plenary session focused on CBAS program and policy updates. Additional workshops will address substance use screening and treatment, person-centered care, quality through marketing, motivational interviewing, the care of persons with Down Syndrome and Alzheimer’s Disease, the PACE program, mindfulness in improving the quality of life of persons with dementia, and Medicare fraud and abuse.

Pre-Conference November 15th – “The New CBAS Individual Plan of Care (IPC)”

CDA has partnered with CAADS to provide this one-day intensive course pre-conference on November 15th to “roll out” the new ADHC/CBAS IPC and the new Standardized Participation Agreement slated for implementation statewide in early 2017. A year-long public participation process - made necessary by federal requirements under the State’s 1115 Waiver and new federal Home and Community Based Regulations - created the need for a renewed emphasis within the IPC on person-centered care planning and outcomes. While many elements in the new IPC will look familiar, fundamental changes in how the IPC is developed to incorporate person centered care principles will be critical in meeting state and federal requirements. Join us on the 15th for this in-depth and timely conversation.

We Hope To See You In November!

 

CBAS Updates September 2016

SEPT 19, 2016 | California Department of Aging (CDA), Community Based Adult Services Branch (CBAS)

CBAS Revised Draft Individual Plan of Care (IPC) and Quality Strategy – Now Posted on CDA Website for Review and Comment

View Update

 

CBAS Updates May 2016

MAY 20, 2016 | California Department of Aging (CDA), Community Based Adult Services Branch (CBAS)

Upcoming Training Opportunity

Webinar: “Adult Day Services in the Managed Care Environment: A Primer for Prospective Providers or New Managers” (May 26th, 2:30 p.m. to 4:00 p.m.)

On May 26th from 2:30 p.m. to 4:00 p.m., CDA will participate in the California Association of Adult Day Services’ (CAADS) webinar on “Adult Day Services in the Managed Care Environment: A Primer for Prospective Providers or New Managers.” The presenters will be Lydia Missaelides, Executive Director of CAADS and the Alliance for Leadership Education (ALE), Gretchen Brickson, Senior Director, Managed Long-Term Services & Supports, L.A. Care Health Plan and Denise Peach, Chief, CBAS Branch, California Department of Aging.

The webinar will orient prospective new providers and new staff members to the evolving managed care environment and the credentialing, contracting, electronic billing, service authorization, auditing, and other requirements associated with being a contracted managed care provider. It also will address the state’s expectations for communication with managed care plans during the pre-screening process and L.A. Care Health Plan’s internal process for analyzing the need for new CBAS centers.

Webinar registration information is available on the CAADS website.

Please Note: The New CBAS Provider Start-Up Training (sponsored by CAADS in partnership with the California Department of Aging and the Department of Health Care Services) that was tentatively scheduled for June 6th and 7th in Sacramento is on hold until further notice. Please contact the CBAS Branch if you have any questions cbas@cda@aging.ca.gov; (916) 415-7545.

 

CBAS Updates February 2016

FEB 9, 2016 | California Department of Aging | Community-Based Adult Services Branch

It’s the beginning of another busy year for the Community-Based Adult Services (CBAS) Branch at the California Department of Aging (CDA) and for CBAS providers. There’s much to accomplish this year.

In this issue of CBAS Updates, we’ll share news that impacts CBAS providers and managed care plans, particularly on the CBAS Home and Community-Based (HCB) Settings Transition Plan (CBAS Transition Plan) and efforts to ensure that CBAS centers comply with the federal HCB Settings requirements and person-centered care by March 17, 2019.

CAADS Members may view the full update on the Members Only page.

 

CMS Approves CBAS Waiver Effective December 1, 2014

NOV 11, 2014 | CDA

The Centers for Medicare and Medicaid Services (CMS) has approved the CBAS Waiver Amendment effective December 1, 2014. Details and the presentation slides from the webinar for CBAS providers are now posted on California Department of Aging (CDA) website. MORE

 

Stakeholders Speak Out About Medi-Cal Provider Rates

FEB 24, 2014 | Senate Budget SubCommittee #1 -- HHS
Agenda| Video [segment starts at 54:40]

Debbie Toth, a member of the CAADS Board of Directors, and the Chief Executive Officer of Rehabilitation Services of Northern California, testified before the Health and Human Services Senate Budget SubCommittee #1 on February 24, 2014. Ms. Toth joined other panelists who provided testimony on Medi-Cal Provider Rates, and she urged legislators to restore the Medi-Cal reimbursement rate for ADHC providers who were subject to a 10% rate cut during the state's severe budget crisis.

 

CMS Approves Waiver Amendment, CBAS Program is Effective April 1, 2012

March 30, 2012 - The Centers for Medicare & Medicaid Services (CMS) approved the State of California's request, submitted January 1, 2012, to amend its Demonstration project authorized under section 1115 of the Social Security Act (Act) entitled the "Bridge to Health Care Reform (Waiver number 11-W-00193/9)," to incorporate the Community Based Adult Services (CBAS) program effective April 1, 2012.

CMS Letter 3/30/12: Approval of amendment to "Bridge to Health Care Reform" to incorporate CBAS program

 

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California Association for Adult Day Services
1107 9th Street, Suite 701 || Sacramento, CA 95814-3610
TEL: (916) 552-7400 || FAX: (866) 725-3123
EMAIL: caads@caads.org

 
 
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