KAPP Meeting Minutes from 11.9.16

NOTE from Shannon:  The 2 attached proposals from Commissioner Anderson are in DRAFT form.  They are working documents, NOT official, NOT in effect and NOT TO BE SHARED or discussed outside of KAPP.  If you have any questions or comments, please contact ME directly.  

 

Annual Membership Meeting

November 9^th, 2016

Lexington

Minutes – submitted by Paula Cowan

 

 

• Welcome – Johnny
  • Election Results – Shannon

Most important day is the day after the election.

State results emailed out last night – KY House, Senate and Exec Branch all now controlled by GOP. Larry Brown defeated Greg Stumbo, New speaker should be Jeff Hoover.

• Republican party took control of KY House as a supermajority, Democrats controlled house since 1921.
• Republicans won most races considered to be close.
• There will be new committee chairs that we will need to get to know.
• Shannon encouraged members to reach out to their legislators and schedule visits, tours, breakfasts, events…to let them meet not only the people you support but your DSP’s.   Shannon offered to come to these events if you schedule them.

 

• National Races: Republicans retained control of Senate –McConnell will return as majority leader. Chuck Schumer will be minority leader replacing retiring Harry Reid.
• National Races: House 52 R, 48 D, 2 I, Louisiana headed to run off election in December.

 

 

• Membership Update

• 110 Members

 

 

• Treasurer Report Shannon/Jen

• Balance today $57,683.73
• Most expenses in September and October were related to the conference.

 

• KAPP Officer & Board Election – Johnny-

• Executive Committee nominated slate of nominees. Current board is on slate since everyone agreed to continue to serve and have time left on term.
• Board of Directors is 14 members – new treasurer nominated to replace Jennifer Fromeyer for 2017. Appreciation of Jennifer’s service noted. New treasurer nominee is David Coons.
• Noted Community Living, Inc. does not exist any longer as noted. This will be changed on documentation. Per bylaws when a board member or officer changes companies, as Steve Zaricki has, the board could remove them from their role. However, since Steve serves as the past chair and would need to for 1 year, there was no one to technically fill that role. The board voted to allow this 1 year exception.
• Motion taken to accept nominees made and seconded to accept Board nominees. Unanimous vote passed for all nominees.
• There will be openings next year for Board of Directors’
• Board meets next week for strategic planning for 2017.

 

• Committee Updates
  • Waiver Redesign Workgroup – Clyde/Shannon
• There are 2 workgroups – 1 is a KAPP workgroup that started out as a Managed Care workgroup but was renamed to look at the larger issues of waiver redesign. We are opening up conversations and exploring models around managed care, ACO’s and provider ability to manage care and ability to be incentivized to do it.
  • Case Management Workgroup – Brandon

 

Commissioner Anderson has established a Waiver Redesign Workgroup of 22 stakeholders and Cabinet staff from DAIL, DMS and DDID.

 

Shannon, Johnny Callebs, Todd Case, Tracy Ruth, Mary Allen, Brandon Griffith, Brad Schneider, Chris George have all been selected to participate. These stakeholders represent all different waivers and services, but do happen to be KAPP members. We will be well represented.

 

 

• Cabinet Updates (Brandon Griffith)

HB 144

• Member Jim Chesser passed away. There will be a remembrance for him at the next meeting.
• Seem to be spinning our wheels in HB 144. The eligibility issue came up in last meeting and they seem to understand.
• New waiver slots and waiting lists is the major discussion in the HB144 meetings.
• Please come to the meetings – now held at 275 E Main St. Next meeting in December.

 

TA C – Chris Stevenson / Johnny Calebs

• Last meeting there was discussion about eligibility issues
• SCL Waiver delay was also discussed, through the end of the year now. What is the delay? 34 pages of comments and questions but they won’t share it with us.
• Open to public and anyone can come.
• Final Rule and MWMA stay on the TAC.
• Recoupment has been addressed.
• Next meeting is next Friday at 10 am at 275 E. Main 2^nd floor

 

Waiver Workgroup

• There is a blog entry on the KAPP website entitled “SCL Waiver Redesign”. Links are attached for the things we have worked on like the letter from Commissioner Anderson, and the most recent reg versions. Make sure you review these regulations for recommended changes.

 

 

 

MWMA

• Not really any updates. Case managers seem to be using and seem to be having less significant issues. If there are issues they seem to be getting resolved. If not, let Shannon know.

 

Final Rule

• Workgroup developed to review packets before being sent to CMS.
• There was a survey that has just gone out for all locations in the agency. Be sure to do it. They want the address of all locations within the agency and that includes DT and FHP’s. If address houses two supports then the address needs listed twice.
• Shannon: Transition plans all look different. Kentucky is committed to making us comply.
• Networking Lunch 11:30 – 12:30 (Catered by Double H Barbecue)

 

• Guest Speaker: Commissioner Debbie Anderson
  • Proposals for Short Term Fix (Draft Proposal Attached. Do not share. Not in effect until finalized and put in e-reg.)

1. Daily Notes vs. Monthly Notes  DRAFT Monthly Summary Proposal with KAPP Comments

• Draft document submitted to members at meeting.
• Took changes from last meeting, wrote recommendations, if KAPP approves they will go to Commissioner Miller and then potentially in an e-reg.
• KAPP will be at the table again regarding regulation rewrite.
• Going to monthly notes instead of daily
• Daily notes were implemented because DDID said our monthly notes “sucked” and now when Comm. Anderson asked if this helped? The answer was NO, that daily notes continue to “suck”. Appears to be a TA issue so that we are correcting the issues instead of just continuing issues.
• When CMS audits states they are looking at 5 core things and they are looking at KY following its own regulations.
• Our regs require too much, which leads to recoupment. Believe that all regulations need some grey areas, SCL regulations are not grey. We need to decide what needs to go into a reg and she would like to get rid of the forms that are not required by reg.
• It does not matter what form is being used as long as the requirements are present. Each agency will have flexibility about what form they use. State will only provide a template with required elements.
• This is only a 10-month fix until waiver rewrite next year.

 

2. Recoupments (Draft Proposal Attached. Do not share. Not in effect until finalized and put in e-reg.)

• 5 requirements  DRAFT: Recoupment Proposal with KAPP Comments

1. Beneficiary identified on all pages of document (name only required)
2. Date service was provided
3. Location/setting service was provided (not address, not specific site. For example, you can say “McDonald’s”….you do not have to specify, “Tates Creek McDonald’s”…you can say “library”, you don’t have to say, “Center Street Library”…you can say “The Mall”….you don’t have to say Oxmoor Mall.
4. Signature of person writing the document
5. Title of person writing the document. (Can be typed in, pre-filled on the document and can be abbreviated.)

• Effective 7/1/17 (new state contract year), DDID will no longer do BILLING AUDITS. DMS (Medicaid) will do all billing audits. This will eliminate the look back audits (double audits).
• DDID will still do your certification reviews for SCL and MP. They will also do a COURTESY review of your billing documents. They will provide verbal technical assistance. The purpose is to help you identify systems problems, patterns of missing documentation (the 5 required items) to help you prepare for your billing audit with CMS and hopefully reduce your recoupment. They will only do a sample audit, so this doesn’t eliminate the possibility of recoupment, but should help you.
• CMS will only recoup if those 5 things listed above are missing.

 

 

3. Exceptional Rate Protocol

• Don’t have the proposal completed, but the process will be greatly simplified. Amount of documentation will be cut down and currently looking at what the documentation requirements will be.
• ESP Rate – Miller does not believe BHDID rate covers provider cost but is realistic about the cost to providers but will likely not be double the regular rate.
• MPW – we’re in a ridiculous situation where several waivers are under renewal at the same time. CMS will only give a 90 day extension on a renewal but only after submission.

Submitted MPW waiver is the one we are operating in today, it is only a placeholder. Hoping to extend MPW renewal in order have time to rewrite the entire waiver. Requesting that KAPP members communicate with families that we are looking at rewrite but it will take some time.

Will be filing a placeholder for ABI in December as well.

 

Meeting Adjourned at 2:00 pm