Uniform Assessment System - New York

Long Term Home Health Care Program

September 20, 2013

Statewide Implementation Plan

Pilot Counties: Broome, Chautauqua, Otsego, Warren (Live Data) Full implementation by June 30, 2013
Managed Long Term Care Plans Begin using UAS–NY October 1, 2013
Mainstream Medicaid Managed Care Organizations Full implementation by February 1, 2014
Complete Transition to UAS–NY for Remaining Fee for Service Programs Spring 2014

Statewide Implementation Plan for Remaining Fee for Service

Region Counties Begin Transition Activities Deadline for Implementation of UAS–NY
6 Allegany, Cattaraugus, Chemung, Erie, Genesee, Livingston, Monroe, Niagara, Ontario, Orleans, Schuyler, Seneca, Steuben, Wayne, Wyoming, Yates May 1, 2013 October 1, 2013
5 Cayuga, Chenango, Cortland, Delaware, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, St. Lawrence, Tioga, Tompkins June 1, 2013 November 1, 2013
4 Albany, Clinton, Columbia, Essex, Franklin, Fulton, Greene, Hamilton, Montgomery, Otsego, Rensselaer, Saratoga, Schenectady, Schoharie, Washington July 1, 2013 December 1, 2013
3 Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster August 1, 2013 January 1, 2014
1 and 2 Nassau, New York City, Suffolk, Westchester September 1, 2013 February 1, 2014

Current Scope of UAS–NY

  • UAS–NY will replace existing assessment instruments in the following programs/plans:
    • Adult Day Health Care
    • Assisted Living Program
    • Care at Home Waivers I & II
    • Consumer Directed Personal Assistance Program
    • Long Term Home Health Care
    • Managed Long Term Care
    • Nursing Home Transition and Diversion Waiver
    • Personal Care
    • Traumatic Brain Injury Waiver
  • For Long Term Home Health Care Programs, the UAS–NY will replace:
    • LDSS – 3139 Home Assessment Abstract
    • DMS – 1 Long Term Care Placement Form

Underlying Program Requirements Remain in Effect

  • Physician override provision still in place; follow existing protocol
  • Alternate Entry
  • Local departments of social services role remain the same
  • Joint assessment still required
  • Adhere to existing program regulations
  • Comprehensive Assessment including OASIS requirements

Fundamental UAS–NY Concepts Reports

Fundamental UAS-NY Concepts Reports

Use of UAS–NY for non–Medicaid Recipients

  • Primary focus is for Medicaid recipients
  • Release required for non–Medicaid Recipients
    • DOH 5032 is required
    • Must be retained by organization
  • Quick Points
    • Reasonable effort to Secure Release
    • Use of Existing Forms
    • Pending Medicaid Application is Acceptable

Long Term Home Health Care Transition to Managed Long Term Care

  • Transition to Managed Long Term Care is being phased in across the State
    • NOW: New York City, Nassau, Suffolk and Westchester
    • CMS APPROVAL: Orange and Rockland
    • END OF 2013: Albany, Erie, Monroe, and Onondaga
    • TO BE DETERMINED: Balance of State
  • Upon transition to the Managed Long Term Care Plan:
    • the individual becomes a member of the Plan.
    • the individual is no longer enrolled in the Long Term Home Health Care program; budget caps no longer apply.
    • must be assessed utilizing the UAS–NY by the Plan. The Plan must adhere to its requirements.
    • Plan will provide the individual with the same level of services for 90–days.

OASIS

  • Federal Requirement – Comprehensive assessment with OASIS data items integrated for those adult patients receiving skilled services (nursing and therapies) at time points required (SOC, ROC, 60–day recert, Transfer, Discharge)
  • The agency must continue to complete the comprehensive assessment for these patients that transition into MLTC; only the payor source is changing.
  • Questions specific to OASIS requirements should be directed to: OASIS@health.state.ny.us

Additional information DOH Website

http://www.health.ny.gov/health_care/medicaid/redesign/uniform_assessment_system/index.htm

Questions may be emailed to: uasny@health.state.ny.us
or
Call UAS–NY Support Desk Monday – Friday
8:30 AM – 4:00 PM
518–408–1021