UAS-NY Readiness and Implementation Strategies for a Smooth Transition

Transcription

1 UAS-NY Readiness and Implementation Strategies for a Smooth Transition Presented by: Kathy Pellatt, Senior Quality Improvement Analyst Linda Spokane, Director of Research & Analytics Kevin Webb, Deputy Director of Technical Services 1 Today s Agenda Provide general overview of UAS-NY Update progress on discussions with DOH Discuss incorporating key transition activities into existing business processes Discuss IT requirements and security considerations Reality check from the field Provide opportunity for individual lap-top assessments 1

2 What is the UAS-NY? A comprehensive assessment system for individuals enrolled in specific community based long term care programs Secure web-based software application Housed within NYS DOH Health Commerce System (HCS) Single record for individuals enrolled in Medicaid Long Term Care system Does not change program-specific regulations (e.g. timing of assessments) Medicaid-specific requirement all Medicaid enrollees in required programs will be assessed with UAS-NY Non-Medicaid enrollees required to provide consent (DOH Form 5032) Purpose of UAS-NY Establish uniformity of assessment across various community based long term care services and programs Evaluate health status, strengths, care needs, and preferences, and guide development of care planning Assist with program eligibility and identification of program options Improve care coordination and facilitate service delivery 2

3 Programs Required to use UAS-NY and the Assessment Instruments Being Replaced Adult Day Health Care - RAI Assisted Living Program PRI, DSS-4449B, DSS-4449D, DSS-4449C Managed Long Term Care plans SAAM Consumer Directed Personal Assistance Program DMS-1 Personal Care Services Program - M27-R 1915c Waiver Programs Long Term Home Health Care Program DMS-1, DSS Care at Home I/II Waiver DSS-4362, DSS-3139 Nursing Home Transition and Diversion Waiver PRI, Screen Traumatic Brain Injury Waiver - PRI, Screen Implementation Schedule Region Counties Begin Transition Implementation deadline Pilot Broome, Chautauqua, March 2013 July 1, 2013 Otsego, Warren MLTC plans Statewide June 1, 2013 Oct. 1, 2013 Region VI Region V Allegany, Cattaraugus, Chemung, Erie, Genesee, Livingston, Monroe, Niagara, Ontario, Orleans, Schuyler, Seneca, Steuben, Wayne, Wyoming, Yates Cayuga, Chenango, Cortland, Delaware, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, St. Lawrence, Tioga, Tompkins May 1, 2013 Oct. 1, 2013 June 1, 2013 Nov. 1,

4 Implementation Schedule Region Counties Begin Transition Implementation deadline Region IV Region III Regions I & II Albany, Clinton, Columbia, Essex, Franklin, Fulton, Greene, Hamilton, Montgomery, Otsego, Rensselaer, Saratoga, Schenectady, Schoharie, Washington Dutchess, Orange, Putnam, Sullivan, Ulster, Rockland Nassau, New York City, Suffolk, Westchester July 1, 2013 Dec. 1, 2013 Aug. 1, 2013 Jan. 1, 2014 Sept. 1, 2013 Feb. 1, 2014 DOH Update LeadingAge NY staff meets regularly with DOH to address critical concerns/issues: ADHC access to HCS and UAS-NY environment Creating a test environment (to be available soon) Identifying entity responsible for completing assessment when individual is enrolled in two programs (i.e. MLTC vs. ADHC) Aggressive implementation timeline Programs investment in additional resources without compensation (i.e. training time for staff, laptops) 4

5 DOH Update, cont. Monitoring how change will affect ALP reimbursement given that UAS-NY RUG categories differ from ALP RUG categories Advocating for more logical approach to MLTC implementation to enable better data set for rate setting and other challenges Adding more program-specific webinars conducted by DOH Requesting LeadingAge NY access to the tool to better support providers from a clinical perspective Business Processes How do you begin the transition to the UAS-NY? 10 5

6 Transition Activities 1. Establish leadership group and commit to successfully implement UAS-NY. Team consists of: Executive management UAS Coordinator HCS Coordinator Key staff involved in assessment process Information Technology Other organizational representation 11 Transition Activities 2. Leadership team must: Ensure excellent internal and external communication Staff memos/meetings Communication with service providers, partners, subcontractors etc. Assess staff computer proficiency Review current assessment process Arrange for technical needs 12 6

7 Transition Activities 3. UAS-NY Coordinator must: Work with HCS Coordinator to perform functions necessary to enable users to gain access to UAS- NY Create HCS user accounts: each user must have his/her own Establish Trust Level 3 assurance for each UAS-NY users Assign UAS-NY roles 13 Transition Activities 4. Assign UAS Roles Based on: What data can be viewed or edited, and What functions may be performed Roles authorize access Multiple staff may be assigned the same role Roles should be assigned based on the level of authority necessary for person to have In general, one role per user is enough for them to perform their responsibilities 14 7

8 Transition Activities UAS Roles (continued) Consider these prior to assigning roles: What are the person s general responsibilities related to the assessment process? What level of access to protected data does the person require? What experience, certification or experience must staff have to perform functions related to the assessment process? What is the most appropriate role for the staff member? Based on the assigned roles, will the organization be able to perform all required responsibilities? What process will be implemented to monitor and modify role assignments? Who will be responsible? 15 UAS Roles Name UAS-15 UAS- 20 UAS-30 UAS-35 Generally Intended For Administrative Staff to create individual records, reports for managers, and to enter information from medical records Review/Consult to indicate participation in an assessment; could be therapists, supervisors or others to indicate that they have reviewed or were involved in the assessment Social Assessors to conduct and contribute to assessments Social Assessor Supervisors to review and manage assessments Available For Local Social Service Districts Service Providers Local Social Service Districts Service Providers Local Social Service Districts Local Social Service Districts UAS-40 Nurse Assessors to conduct and sign assessments Local Social Service Districts Service Providers UAS-45 UAS-50 Nurse Assessor Supervisors to review and manage assessments and reports for the organization Managers to review assessment, workflow and administrative reports. Managers who are responsible for authorizing services may sign as assessment using the Review/Consult capability Local Social Service Districts Service Providers Local Social Service Districts Service Providers 16 8

9 Transition Activities 5. Education is paramount! Read the Transition Guide thoroughly Participate in the Implementation Kick-off webinar for your county/region Participate in topic-specific webinars offered by DOH to support your organization s successful implementation of the UAS-NY Provide computer training to staff as needed Promote and support staff completion of the mandatory and recommended training available in the UAS-NY training environment 17 UAS-NY Transition Tools The Roles Executive Sponsor UAS-NY Coordinator HCS Coordinator Information Technology Knowledge Leaders End Users Leadership Commitment Credibility Leadership Communication Project Management UAS-NY Role Assessment DOH Portal Administration End User Access Liaison Data Security Equipment Configuration Technical Assistance Process Understanding UAS-NY Role Identification Early Adopters Computer Skills Training UAS-NY Training Process Implementers 18 9

10 UAS-NY Transition Tools Role Assignment Role Executive Sponsor UAS-NY Coordinator HCS Coordinator Information Technology Knowledge Leaders End Users Person(s) 19 UAS-NY Transition Tools The RASCI Chart 20 10

11 UAS-NY Reporting Features Individual Reports Specific to the person being assessed Accessed from within the person s case file Aggregate Reports Summary across your organization Based on case files in your organization s case list Ad Hoc Reporting Allows users to create custom reports from case files for use in local case management or quality systems 21 Samples of Individual Reports 22 11

12 23 Samples of Individual Reports 24 12

13 UAS-NY Resources UAS-NY website (project information and updates): assessment_system/index.htm UAS-NY Project Team: UAS-NY Helpdesk: LeadingAge NY Staff: or Anne Hill: (Adult Day Health Care) Cheryl Udell: (Care at Home I and II, LTHHC, Personal Care, Consumer Directed Home Care, Nursing Home Transition and Diversion Waiver and Traumatic Brain Injury Waiver) Diane Darbyshire: ddarbyshire@leadingageny.org (Assisted Living) Patrick Cuccinelli: pcuccinelli@leadingageny.org (Managed Long Term Care)

14 27 Two ways to access UAS-NY applications Online Application Offline Application Access to both is granted via the Health Commerce System (HCS) HCS is NYDOH s secure web portal Individual HCS accounts are required in order to access UAS-NY applications HCS accounts are established and maintained by your organization s HCS Coordinator 28 14

15 Browser Considerations 29 Scenario 1: Getting Access 30 15

16 Online Application 31 Scenario 2: Using the Online Application 32 16

17 Online Application Notes Requires no special security measures beyond HCS and UAS-NY access protocols and your organizations policies regarding access to HIPAA and HITECH protected data. Exchange of data is with a secured remote application. End user still responsible for data in plain text that leaves the confines of the secure application (i.e. Screen displays, Printed material, etc.) 33 Offline Application 34 17

18 Scenario 3: Using the Offline Application 35 Offline Application Notes Requires the installation of an application on the end user s computer. HIPAA and HITECH Protected data is stored on the end user s computer. Additional steps must be taken to protect it. What are those additional steps? 36 18

19 Additional Security Concerns While no system is 100% secure, it is in your best interest to take as many steps as possible to prevent protected health data from being accessed by individuals who should not access it. Here are some additional steps to protect sensitive health data. Treat all health data as if it were your own Protect access to your computer with industry standard authentication practices such as: Windows domain individually specific accounts. Don t share accounts. Strong password rules Strong password expiration rules Password lock your computer when not in use Password protect your boot-up screen Use a computer and/or operating system that supports disk level encryption 37 Additional Security Concerns What is encryption? A security scheme that scrambles data into a format that is unreadable without knowing the value of the encryption key. Types of encryption SSL or HTTPS when transmitting data over the internet Full Disk Encryption (FDE) of your local computer File Level Encryption (FLE) when making copies of specific files that physically leave the confines of your personal security The combination of these things contribute to a complete and comprehensive security plan

20 Additional Security Concerns Leading Full Disk Encryption solutions Microsoft BitLocker Drive Encryption. BitLocker is included in the Ultimate and Enterprise versions of Windows 7, but not in the lower end versions. TrueCrypt. Free and open-source. While the price tag is impressive, there is no key management and is best suited for small implementations that have IT support behind it. Check Point Full Disk Encryption McAfee Endpoint Encryption Sophos SafeGuard Enterprise Symantec PGP Whole Disk Encryption WinMagic SecureDoc Disk Encryption Source: 39 Additional Security Concerns Recommended specs for new computers Windows 7 Ultimate (Bitlocker built-in) Minimum 4gb Memory Screen capable of high resolution Work with your IT department or vendor and be consistent with the setup Security Demonstration Q & A 40 20