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CAADS PRE-CONFERENCE TRAINING -- The Revised IPC for ADHC/CBAS
CAADS FALL CONFERENCE -- The Quality Imperative
CBAS CERTIFICATION FOR NEW ADHC CENTERS
HELP II LOAN PROGRAM -- Affordable Capital
What's New . . . August 29, 2016
IMPROVING ACCESS: Moving Medi-Cal Forward — Together
AUG 17, 2016 | California Health Care Foundation (CHCF)
CHCF thanks everyone who participated in the July 13 briefing on the future of Medi-Cal. Over 500 people joined in person, online, or by phone to hear noted experts discuss the findings and recommendations in a new CHCF-sponsored report from Manatt Health, Moving Medi-Cal Forward on the Path to Delivery System Transformation.
In her latest article for The CHCF Blog, CEO Sandra Hernández reflects on the key takeaways from the briefing, including the widely agreed-upon vision for Medi-Cal as a program that should foster shared accountability among providers to achieve high-value, high-quality, and whole-person care. She shares data on how attendees at the briefing ranked the report's recommendations, presents some of CHCF's next steps to advance Medi-Cal reform, and explains how you can stay engaged in this work.
"No single organization, government agency, or foundation can tackle this work alone, but I am confident that together we can help move Medi-Cal forward."
Read the complete article and share your thoughts on social media using #MediCal4ward.
Coordinated Care Initiative Update
Streamlined Enrollment to Begin for Cal MediConnect
The Department of Health Care Services (DHCS) will begin streamlined enrollment during the week of August 22, 2016, for Cal MediConnect as part of the Coordinated Care Initiative (CCI).
Streamlined enrollment allows Cal MediConnect health plans to submit enrollment changes to DHCS on behalf of their members. This will provide a simpler method for beneficiaries to enroll in the Cal MediConnect program associated with their Medi-Cal managed care long-term services and supports (MLTSS) health plan as they will no longer have to take the extra step to contact the state enrollment broker, Health Care Options (HCO), to complete their enrollment choice.
Providing streamlined enrollment is part of DHCS' comprehensive strategy for improving the CCI and Cal MediConnect program. Streamlined enrollment builds upon lessons learned about effective beneficiary outreach, including that the best way to educate beneficiaries is through one-on-one conversations that answer their specific questions about their providers, how the program works and how to make a smooth transition.
DHCS has safeguards in place to protect beneficiaries and will work with the plans to ensure the process is smooth and that beneficiary protections are working.
For more information about streamlined enrollment, click here .
Telephone Survey Findings Released
The UCSF Community Living Policy Center and the UC Berkeley Health Research for Action Center conducted an evaluation of Cal MediConnect as part of California's Coordinated Care Initiative (CCI).
As part of this three-year evaluation, researchers conducted a representative telephone survey with 2,139 beneficiaries who were dually eligible in early 2016 to examine their experiences with Cal MediConnect. Researchers compared the experiences of Cal MediConnect beneficiaries with those who opted out and duals who reside in non-CCI counties to identify areas where experiences are significantly better or worse than those who did not participate.
Cal MediConnect Ombudsman Program
The Department of Managed Health Care is soliciting proposals from qualified entities to provide services to California's dual eligible beneficiaries in Coordinated Care Initiative (CCI) counties, including consumer assistance, education, training and outreach. It is anticipated that the contract will begin on October 1, 2016, and end on December 31, 2017. This will ensure beneficiaries can continue to access these critical services from an independent ombudsman program.
You are invited to review and respond to this Request for Proposals (RFP), entitled "Cal MediConnect Ombudsman Program." Potential proposers are encouraged to download the solicitation package as well as any future addendums from Cal eProcure. The deadline for submitting proposals is 4 p.m. Pacific Standard Time (PST) on September 2, 2016. Please contact Christopher Rendall at Christopher.Rendall@dmhc.ca.gov or (916) 324-1618 if you have any questions.
New Atlas on Cost and Quality
AUG 11, 2016 | California Health Care Foundation (CHCF)
Benchmarking and tracking quality and cost measures is critical to reducing unwarranted variation and achieving high-quality, affordable care for all Californians. The new atlas is a collaboration of the Integrated Healthcare Association (IHA), the California Health Care Foundation (CHCF), and the California Health and Human Services (CHHS) Agency, and includes data for nearly two-thirds of Californians. See the new data tool and listen to a discussion.
Caregiver Cruise -- Possibly The First Of Its Kind In The Country
We can all use a vacation, but what about traveling when your loved one has dementia? It can certainly be difficult, and that’s why Insight Memory Care Center offers a Caregiver Cruise! Both the individual with a dementia diagnosis and their caregiver attend, making the program possibly the first of its kind in the country. In addition to the many benefits a cruise offers – the chance for a vacation, seeing new sights, a getaway – the caregiver cruise provides families with a chance to vacation in a safe and supportive environment.
New Video from Institute on Aging
We believe the future should be something to look forward to, at every age.
This short film [1:36 minutes] simply titled "ME," was created to encourage and inspire the 42 million older adults in this country, and to help remind everyone that the hopes, dreams and ambitions of those over 65 are not only alive and well; they are as vibrant and strong as ever.
New Interactive Tool Highlights Economic Stimulus Impact of Social Security
AUG 4, 2016 | Justice in Aging Health Network Alert
Social Security is the most successful anti-poverty program ever created, providing essential support to millions of older adults, people with disabilities, surviving spouses, and children. However, the overall economic benefits of Social Security go far beyond the direct benefits it provides.
A new interactive tool, Social Security Spotlight, produced by our friends and partners at the National Committee to Preserve Social Security and Medicare, highlights the valuable economic stimulus impact of Social Security in every state and in communities nationwide.
This tool can be helpful for advocates in their daily work as it provides detailed data about beneficiaries by state, county, congressional district, age, race/ethnicity and gender that anyone can access easily with just a few clicks. It can also bolster all of our advocacy by showing clearly how Social Security provides $1.6 trillion in economic stimulus impact and also serves as an automatic economic stabilizer, even during economic downturns.
You can access the tool at www.socialsecurityspotlight.org .
Opportunity for Regional Center Vendors to Apply for HCBS Compliance Activities Funding
AUG 3, 2016 | California Department of Developmental Services (DSS)
The 2016 Budget Act (SB 826, Chapter 23, Statutes of 2016) contains $15 million to help fund changes necessary for regional center service providers to come into compliance with the HCBS rules. The letter and accompanying enclosures sent to regional centers are available below.
The Department will conduct two webinars to review the compliance funding process and answer questions. The schedule for these webinars is:
Choose one of the above dates/time to participate in the webinar. Select the corresponding registration link. Follow the prompts to receive instructions for participating in the webinar. Email questions, comments, and concerns to HCBSregs@dds.ca.gov.
What Are Home and Community-Based Services (HCBS)?
The New HCBS Rules Affect More Than Just DDS
On August 14, 2015, DHCS, as the single state agency for the Medi-Cal program, submitted the Statewide Transition Plan for home and community-based settings to CMS for approval. It covers all existing California programs that are affected by the home and community-based settings requirements, including the HCBS Waiver for Californians with Developmental Disabilities and the DDS 1915(i) State Plan program.
New HCBS programs are not covered by the Statewide Transition Plan. New programs, such as the proposed Self-Determination Program Waiver, must be in compliance with the HCBS rules when they are implemented.
DDS HCBS Advisory Group
In early February, 2015, a number of individuals accepted invitations from Director Santi Rogers to participate on the HCBS Advisory Group (Advisory Group). The Advisory Group provides greater depth and breadth of analysis on the focused issues and processes impacted by, or necessary for, developing, implementing, and continuing compliance with the federal HCBS requirements. Members represent the various interests and perspectives impacted by the HCBS regulations by including consumers, family members, providers, regional centers, and advocates. Interested individuals are welcome to attend meetings.
For questions, or information on future meetings, email to HCBSregs@dds.ca.gov.
Cal Duals Update -- JULY 2016
Medicaid's Role in Meeting Seniors' Long-Term Services and Supports Needs
AUG 2, 2016 | The Henry J. Kaiser Family Foundation | View Article
Apply Now! 2016 Rosalinde Gilbert Innovations in Alzheimer's Disease Caregiving Legacy Awards
With continuing support from The Rosalinde and Arthur Gilbert Foundation, Family Caregiver Alliance (FCA) is pleased to announce that applications are now being accepted for the 2016 Rosalinde Gilbert Innovations in Alzheimer’s Disease Caregiving Legacy Awards.
$20,000 awards in each of these 3 categories:
The Gilbert Caregiving Legacy Awards reception will be held at the annual conference of the American Society on Aging, AiA17, March 20-24, 2017, in Chicago.
Oral Health in California: What About Older Adults?
JUL 27, 2016 | Justice in Aging Health Network Alert
Oral health is a critical aspect of overall health for people of all ages, but especially for older adults. Unfortunately, the oral health needs of older adults, particularly low-income older adults have been neglected.
A new Issue Brief by Justice in Aging, Oral Health in California: What About Older Adults? explores the reasons why the oral health of older adults in the state is suffering and offers recommendations for improvements.
The issue brief launches a new area of advocacy for Justice in Aging in which we seek to improve oral health for low-income older adults in California.
California ranks 30th in dental care for older adults. Older adults with limited income especially face barriers accessing quality dental care through the state’s Denti-Cal program, which provides dental services under the Medi-Cal program. For example, only one in four California dental providers provide services to Denti-Cal enrollees. Five California counties have no Denti-Cal providers and several other counties have Denti-Cal providers, but they are not accepting new patients. As a result of this and other reasons, older adults in California have high rates of dental decay and tooth loss.
Justice in Aging presented a webinar on this topic on Tuesday, July 26. You can access the webinar slides or watch the video here.
This issue brief and its accompanying webinar was funded by a grant from The California Wellness Foundation (Cal Wellness). Created in 1992 as a private independent foundation, Cal Wellness’ mission is to improve the health of the people of California by making grants for health promotion, wellness, education and disease prevention.
New Fact Sheets on How Medicare and Medicaid Work for LBGT People
JUL 21, 2016 | Justice in Aging Health Network Alert
LGBT people need to be aware of recent developments that change how Medicare and Medicaid work for them. First, the Supreme Court’s legalization of same sex marriage in all states changed how Medicare and Medicaid evaluate the eligibility of same sex spouses for both programs. Depending on the program and the individual’s circumstances, the changes can be positive or negative. Additionally, Medicare has begun covering Gender Reassignment Surgery and issued new rules that protect transgender older adults from sex discrimination in healthcare.
Three new fact sheets can help consumers learn how these changes may affect them, whether they are LGBT individuals married to someone of the same sex, or transgender individuals needing to access health care. These fact sheets were produced in partnership with SAGE (Services & Advocacy for Gay, Lesbian, Bisexual, & Transgender Elders), the SHIP National Network (State Health Insurance Assistance Programs), and Administration for Community Living (ACL).
The three fact sheets are:
All are available for download at the National Resource Center for LGBT Aging.
Direct service advocates are encouraged to share these resources widely with the individuals they serve.
Also available from Justice in Aging, Can Legal Services Better Meet the Needs of Low-Income LGBT Seniors?, a special report produced in partnership with Services and Advocacy for Gay, Lesbian, Bisexual, & Transgender Elders (SAGE). This report explains why LGBT older adults have higher rates of poverty, outlines how discrimination and other factors lead to unique legal needs, and provides practical tips for outreach, intakes, and providing culturally competent legal services to LGBT older adults.
Tell CMS What Isn't Working and to Improve Access to Durable Medical Equipment
JUL 19, 2016 | Justice in Aging Health Network Alert
Consumers with both Medicare and Medicaid coverage face recurring problems getting approval for Durable Medical Equipment (DME), getting repairs, and finding reliable suppliers. DME includes many vital items, such as wheelchairs, walkers, hospital beds, home oxygen equipment, and even diabetes test strips used with a glucose monitor. After dialogue with advocates about these problems, the Centers for Medicare and Medicaid Services (CMS) recently issued a Request for Information seeking more information about problems accessing these vital forms of equipment.
This is a very important opportunity to tell CMS what isn’t working and to improve access to DME. Please consider commenting and share this opportunity with others, both advocates and consumers, who can provide input to CMS.
The deadline for comments is August 23.
CMS noted some of the obstacles facing dual eligibles in getting access to DME including:
The agency asked for examples of these problems, as well as suggestions for legislative and administrative measures that could remedy the issue.
The full list of CMS questions is here. It is very open-ended. We hope that policy advocates will talk about trends they see and specific policy changes that would help. We also hope that consumers who can recount first hand problems will respond (but since comments are public - please don’t include personal information such as a Medicare number).
Please take advantage of this chance to help make DME more accessible to dual eligible beneficiaries!
Drop in Percentage of Physicians Participating in Medi-Cal Raises Red Flags
JUL 8, 2016 | Amy Adams, California Health Care Foundation
New 2015 data now available on ACA 411 show the percentage of physicians participating in Medi-Cal has declined since 2013 — during the same period Medi-Cal enrollment skyrocketed by 39%. This raises serious concerns about whether the supply of physicians participating in Medi-Cal can meet the increased demand.
Self-reported data from a voluntary survey of California physicians show physician participation in Medi-Cal declined from 69% in 2013 to 63% in 2015. (Physicians are identified as participating in Medi-Cal if they report any of their patients are covered by Medi-Cal.) The percentage of specialty care physicians participating in Medi-Cal likewise dropped during this time, from 70% to 64%. MORE
Changes to the Medicaid Managed Care Regulations in Effect
JUL 5, 2016 | Justice in Aging
On July 5, the first wave of new Medicaid Managed Care regulation requirements went into effect. The Centers for Medicare and Medicaid Services (CMS) published the final Medicaid managed care rule this spring, introducing sweeping changes to how the federal government will regulate entities that manage long-term services and supports (LTSS).
Justice in Aging discussed some of the most important pieces of the new regulations in a webinar on June 30. Watch the webinar or download the slides here. Read about the changes on our blog.
HHS Issues Guidance on Facility Residents’ Return to Community Living
JUL 5, 2016 | Justice in Aging Health Network Alert
Recent federal guidance instructs nursing facilities on how to better identify and support residents who want to move to community settings. As the guidance notes, unnecessary nursing facility placement may constitute illegal disability-based discrimination.
The guidance concerns how a facility should administer an assessment document called the Minimum Data Set — MDS for short. Since 2010, the MDS has included Section Q, which is designed to determine a resident’s interest in moving from the facility to a community setting. According to the HHS Office of Civil Rights —the author of the guidance — many nursing facilities are administering Section Q improperly, which results in residents being deprived of opportunities to move from facilities into community settings.
One MDS question asks if “active discharge planning” is occurring. The Office of Civil Rights reports that too many facilities are answering “yes” based on the file containing a pro forma “discharge plan” that has no practical effect. Under MDS assessment protocols, this “yes” answer results in the resident not being asked whether he or she wishes to speak to someone about the possibility of moving from the facility into the community.
The guidance also identifies problems in how the facilities ask whether the resident wishes to speak to someone about possibly moving into the community. The guidance instructs facilities to emphasize that the resident does not need to know exactly how or whether a move would take place: the resident just needs to have an interest in the possibility of moving.
Finally, the guidance advises that interested residents be referred to the “Local Contact Agency” designated to assist residents in moves into the community. A facility should not short-circuit the process based on its estimation that the resident would not be able to live in the community, or on the opinions of the resident’s family.
Justice in Aging commends HHS for its attention to these issues, and encourages residents, family members, and care coordinators to actively explore how moves to the community might be facilitated. The federal guidance and contact information for Local Contact Agencies each is available on-line.
For more information from Justice in Aging about rights under the Americans with Disabilities Act (ADA) and Olmstead, see our issue brief, ADA at 25: Aging Advocates Celebrate Partnership and Progress.
STOP THE THREAT TO SHIP PROGRAM FUNDING
State Health Insurance Assistance programs provide local help for people with Medicare
JUN 21, 2016 | Justice in Aging Health Network Alert
The Senate Appropriations Committee shocked advocates last week by approving a bill that would entirely eliminate funding for State Health Insurance Programs (SHIPs). The Senate bill now goes to the House Appropriations Committee.
SHIPs in every state provide vital one-on-one benefit counseling to people with Medicare, helping them choose Medicare plans and navigate denials. They assist low income Medicare beneficiaries in accessing programs that lower their costs, such as Medicare Savings Programs and the Low Income Subsidy, and in using those programs effectively. For example, in 2015, SHIPs served over 1 million beneficiaries with one-on-one assistance during the Medicare Open Enrollment Period. Losing SHIPs would be a major blow to the people we all serve.
Now is a good time for your Senators and Representatives to hear from you. Use our Action Alert to contact members of the House of Representatives and urge them to reject the Senate proposal and invest in SHIPs. For more information, this Kaiser Health News article explains the potential consequences of a loss in funding, and The National Council on Aging (NCOA) also prepared an issue brief on SHIP funding.
Make your voice heard and let the House know how important SHIPs are for Medicare beneficiaries.
LawHelpCA.org News Features Advance Planning, Scam Alerts
JUN 3, 2016 | LawHelpCA.org
LawHelpCA is a statewide resource for legal information and referrals. This issue of LawHelpCA.org News features:
Mental Health Access for Persons with Dementia
As this paper, Mental Health Services for Californians with Alzheimer's Disease, proposes, California has a number of timely opportunities to improve access to mental health services for people with dementia, beginning at the point of diagnosis. An urgent need exists to pursue such opportunities immediately to prevent the types of crises presented here, enable families to stay together, improve quality of life, and reduce the cost of care.
Human Kindness--it just flows around here[Download Real Player]
6/20/16 California Healthline
4/12/16 California Healthline
Geriatric ERs Reduce Stress, Medical Risks For Elderly Patients
Elderly Patients In The Hospital Need To Keep Moving
Exclusive: Losses from Obamacare, other business force Blue Shield to take a week off in September
Elderly Hospital Patients Arrive Sick, Often Leave Disabled
Painting to remember
Long-Term Care Is An Immediate Problem — For The Government
Doctors Are Improperly Billing Some on Medicare, U.S. Says
Democratic And Republican Platforms Back Home-Based Care For Older Adults
Adult day centers provide care for older adults, respite for caregivers
UnitedHealth, Aetna to join major Medi-Cal markets
El Monte center pays former employee $9,187 in unpaid wages, penalties
Savvy Senior: How to Choose an Adult Day Care Service
Jerry Brown signs $167 billion California budget, makes no cuts
Fighting the Swell of Latino Dementia
California Budget: Small Health Gains, Advocates Look To Nov. Ballot For Big-Ticket Items
Institute on Aging
San Ysidro Health Center, Inc.
Your Money, Your Life
Marin Adult Day Health Care