State of Alaska > Health & Social Services > Senior & Disabilities Services > Director's Corner > Update
DIRECTOR’S UPDATE MAY 2008
Much has occurred since my last update, including starting the New Year! During which we wrapped up our first ever 90 day session, seen a change in our PCA leadership, and witnessed the resignation of Commissioner Jackson.
Bill Hogan will serve as the DHSS Acting Commissioner until a decision is made regarding a new appointment. Bill wasted no time in energizing and challenging his Director’s to speak up regarding their needs, vision, and desires for building a “team” approach to providing community services. To that end, DHSS will focus on five themes to govern future direction. These are, Substance Abuse, Health and wellness, Health Care reform, Long Term Care, and Vulnerable Alaskans.
We now have our senior SDS leadership organizational chart posted. You can review this information at ~ http://hss.state.ak.us/dsds/docs/sdsOrgChart.pdf
RECENTLY ASKED DIRECTOR QUESTIONS
Rates, rates, rates
Yes, it’s true, the increment of 4% for home and community based services was passed AND has been approved by the Governor. This includes a 6% increase to PCA and Care Coordination reimbursements. There is an additional, one-time funded 2% increase for assisted living home reimbursements. We will work closely with providers to mitigate the impact changing rates will have on the billing cycle. PCA and Care Coordination adjustments are easy. We can affect them electronically without disruption to the prior authorization process. The same is mostly true for assisted living home reimbursements, however, for most providers, especially those with aggregated cost based rates, we have to coordinate with you, First Health, and Health Care Services to limit the disruption of adjusting your rates. We will do everything we can to make the adjustment painless.
Meyers and Stauffer
We are working with Allan Hansen and crew to implement the “pilot” survey tool to begin evaluating provider costs. They are going to also serve as our pilot contractor. The Office of Rate review will be reviewing cost results with the “contractor.”
Bottom line, SDS will not be the entity working directly with providers to establish rate methodologies. We will facilitate the “hook ups” and be at the table to review results, but we will not develop the end result.
As we move more into the nuts and bolts of costs, Mr. Jack Neilson, CPA, Executive Director of the Medicaid Rate Advisory Commission will be taking over from Pat Sidmore as the point of contact.
As a reminder, we are on a Legislative deadline to present our findings next session.
PERM
Check out the updated website ~ http://www.permaudit.alaska.gov/
Anything I would be able to say about the PERM is contained within the above link. Staff are doing a great job keeping the web information up to date, so it would be a good idea to check back from time to time to monitor information.
SENIOR GRANTS
There was $1 million added to the Senior Grants program by the Legislature, aided in large measure by the efforts of the Alaska Commission on Ageing (ACOA). The federal grant program enters into the initial phases of implementing the new Alaska state plan which shifts dollars awarded to programs based upon senior population. There is further adjustment to how funds are allocated based upon the move from five basic regions to nine, also a feature of the new state plan. Ms. Lisa Morley and her staff are working closely with Ms. Denise Danello and the ACOA to review, coordinate and develop strategies for distribution of funding in accordance with the state plan. There will be further updates regarding this increment and allocations upon closure of the current RFP period.
PCA
After several years, Ms. Carissa Blades and her family left Alaska for Idaho to pursue careers (her husband graduated). We knew when we hired Carissa this day would come, but it made it no easier to see her go. We are however, fortunate to have Kjersti Langnes taking over the PCA helm. Kjersti is no stranger to SDS or many of you. We look forward to supporting Kjersti in her new role and are excited about improving the PCA program under her leadership. To that end, I will offer that we are close to implementing an acuity based/assessment process. Pat Sidmore, Chris Hamilton, and I, have been working for months on analyzing the past 18 months of records regarding PCA assessments. We are defining parameters of service hours based upon the PCAT score and extrapolating result variables in order to generate an acuity based outcome.
We are sampling (population) PCA consumers and identifying extremes (limits) at this time. We will be working to correlate these findings with a confidence level that satisfies the statistical application of the acuity function. The PCAT, will result in a score that comports with a given number of approved service hours. These hours (results) will be used as the CONSUMER directs and documented by the PROVIDER as rendered. We will no longer use time for task analysis or mandate break out of time by minutes.
ASSESSMENTS
We are hard at work trying to get to a system in place that is efficient and TIMELY. It seems like November was ages ago. Really, it was just as of November we could even legally begin to work on developing the resources necessary to do assessments. While far from where we want to be, we have come a long way, and it appears we will be caught up and reducing lag time by mid-June. Our goal is to perform, complete, and submit assessments within three weeks of notice. We may have to brace ourselves for the cost of maintaining that performance as fuel costs and reduced travel options emerge. For now, that goal is within reach.
I will have another update soon. We are meeting with our new Acting Commissioner this week, and will begin to discuss budgets, missions and measures as a “team.” I will share the results and strategies with you as they are made known to me. I will also break down the SDS budget for FY09
