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CAADS - California Association for Adult Day Services

What's New
 
HIGHLIGHTED MEDIA COVERAGE

12/08/2014, Media Release
Blue Shield of California To Enter Medi-Cal/Medicaid with Acquisition of Care1st

12/01/2014, California Healthline
New Legislative Strategies May Emerge To Raise Medi-Cal Reimbursement Rates

11/10/2014, California Healthline
Fragile, Rural Population About To Be Moved Into Medi-Cal Managed Care

10/01/2014, California Healthline
Governor Rejects Adult Day Health Bill; Future of Senior Program...

07/07/2014, California Healthline
Lawsuit Slams the State's Duals Project

03/31/2014, California Healthline
Adult Day Centers Still Struggling

03/05/2014, California Healthline
Medi-Cal Cuts Undermining Senior Programs, Facilities, Advocates Say

Quick Links . . .

       Arrow Right ASSOCIATE MEMBERS (Vendors, Consultants & Networks)
       Arrow Right CBAS
       Arrow Right CCI / CAL MEDICONNECT
       Arrow Right LEGAL UPDATES


Coordinated Care Initiative (CCI) / Cal MediConnect

DEC 15, 2014
Cal Duals Weekly Update | Cal Duals Website featuring Enrollment Data, FAQs and more!

DEC 8, 2014
Cal MediConnect Cartoon Videos Now Available

Five 2-3 minute cartoon videos about Cal MediConnect are now available for viewing on the CalDuals website. Each video covers a different aspect of the program. The videos are available in English, Spanish and with English subtitles. Information sheets are also now available in twelve languages at the Cal Duals website.

DEC 8, 2014
L.A. Care CCI Stakeholder Workgroup October 23 Meeting Minutes Now Available

The October 23rd CCI Stakeholder Operational Workgroup meeting minutes are now available. The minutes also include the Q&A’s from the end of the meeting.

OCT 2, 2014
L.A. Care To Accept Cal MediConnect Passive Enrollment Starting January 2015

L.A. Care Health Plan, the nation’s largest publicly operated health plan, has learned the results of the annual Medicare Star Ratings, which indicate that L.A. Care’s Medicare Part D Star Rating has improved for 2015. With this new rating, L.A. Care will begin accepting passive enrollment into the Cal MediConnect program starting January 2015.

Cal MediConnect offers members a coordinated care model within a single health plan to help foster better health outcomes and improved quality of life. In light of Cal MediConnect, L.A. Care has made the decision to close its Medicare D-SNP on December 31, 2014. Read more.


CBAS Waiver

NOV 28, 2014
CMS Approves CBAS Waiver Effective December 1, 2014

Details, including slides from the state's December 2, 2014 webinar for CBAS providers, are posted on the CDA website.


Dual Eligible Beneficiaries

NOV 24, 2014
Primary Care Provider Assignment for Dual Eligibles Explained in DHCS All Plan Letter
Courtesy of National Senior Citizens Law Center

DHCS has released All Plan Letter (APL) 14-015 directed at the Medi-Cal plans addressing primary care provider (PCP) assignment for dual eligible beneficiaries. Specifically, the APL states that a Medi-Cal plan should not assign a PCP to a dual eligible except in very limited circumstances. The APL is dated November 24, 2014.

This policy is very important because there have been circumstances where the Medi-Cal plan has assigned a dual eligible a PCP and the assignment has caused disruption in care. The issue arises when the dual eligible visits his or her Medicare PCP and the Medicare PCP refuses to see the dual because of the Medi-Cal PCP assignment. The APL is very clear that the Medi-Cal plan's assignment of a PCP for a dual eligible member should be a rare practice.

AUG 8, 2014
Balance Billing Dual Eligibles Violates Federal and State Law
Courtesy of National Senior Citizens Law Center

Advocates continue to report attempts by providers, particularly physicians, to ”balance bill” dual eligible beneficiaries (those who qualify for both Medicare and Medi-Cal) for charges not covered by Medicare or Medi-Cal. Balance billing violates both federal and state law. Providers may not balance bill any Medi-Cal patient who presents a Medi-Cal card. In other words, a provider must accept as payment in full whatever amount the provider receives from Medicare, other insurance (if any), and Medi-Cal.

The balance billing protection remains even if Medi-Cal pays nothing to the provider. The only exception is that providers may bill Medi-Cal beneficiaries who have a monthly share of cost obligation, but only until that obligation is met for the applicable month. If a provider bills a patient in error, the provider must stop immediately upon proof of Medi-Cal enrollment and must call off any collection efforts that have begun. Upon receiving proof of Medi-Cal eligibility, debt collection agencies and/or providers also must correct any erroneous information sent to credit reporting agencies.

Providers also are prohibited from asking a beneficiary to enter into a private pay agreement or otherwise waive balance billing protection. Advocates who encounter balance billing issues may find that, in some cases, providers are genuinely confused about their obligations and unaware of procedures for processing crossover Medicare claims through Medi-Cal.

The following resources can be helpful in addressing these situations:

  • Physician’s Toolkit
    A new resource prepared by the California Department of Health Care Services particularly around the Coordinated Care Initiative but containing explanations that apply to providers and advocates in non-CCI counties as well. Look especially at “Physician services and payment under the CCI” and “FFS Medicare and the CCI”, both of which explain the prohibition and assist providers in understanding how they can properly process claims with Medi-Cal.
  • Crossover Only Provider Authorization Information
    Advocates can direct providers to this page on the DHCS website where they can complete an abbreviated form in order to submit crossover claims to Medi-Cal without enrolling as full Medi-Cal providers.

If you are seeing balance billing issues for your clients, please let NSCLC know. Contact Georgia Burke, gburke@nsclc.org.


HIPAA

In Compliance with the "HIPAA Omnibus Rule?" Get CAADS Updated HIPAA Manual for ADHC!
New Requirements! || Order Form

As of September 23, 2013, all ADHCs need to be in compliance with the “HIPAA Omnibus Rule” which implements changes required by the HITECH Act of 2009. Failure to have internal guidelines in place that comply with the new Rule can lead to fines and other sanctions. CAADS worked with Allan Jergesen of Hanson, Bridgett to produce a HIPAA Compliance Kit to help you quickly come into compliance with new HIPAA rules.


Home and Community Based Services (HCBS)

OCT 16, 2014
CAADS Letter to DHCS Urges HCBS Rules that Support Access and Safety for Alzheimer's Patients Voluntarily Attending Adult Day Programs

In a letter to Toby Douglas, Director of the California Department of Health Care Services (DHCS), CAADS provided input regarding California's draft Home and Community-Based Services (HCBS) Statewide Transition Plan developed as a result of the new Federal Home and Community-Based Setting requirements, CMS 2249-F and CMS 2296-F affecting 1915(i) and 1915(c) waivers.

The letter emphasizes that the rules should adequately address the needs of the population with Alzheimer’s and other types of dementia and allow them the broadest possible access to community-based services with a customized, individualized and personalized approach. CAADS urges the state’s plan support HCBS programs that ensure the safety and well-being of this population while participating in voluntary day programming by allowing for time-delayed egress devices and secured perimeter fences, consistent with the protections and provisions that exist in current law California Health and Safety Code 1569.698 – 1569.6991.

OCT 15, 2014
Alzheimer's Association Submits Letter to CMS Regarding Anticipated HCBS Guidance on Non-Residential Care Settings

The California Council of the Alzheimer’s Association, on behalf of a coalition of the five chapter offices in California, has submitted a letter to CMS to share their perspective on the discussions that CMS has been having with stakeholder groups and state agencies regarding implementation of the new Home and Community-Based Services (HCBS) regulations. The letter addresses the anticipated CMS Guidance on Home and Community-Based Services, Non-Residential Settings.


In Home Supportive Services (IHSS)

NOV 21, 2014
ATTENTION: People Who Use IHSS and IHSS Providers
Courtesy of Disability Rights California (DRC)

New federal rules require that IHSS workers receive overtime pay starting on January 1, 2015. California has limited the amount providers can work each week to 61-66 hours, with no exceptions.

The state will not enforce the new rules until April 1, so no need to rush to act!

We know the new rules will be a problem for some consumers. Disability Rights California (DRC) is trying to get the state to allow exceptions when needed.

We want to hear from you if you are an IHSS consumer or provider and you fit into one of these groups:

  1. Two or more relatives receive IHSS from the same family member and the total weekly hours for consumers add up more than 61-66 per week; OR

  2. A consumer who receives IHSS AND Waiver Personal Care Services through the Nursing Facility / Acute Hospital or IHO Waiver with one or more providers who work more than 61-66 hours per week.

Please call the Disability Rights California (DRC) office at 1-800-776-5746 and explain that you are calling about IHSS Overtime issues.


Managed Long-Term Services and Supports (MLTSS)

NOV 2014
What's in a Notice? How Notices Of Action Protect Consumers in Medicaid Managed Long-Term Services and Supports
Courtesy of National Senior Citizens Law Center

As Managed Long Term Services and Supports (MLTSS) rolls out nationwide, advocates on the ground have seen due process violations in appeals and notices of action. In this tool for advocates and consumers, NSCLC focuses on notice and appeal rights in MLTSS. NSCLC provides background information on notices of action, including an explanation of what type of Managed Care Organization (MCO) behavior constitutes an action that could give rise to due process violations.

This tool also provides advocates with the specific information that must be included in each notice of action to meet due process requirements, and outlines how continuation of services and aid-paid-pending plays out in the managed LTSS context.


Medicaid

NOV 17, 2014
New Changes to Medicaid.gov Website As Next Marketplace Open Enrollment Period Launches

The Centers for Medicare & Medicaid Services (CMS) is pleased to announce several changes to the Medicaid.gov website as we launch the next Marketplace open enrollment period and continue our ongoing efforts to improve and expand Medicaid coverage across the country:

  • New Medicaid.gov Home Page -- We have given our Medicaid.gov home page a streamlined and more modern look! You’ll still find quick links to new and notable items on the site including federal policy guidance and other new technical assistance resources. We also made it easy to complete key tasks from the home page, like sign up for e-mail updates and comment on pending 1115 demonstrations.
  • Streamlined Resources for Consumers -- A great deal of our website traffic actually comes from consumers who are interested in finding out how to apply for Medicaid coverage. In order to make that information as clearly available as possible, we created a new Consumer Action page to help them find the information they need, either through their state’s Medicaid program website or by visiting www.HealthCare.gov. We also include information about coverage opportunities for children and a link to the great resources that are available on our sister site www.InsureKidsNow.gov.
  • Medicaid and CHIP National Program Information -- We have incorporated the information that used to reside in our Medicaid Moving Forward section into a new area that highlights National Medicaid and CHIP program information. There you will find an expanded page for our monthly Medicaid and CHIP Enrollment Reports as well as our national tables outlining Medicaid-Marketplace Coordination and the list of states that have adopted Targeted Enrollment Strategies. If you had bookmarked the Medicaid Moving Forward location, please take a moment to update your bookmark so you can get to the new location.
  • Medicaid and CHIP State Profiles -- We have also expanded our State Medicaid and CHIP profiles to provide a more complete picture of the many policy and programmatic features that make up each state’s Medicaid and CHIP program. Some of the new elements of these state-specific profiles include: Medicaid and CHIP eligibility levels; monthly Medicaid and CHIP enrollment data; a state-specific list of approved state plan amendments and waivers; links to detailed Medicaid managed care profiles, and children’s participation rates in Medicaid and CHIP.

CAADS

California Association for Adult Day Services, a 501 (c) 6 non-profit grassroots-driven organization, advocates for the growth and development of adult day services in California and nationally. CAADS was the first state association formed in the United States for the purpose of advancing adult day services. Centers in membership with CAADS provide innovative day programs that support individuals with physical or mental disabilities and older adults with Alzheimer's disease and their families.

A nationally recognized leader in the field of aging, the Association is governed by the CAADS Board of Directors and provides timely information, analysis, advocacy, technical assistance, education, and networking opportunities for its members. CAADS members agree to abide by the Association's Bylaws and Code of Ethics. For more about CAADS Membership click here!

The CAADS Members Only page features information specific to Adult Day Services:

  • State Budget Proposals
  • CBAS Waiver
  • Medi-Cal Issues
  • Medicare and Medi-Cal Dual Beneficiaries News
  • Managed Care Health Plans
  • Coordinated Care Initiative (CCI) and CalDuals Updates
  • CA Dept of Managed Health Care Updates
  • CA Dept of Public Health Licensing & Regulations for ADHC / CBAS Centers
  • CA Dept of Social Services Licensing & Regulations for ADP Centers
  • Legislative Alerts and Advocacy
  • Funding Sources
  • Technical Assistance
  • Education / Training Materials / Webinar Recordings
  • CAADS Membership Roster

CAADS

The Alliance for Leadership and Education (A.L.E.) is a non-profit 501(c)(3) public benefit arm of CAADS. Its mission is to advance innovation and quality in Adult Day Service through research and analysis, education and training, and leadership for the benefit of consumers and their caregivers. The organization is governed by the 7-member A.L.E. Board of Directors.

BACK TO TOP


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


Human Kindness--it just flows around here
[Download Real Player]

Click to view the clip from CAADS 25th anniversary video
Honoring Adult Day Services pioneers and those they serve.


NSCLC Video Features
Adult Day Health Care

View Video
ADHC starts at 4:10 mark


Forever In Our Hearts
Nina Martine Nolcox,
RN, PHN

1965 - 2014

NINA M. NOLCOX
SCHOLARSHIP FUND Now Accepting Contributions

The Alliance for Leadership and Education (ALE), a subsidiary of CAADS, has established the
Nina M. Nolcox
Scholarship Fund

to inspire students of nursing to become leaders in their communities.


MEDIA CORNER

Quick Links . . .
Videos/YouTube   ||  
Media Archives

Recent Coverage

Daily Democrat
DEC 17, 2014
Housing project to expand Yolo Adult Day Health Center
Supes approve first phase of construction
Sarah Dowling
Key Words:
Yolo Adult Day Health Center

New America Media / Black Voice News
DEC 13, 2014
CA Advocates Hope Low-Income Black Elders Ready for New Health Program
Corey Arvin
Key Words:
Cal MediConnect (CMC) health care program | continuity of care | Inland Empire Health Plan (IEHP) | Molina Healthcare | adult day health centers

Catholic San Francisco
DEC 10, 2014
Adult Day Services a home away from home
Jeff Bialik
Key Words:
Catholic Charities Adult Day Services San Mateo County | licensed adult day program

Media Release
DEC 8, 2014
Blue Shield of California To Enter Medi-Cal/Medicaid with Acquisition of Care1st
Key Words:
Blue Shield of California | Care1st Health Plan | Medi-Cal | dually eligible for both Medicaid and Medicare

Visalia Times-Delta
DEC 5, 2014
Day services for adults with dementia needed in Visalia
Teresa Douglass
Key Words:
Porterville Adult Day Services| adult day program | Personal Adult Day Services (PADS) | adult day services

California Healthline
DEC 1, 2014
New Legislative Strategies May Emerge To Raise Medi-Cal Reimbursement Rates
David Gorn
Key Words:
Medi-Cal provider reimbursement rates | 10% payment cut | access problems

Black Voice News / blackvoicenews.com
NOV 26, 2014
Health Advocates Hope Black Medi-Cal, Medicare Recipients Ready for Cal MediConnect
Corey Arvin
Key Words:
Cal MediConnect (CMC) health care program | continuity of care | Inland Empire Health Plan (IEHP) | Molina Healthcare | adult day health centers

Novato Advance
NOV 20, 2014
Marin's unsung heroes recognized
Joe Wolfcale
Key Words:
Marin Adult Day Health Care Center | National Family Caregiver Month | MADHC | LifeLong Medical Care

Lodi News-Sentinel / lodinews.com
NOV 13, 2014
Former teacher Amelia Ernst plans legacy endowment for Lodi's adult day care program
Rich Hanner
Key Words:
adult day care | Lodi Adult Day Care program | adult day care services | Lodi Community Foundation

California Healthline
NOV 10, 2014
Fragile, Rural Population About To Be Moved Into Medi-Cal Managed Care
David Gorn
Key Words:
Medi-Cal managed care health plans | SPDs | most at-risk for institutionalization | continuity-of-care

Davis Enterprise
OCT 28, 2014
Seniors get a helping hand at Adult Day Care Center
Anne Ternus-Bellamy
Key Words:
Yolo Adult Day Health Center | Yolo ADHC | Adult Day Health Center | Adult Day Health Planning Council | Dignity Health: Woodland Healthcare | Friends of Adult Day Health Care

Ventura County Star
OCT 22, 2014
Camarillo adult day care program hosts open house for renovated space
Alicia Doyle
Key Words:
Building Hope Adult Day Center | Camarillo Health Care District | adult day program

Orange County Register
OCT 22, 2014
Garden Grove adult care facility celebrates 35 years of holding to life's bright side
Key Words:
Acacia Adult Day Services | community-based health home | Adult day care

Daily Democrat
OCT 21, 2014
Blues Harvest helps celebrate center's anniversary
Marie Graham
Key Words:
Yolo Adult Day Health Center | Friends of Adult Day Health Care

AFSC News
OCT 8, 2014
Alzheimer's Family Services Center Earns 'Excellence in Care' Distinction from Alzheimer's Foundation of America
Key Words:
Alzheimer's Family Services Center (AFSC) | adult day programs | adult day services provider

AARP
OCT 2, 2014
Thinking Policy
Adult Day Services: A Model of Person- and Family-Centered Care
BLOG by Lynn Friss Feinberg
Key Words:
community-based adult day service (ADS) centers | home- and community-based services | person- and family-centered system of long-term services and supports in the community

California Healthline
OCT 1, 2014
Capitol Desk
Governor Rejects Adult Day Health Bill; Future of Senior Program Now Up in Air
David Gorn
Key Words:
adult day health care | CBAS program | AB 1552 | long-term care and services | California Association of Adult Day Services

Quick Link . . .
Coverage Archives

 

Videos / YouTube

National Senior Citizens Law Center
OCT 23, 2014
"Forget About Living Paycheck to Paycheck. Let's talk about Day to Day"
1 in 5 senior women lives in poverty. Dollie, Myrtle, Sandy, and Lidia share stories about what life is like for low-income older women.

San Ysidro Health Center, Inc.
OCT 2014
Caring for Our Greatest Generations
In celebration of
SYHC's 45th Anniversary

Your Money, Your Life
APR 14 & 15, 2014
What are Adult Day Services
Elder Law Attorney Ramsey A. Bahrawy interviews Amanda Sillars of Total ADHC Solutions
Part I
What Are Adult Day Services

Part II
Adult Day Services - a win, win, win opportunity
Part III
Resistance and Dementia
Part IV
Adult Day Services vs. Home Care: "It's about value"

PBS NewsHour
MAR 20, 2014
Innovating technology for the needs and health of elders
Featuring
Institute on Aging

Marin Adult Day Health Care
JAN 29, 2014
"A Day in the Life":
LifeLong Medical Care's Marin Adult Day Health Care Center

SBSS AGEnts for Change
2014 Video Series
In Home Supportive Services: This Is Important

Safe and Secure Housing: We Can Do Better

The Falling Monologues
MAR 7, 2012
Full Length
Falling Monologues
37:18)
Segments
Introduction
(2:53)
The Ladder
(7:28)
The Bus
(7:31)
The Sidewalk
(6:28)
Scatter Rug
(5:15)
Don't Ask
(7:45)

Quick Link . . .
Coverage Archives

 

caads.org
Please Direct Questions and Comments to
caads@caads.org




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THE CAADS STAFF

 

Photo of Lydia Missaelides

Lydia Missaelides, MHA
Executive Director


Photo of Pamela Amundsen

Pamela Amundsen
Education & Events Manager


Photo of Kathryn Atkinson

Kathryn Atkinson
Membership & Communications Director


Photo of Coni Segretto-Ricci

Coni Segretto-Ricci
Office Assistant


Phyliss Regino
Office Assistant
(not pictured)


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