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Aging Services of Washington Posts 2012 Legislative Session Advocacy Briefs

2012-01-24T15:47:00.000-08:00

Aging Services of Washington is pleased to share our 2012 legislative introduction and Advocacy Briefs of January 6, 2012. As you know, the regular Legislative Session began Monday, January 9, and we trust you will find these documents useful as together, we continue our advocacy for seniors and their housing, care and service providers. Contact jmartin@agingwa.org for assistance or additional information. NOTE: Contact arunnels@agingwa.org for log-in and password access.

HUD Service Coordinator Grant Extension Guidance

2012-01-24T15:44:00.000-08:00

On Jan. 5, the U.S. Department of Housing and Urban Development (HUD) announced the release of the FY 2012 guidance providing instruction on requesting service coordinator grant extension funds. HUD estimates that there will be sufficient FY 2012 funds to fund all eligible grants that expire on or before Dec. 31, 2012, including a 2.5% increase over funds awarded or expended in FY 2011.

PRAC Contracts To Be Funded, Per HUD

2012-01-24T15:40:00.000-08:00

According to the U.S. Department of Housing and Urban Development (HUD), there will be funds available to renew all Project Rental Assistance Contract (PRAC) agreements as well as for implementation of new authorities.

Also covered in the widely circulating announcement, expectation of funding competitions of $25 million for new Assisted Living Conversion Program (ALCP), $11 million for service coordination, priorities for use of limited funding available for Capital Advance and PRAC Amendments, and new Section 8 HAP contracts authorized as part of the new Section 202 Senior Preservation Rental Assistance Contracts, which was part of LeadingAge's successful signature legislation and preservation proposals.

Legislative News - Conference Calls Each Friday

2012-01-24T15:34:00.000-08:00

Don't forget! Aging Services hosts a member call-in each Friday afternoon during legislative session from 3:00-3:30 pm for Nursing Homes issues, and then again from 3:45-4:15 pm for Assisted Living topics. Contact Paul Montgomery or Julie Martin for access numbers and further assistance.

Caregiver Training & Background Checks for Assisted Living, Home Care & Health

2012-01-24T15:32:00.000-08:00

Many members have been asking clarifying questions about the new laws for home care aides, formerly known as caregivers, as they contemplate compliance requirements for new hires and existing employees of assisted living, adult family homes and home care. This is a comprehensive compilation of the topics discussed with members to date:

Contact Julie Martin for assistance, additional information or if you have challenges with any of the embedded links below.

Re: Background checks in general: A new crime has been added to the DSHS List of Crimes and Negative Actions as of December 1, 2011, Endangerment with a Controlled Substance. This is a permanently disqualifying crime for unsupervised access to vulnerable adults. The revised disqualifying crime list can be accessed here.
Newly hired (on or after January 2, 2012) long term care workers must undergo FBI Fingerprint Background Checks in addition to the state’s BCCU checks. This includes RNs, LPNs, NACs and non-credentialed direct care workers.
FBI Background Checks are not required of existing boarding home caregivers or of boarding home administrative/clerical workers. They are not required of nursing home workers. For those of you who might share staff between care settings on your campus, this detail will need to be factored in to your hiring/screening processes.
You will continue to use your Assisted Living Background Check Account Number as you do now for the state's BCCU check. Do not use your Nursing Home Background Check Account Number for new assisted living employees.
FBI Fingerprint Background Checks can only be scheduled AFTER you receive the Interim Result Letter from BCCU.
On this Interim Result Letter will be found a BCCU Inquiry ID/OCA Number. The BCCU Inquiry ID/OCA Number is a required component of the application form for the FBI Background Check.
This ID/OCA Number is also a requirement of the employee's application to the Dept. of Health for certification as a home care aide. Remember that this application is due within three days of hire, and must be accompanied by a non-refundable $60.00 fee. A conditionally hired new employee is not considered an official hire for the purpose of this three day time period, as BCCU may take more than three days to complete their work and the ID/OCA number will not be available until you've been notified of their interim results.
You may apply for a Fingerprint Background Check appointment online or via telephone. Unfortunately, there are limited locations and times available for appointments. Note: A company contracted by the state is conducting the Fingerprint Background Check system. You will not be coordinating this part of the process through DSHS' BCCU.
Your applicant/new hire must go to an external location to have their fingerprints taken.
Once the FBI background check has been completed, you will receive a final Result Letter, also from BCCU. Note that this letter looks substantially similar to the Interim Result Letter you would have received from BCCU before you scheduled the FBI Fingerprint Background Check. Read it carefully.
You may conditionally hire a long term care worker, as you have in the past, pending the results of either of the two background checks required.
A long term care worker is only allowed 120 days of conditional employment while awaiting the results of the FBI Background Check.
You must complete a Character, Competence and Suitability Review and may use the DSHS-developed (C/C/S) form when making the decision(s) to conditionally hire based upon the results of either background check. For instructions and guidance on using this form, read the information at the bottom of this page.
Should you decide NOT to conditionally hire based upon the state background check, you will not schedule a FBI Fingerprint Background Check.
The applicant/new hire must be given a copy of both state and FBI background checks completed.
You will not be completing an FBI background check on volunteers, contractors, etc.
NACs, RNs and LPNs hired on or after January 7, 2012 are no longer required to take the Modified Fundamentals of Caregiving.
NACs, RNs and LPNs hired on or after September 9, 2011 (no more than 120 days prior to January 7, 2012) but before January 7, 2012 must continue to take/test for the Modified Fundamentals as that was a requirement at their time of hire.
The Revised Fundamentals of Care formally required of all non-credentialed caregivers will now be only ONE component of several that are required of the new hires. If your boarding home/assisted living only hires NACs (as the minimum credential accepted) after January 6 of this year, this is a reminder that they are not subject to the requirements of the 70 hours of basic training and certification as a home care aid through the Department of Health.
The required 2 hours of orientation and 3 hours of safety training must be completed before a non-credentialed new hire is able to provide care. DSHS has developed curriculum you may use for these two trainings, if you have not received your own curriculum approval or do not wish to develop and submit your own. You do not need to obtain curriculum approval for the DSHS curriculum, found here. You must obtain, however, approval to teach the orientation and safety training. Click here for the form and simple instructions.
Long term care workers may not be employed by you or anyone else as a caregiver/home care aide/long term care worker at any time that they are out of compliance with these timeframes/deadlines.
A new employee is considered a long term care worker and must obtain a home care aide certification if they provide assistance with either Activities of Daily Living OR Activities of Daily Living AND Instrumental Activities of Daily Living.
A person is not required to obtain certification if they provide only instrumental activities of daily living. DSHS advises caution in your application of this law. For instance: If your shuttle driver, on occasion, needs to help with the “transfer” of a resident or “assist” the resident onto the shuttle, then they may be performing both activities of daily living AND instrumental activities of daily living. However, if there is another worker who accompanies the residents and that person is expected to take care of any transfer or assistance, then the shuttle driver may very well be performing only instrumental activities of daily living. If your housekeeper assists the resident off the couch or helps to feed the resident, they may be providing both types of services. If your kitchen or dining staff assists a resident with eating, they may be providing both types of services. It is up to you to assure that you correctly require certification of any employee who may be performing both types of duties.
Note: Based on your staffing models and service delivery, you will likely determine different ‘types’ of staff who may be considered to be a long term care worker and must take the training and become certified. Activity directors, drivers, housekeeping, kitchen staff are a few that come to mind – just apply the logic of above but perhaps err on the side of caution.
If you hire a new Nursing Assistant Registered (NAR), they are exempt from the new training and home care aide certification requirements if they are in an approved training program for certified nursing assistants under chapter 18.88A RCW. However, they must become credentialed as an NAC within 4 months (120 days) of their employment date.
The specialty training requirements such as dementia, mental health and DD remain in place, unchanged, for both new and existing long term care workers.
It is incumbent upon you as the employer to obtain and keep records of any employee’s exemptions from the training and certification requirements. You will need this documentation, if asked, during licensing inspections. The caregiver, of course, is also liable to fulfill necessary requirements and keep their own proof of completion or exemption as necessary.
If the employee worked for another boarding home in 2011 or prior to January 7, 2012 and fulfilled their training requirements while employed by someone other than your community, you will need proof of that for your own files, i.e. copy of Revised or Modified Fundamentals completion, specialty training, etc., as well as documentation of their prior employment, dates of employment, etc. If they worked for you in 2011 or prior to January 7, 2012, you will want to document these same details in your files so they are easily available and understandable to the department.
Between now and June 30, 2012 you may continue your current process/system regarding Continuing Education for your NACs and non-credentialed caregivers. New requirements do not take effect until July 1, 2012.

January 11, 2012 Issue of In-Depth Available Online

2012-01-24T15:30:00.000-08:00

Missed an issue? Want to review a piece of news or regulation? Stay current with all of the regulatory, legislative and fiscal news & analysis from Aging Services of Washington: Click/Bookmark this link.

For assistance, contact Julie Martin.

Grant Applications Being Accepted for Transportation Services

2012-01-24T15:29:00.000-08:00

These grants are open to any provider of transportation for seniors, which may include housing providers who offer transportation services. Applicants do not have to be a sole provider of transportation services. Applications are only being accepted during a two week period: Jan 15-29, 2012.

The Beverly Foundation will be awarding $10,000 to up to 18 senior transportation services and programs through the 2012 STAR Awards. To be eligible for a STAR Award, applicants must: deliver transportation services to senior passengers; be in operation for at least three years; know how to report transportation data (e.g., driven miles, cost per ride, number of senior passengers); demonstrate an ability to identify good practices in delivering transportation services to senior passengers; and submit a complete application.

The STAR Awards application may be accessed through the Beverly Foundation website starting January 15 and will close on January 29.

PAs to Perform SNF Level of Care Certs and Recerts

2012-01-24T15:18:00.000-08:00

CMS has recently released an article allowing Physician Assistants to Perform Skilled Nursing Facility (SNF) Level of Care Certifications and Recertifications, with an implementation date of Feb. 13, 2012.

This article is based on Section 3108 of the Affordable Care Act of 2010, which adds physician assistants to the list of practitioners who can perform SNF level of care certification and recertifications.

The CR7701 directs Medicare contractors to recognize physician assistants to perform the required initial certification and recertifications for Medicare coverage of SNF services under Part A.

Hoarders a Focus of Emergency Personnel & First Responders, Too

2012-01-24T15:08:00.000-08:00

This is a great article, with accompanying video, published by the National Fire Protection Association and offers pointers for managing hoarding behavior.

Report on Not -for-Profit Jobs Just Released

2012-01-24T15:03:00.000-08:00

A report on year-to-year changes in employment in the not-for-profit sector was released January 18, 2012. Based on Bureau of Labor Statistics data, it covers the decade between 2000-2010.

The report makes five major points:

U.S. nonprofit 501(c)(3) organizations are major employers;
Nonprofit organizations have been major job creators;
Nonprofits held the fort for the nation on job growth during the recent recession;
The rate of nonprofit job growth has slowed as the country’s economic crisis has worn on;
Nonprofits are facing increased competition from for-profit firms.

Face-to-Face Encounter Documentation Requirements for Home Health Agency (HHA) Services

2012-01-24T14:49:00.000-08:00

This is an excellent resource for the CMS guidelines that allow patients to be admitted
to a home health agency following an acute or post-acute stay.

This applies to Jurisdiction 11 Home Health and Hospice//Home Health Agencies.

Nursing Home RAI Manual Updated

2012-01-24T14:45:00.000-08:00

The latest MDS 3.0 version of the RAI Manual, MDS3.0 V1.08, that will be effective April 1, 2012, is now available for download.

Also download AllChange Tables and Pages and the MDS3.0 Training Aids Slides Instructor Guides.

Contact Paul Montgomery @ Aging Services of Washington for assistance.

Exceptions to Therapy Caps Ends Feb. 29, 2012

2012-01-24T14:08:00.000-08:00

Contact Paul Montgomery for assistance with this issue.

In a letter to members of a U.S. House of Representatives and U.S. Senate conference committee, LeadingAge's Larry Minnix advocated for a year-long extension of the Medicare therapy caps exceptions process. He also urged the conferees not to impose new Medicare or Medicaid cuts on long-term services and supports providers who already have absorbed significant payment cutbacks. The therapy caps exceptions process is part of H.R. 3630, which would extend a number of other Medicare provisions, the payroll tax holiday, and unemployment compensation. The House-Senate conferees are working to resolve differences in the legislation as passed by the House and Senate. Without this extension, the exceptions process is due to expire as of February 29.

Lobby / Rally Day Next Wednesday, February 1

2012-01-24T14:00:00.000-08:00

If you have not sent in your “Rally Day Reservation” – there’s still time. We are working on Legislative appointments for your staff and residents – and want to be sure everyone is taken care of. If you have any questions, contact Cassi Meritt.

HUD's Affirmative Fair Housing Marketing Plan Updated

2012-01-10T13:37:00.000-08:00

Please note that HUD's Form 935-2a was updated in December, 2011 and must be used for the submission of all Affirmative Fair Housing Marketing Plans until further notice.
A helpful tip sheet can be found here. Contact jmartin@agingwa.org for information.

Legislative Rally Day February 1, 2012

2012-01-10T09:48:00.000-08:00

Join invited guests and Aging Services staff for the latest on the state's budget, legislative progress to date, and an update on the areas we need YOUR advocacy efforts. Contact Cassi Meritt should you need additional information or assistance. Register now - this is always a popular event for providers and residents.

New Guidance Issued for Home Health Agencies

2012-01-10T09:42:00.000-08:00

The Centers for Medicare and Medicaid Services (CMS) has issued a new Survey and Certification Letter updating the guidance on home health agency (HHA) certification when there is a change of ownership.

The letter, Home Health Survey and Certification Activities Related to Program Safeguards: Change of Ownership, advises that HHAs that undergo a change in majority ownership within three years of their initial Medicare enrollment or within three years of a previous change in majority ownership must enroll in the Medicare program as a new HHA, obtain a new State survey or deemed status accreditation, and sign a new Medicare provider agreement.

Enforcement Delayed - Nursing Home Upgrade to Version 5010, ICD 10

2012-01-10T09:37:00.000-08:00

The Version 5010 deadline was on January 1, 2012; however, because of the 90-day enforcement discretion period for all HIPAA covered entities upgrading to Version 5010 (ASC X12 Version 5010), the Centers for Medicare & Medicaid Services (CMS) will not initiate enforcement action until April 1, 2012.

CMS made this decision based on industry feedback that many organizations and their trading partners were not yet ready to finalize system upgrades to be compliant. CMS encourages you to continue internal testing as well as external testing of Version 5010 transactions with trading partners to ensure compliance for Version 5010.

Although enforcement action will not be taken prior to April 1, 2012, it is important that you continue to move forward to meet Version 5010 requirements as soon as possible. In addition to testing, if you have not yet created a plan for Version 5010, you should do so in order to meet these compliance deadlines.

Apply for a Qualis Health Award of Excellence

2012-01-10T09:31:00.000-08:00

It is that time of year again when the applications for the Qualis Health Awards for Excellence are being requested. This is your chance to share how a program or process you have developed addresses the three broad aims of the Advancing Excellence program: Better Healthcare (for individuals); Better Health (for populations); and Reduced Costs Through Improvement.

Contact Bonnie Blachly for assistance and additional information.

We encourage you to apply for this award if you have an innovative program you've put in place that addresses any one of these areas or all three areas collectively. Let others recognize the good work that you are doing!

Friday, February 24, 2012 is the deadline for applications.

Obama Administration Recommending Greater Coordination Among Federal Rental Housing Programs

2012-01-10T09:15:00.000-08:00

Just released December 31, 2011 is a document outlining 10 areas of concern and proposed alignment actions, one of which is seeking greater harmonization among the agencies to address accessibility for people with disabilities, local opposition to the development of affordable housing, systemic patterns of discrimination, discrimination against voucher holders, and inconsistent application of the requirement to affirmatively further fair housing, particularly in the LIHTC program.

Read about the remaining 9 areas identified in the full report.

What Qualifies as 'Active Practice' for Nursing Continuing Competency Requirements?

2012-01-10T09:03:00.000-08:00

The Washington State Nursing Commission will be reviewing this issue at its January 20, 2012 meeting due to the unexpected number of questions they are receiving from nurses inquiring about compliance with the new requirement. Contact bblachly@agingwa.org for additional information.

New Interpretative Statement Issued: Filling Medication Organizers

2012-01-10T08:56:00.000-08:00

Registered nurses and licensed practical nurses may fill customized patient medication packages (e.g. 'medisets', medication organizers) ONLY under the following conditions:

The most recent advisory commission as published in the Winter 2012 issue of the Washington Nursing Commission News. The programs and care settings affected by the Commission's interpretation include boarding homes (assisted living), adult family homes and home health.

Contact Julie Martin for additional information or assistance.

REAC Questions of the Month

2012-01-10T08:43:00.000-08:00

An excellent resource for those of you preparing for a REAC inspection, or just want to keep up with the latest interpretations HUD's inspectors use when scoring your properties.

Extension of Exceptions Process for Medicare Therapy Caps

2012-01-04T10:40:00.000-08:00

With Congress' action of December 23, 2011, the exceptions process for outpatient therapy caps has been extended for two months.

Contact Paul Montgomery for additional information.
Outpatient therapy service providers may continue to submit claims with the KX modifier, when an exception is appropriate, for services furnished on or after January 1, 2012, through February 29, 2012. The therapy caps are determined on a calendar year basis, so all patients begin a new cap year on January 1, 2012.

For physical therapy and speech language pathology services combined, the limit on incurred expenses is $1,880. For occupational therapy services, the limit is $1,880. Deductible and coinsurance amounts applied to therapy services count toward the amount accrued before a cap is reached, and also apply for services above the cap where the KX modifier is used.

Call in Tuesday, January 10th! AL Inspection Trends * January 10th @ 2 p.m. Facilitated by Bonnie Blachly

2012-01-03T12:06:00.001-08:00

Contact Cassi Meritt for registration information.