NOVEMBER IS NATIONAL CAREGIVERS MONTH
Visit AARP's New Caregiving Collection Site -- I Heart Caregivers!
HIGHLIGHTED MEDIA COVERAGE
• Fragile, Rural Population About To Be Moved Into Medi-Cal Managed Care California Healthline, 11/10/14
• Governor Rejects Adult Day Health Bill; Future of Senior Program... California Healthline, 10/1/14
• Lawsuit Slams the State's Duals Project California Healthline, 7/7/14
• Adult Day Centers Still Struggling California Healthline, 3/31/14
• Medi-Cal Cuts Undermining Senior Programs, Facilities, Advocates Say California Healthline, 3/5/14
Quick Links . . .
ASSOCIATE MEMBERS (Vendors, Consultants & Networks)
CCI / CAL MEDICONNECT
Coordinated Care Initiative (CCI)
Visit CAADS CCI / Cal MediConnect Web Page for NOV 24, 2014 Cal Duals CCI Weekly Update and more.
Visit Cal Duals Web Site for CCI Enrollment Data, Frequently Asked Questions about January 2015 Cal MediConnect Enrollment, and more.
Last Call to complete the 2014 National Study!! Deadline: DEC 5, 2014
NOV 2014 | NSLTCP
If you've already submitted the National Study of Long-Term Care Providers (NSLTCP) questionnaire for your center, great! If not, how can we expect to gather national data without your input? Adult day centers have an opportunity to provide input about the characteristics of adult day services centers and the participants they serve by responding to a brief federal survey that is a valuable resource to state and federal policymakers, providers and researchers.
The information collected through NSLTCP is used to inform the CDC overview report on the major types of long-term care providers that include adult day services centers, assisted living and other residential care communities, home health agencies, nursing homes, and hospices.
NCHS has contracted with RTI International, an independent, nonprofit research organization, to collect the NSLTCP data. If you received a questionnaire packet in the mail and you have not completed it yet, please do so as soon as possible. If you have questions about completing the questionnaire, or received a questionnaire packet in the mail but no longer have it or cannot find it, please contact the NSLTCP Help Desk today at 1-877-225-4434.
What's In A Notice? How Notices Of Action Protect Consumers in Medicaid Managed Long-Term Services and Supports
NOV 2014 | Guide | NSCLC
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.
Attention: PEOPLE WHO USE IHSS AND IHSS PROVIDERS
NOV 21, 2014 | Disability Rights California (DRC) | View on DRC Web Site
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:
- 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
- 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.
New Changes to Medicaid.gov Website as Next Marketplace Open Enrollment Period Launches
NOV 17, 2014 | Medicaid.gov
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.
CMS Grants Second Temporary Extension of CBAS Waiver through NOV 30
OCT 30, 2014 | CDA ACL #14-08 | CDA CBAS Branch
The California Department of Aging (CDA) Community Based Adult Services (CBAS) Branch issued All Center Letter # 14-08 on October 30, 2014, to announce that the Centers for Medicare & Medicaid Services (CMS) is granting a second temporary extension through November 30, 2014, for the Community-Based Adult Services (CBAS) benefit authorized under California’s Bridge to Reform Demonstration Waiver. The previous temporary extension was through October 31, 2014. This second temporary extension allows the state to continue to provide CBAS as described in the current Waiver special terms and conditions (STCs) while allowing additional time for CMS to review the Draft CBAS Waiver Amendment submitted on June 13, 2014.
Alzheimer's Association Submits Letter to CMS Regarding Anticipated HCBS Guidance on Non-Residential Care Settings
OCT 15, 2014 | Alzheimer's Association Letter to CMS | CA Council of the Alzheimer's Association
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. Read letter. . .
CAADS Letter to DHCS Urges HCBS Rules that Support Access and Safety for Alzheimer's Patients Voluntarily Attending Adult Day Programs
OCT 16, 2014 | CAADS Letter to DHCS
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. Read letter. . .
L.A. Care to Accept Cal MediConnect Passive Enrollment Starting January 2015
OCT 2, 2014 | L.A. Care Health Plan
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 full announcement . . ..
Adult Day Services: A Model of Person- and Family-Centered Care
OCT 2, 2014 | BLOG by Lynn Friss Feinberg | AARP
The AARP Public Policy Institute has released a new blog post on adult day services (ADS). Lynn Friss Feinberg writes that ADS provides supportive services for both the adult with functional limitations and their family caregiver. With more consumers rejecting nursing homes in favor of home and community-based services, ADS can help build a better person-and family-centered system of long-term services and supports in the community. Access the blog and more on the CAADS Publications page.
THE NEW POLST: 6 Things You Should Be Doing To Prepare
SEPT 24, 2014 | Polst California | Coalition for Compassionate Care of California
Here are 6 things you should be doing right now to prepare for the new form.
- Order new POLST forms from Med-Pass
- Familiarize yourself with the new form: download a copy in English
- Learn about key changes to the form -- Read “Key Talking Points for Healthcare Providers” (1 Minute); Watch a recording of the “Changes to POLST in 2014” webinar for an in-depth look at the changes to POLST (1 Hour)
- Spread the word among your colleagues
- Replace old forms. Previous versions of POLST will still be honored after the 2014 form goes into effect; however, it is best practice to complete a 2014 version of POLST—and void older versions of the form—when a patient’s POLST is updated
- Download the 2014 POLST form in other languages -- Ask the responsible staff person to download all copies of POLST in other languages and have these forms ready for when you ned them. Get copies of the forms at http://capolst.org/2014polst. Order POLST in braille by sending a request to email@example.com.
Get more information about POLST by contacting your local POLST Coalition, or contact the Coalition for Compassionate Care of California at (916) 489-2222 or info@caPOLST.org.
Medicare Part D Open Enrollment Period: OCT 15 - DEC 7, 2014
AUG 18, 2014
Open enrollment is an opportunity for beneficiaries to review and update their Part D prescription drug coverage. New healthcare plans become available each year that may offer better coverage or save money, so it’s important for participants to take the time to carefully review their options. This year, open enrollment starts on Wednesday, October 15 and closes on Sunday, December 7.
Download Part D Open Enrollment Toolkit -- Share this tool kit with patients, constituents and stakeholders. With a wide variety of prescription drug plans to choose from, Medicare Part D has a plan that will fit any patients’ needs.
Medicare Part D saves and improves patient lives at a low cost, expanding access to treatment for patients in a dramatic way. With an 86 percent patient satisfaction rate according to a recently released survey and total costs coming in at $349 billion, 45 percent less than 10-year projections, it’s an American success story.
To learn more about the prescription drug plans that are available in your area, check out the Medicare Plan Finder at www.medicare.gov/find-a-plan. You can also call Medicare at 1-800-MEDICARE (1-800-633-4227) or visit www.medicare.gov to enroll.
Balance Billing Dual Eligibles Violates Federal and State Law
AUG 8, 2014 | NSCLC
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, firstname.lastname@example.org.
Updated HIPAA Manual Available From CAADS
Is your ADHC in compliance with the "HIPAA Omnibus Rule?"
New Requirements! || Order Form
Don’t forget, 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.
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
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: email@example.com
Human Kindness--it just flows around here
[Download Real Player]
Honoring Adult Day Services pioneers and those they serve.
NSCLC Video Features
Adult Day Health Care
ADHC starts at 4:10 mark
Forever In Our Hearts
Nina Martine Nolcox,
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
to inspire students of nursing to become leaders in their communities.
NOV 20, 2014
Marin's unsung heroes recognized
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
adult day care | Lodi Adult Day Care program | adult day care services | Lodi Community Foundation
NOV 10, 2014
Fragile, Rural Population About To Be Moved Into Medi-Cal Managed Care
Medi-Cal managed care health plans | SPDs | most at-risk for institutionalization | continuity-of-care
OCT 28, 2014
Seniors get a helping hand at Adult Day Care Center
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
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
Acacia Adult Day Services | community-based health home | Adult day care
OCT 21, 2014
Blues Harvest helps celebrate center's anniversary
Yolo Adult Day Health Center | Friends of Adult Day Health Care
OCT 8, 2014
Alzheimer's Family Services Center Earns 'Excellence in Care' Distinction from Alzheimer's Foundation of America
Alzheimer's Family Services Center (AFSC) | adult day programs | adult day services provider
OCT 2, 2014
Adult Day Services: A Model of Person- and Family-Centered Care
BLOG by Lynn Friss Feinberg
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
OCT 1, 2014
Governor Rejects Adult Day Health Bill; Future of Senior Program Now Up in Air
adult day health care | CBAS program | AB 1552 | long-term care and services | California Association of Adult Day Services
Quick Link . . .
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.
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
What Are Adult Day Services
Adult Day Services - a win, win, win opportunity
Resistance and Dementia
Adult Day Services vs. Home Care: "It's about value"
MAR 20, 2014
Innovating technology for the needs and health of elders
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
Quick Link . . .
Caring for a Veteran?
For help call
VA CAREGIVER SUPPORT LINE (toll-free):
Mon - Fri 8 AM - 11 PM (EST)
Sat 10:30 AM - 6 PM (EST)
- - - - - -
To report fraud and abuse call
The call is free and you can
THE CAADS STAFF
Lydia Missaelides, MHA
Education & Events Manager
Membership & Communications Director