CALA Webinar Update
September 2016

Latest News from CALA!

The excerpt below is from a letter to the CALA Board Members.  It is just one example of how CALA is working for the Assisted Living community.  Please note the valuable links below and share as needed.

Board Members,

Here is my update on the ALR Billing meeting that we had with HCPF yesterday........

Every ALR in attendance and on the phone had an opportunity to share their problems with processing claims and reimbursement issues with the HCPF staff.  I got the impression that they did not know the severity of the problem. They were very professional and made the commitment to work with us on the problems we shared with them.

Shown below are two links that the department sent over to me this morning. These links will help people with any of their problems.

Corky Kyle, MPA, CAE


https://www.colorado.gov/hcpf/provider-resources

https://www.colorado.gov/hcpf/known-issues


Please watch the video below (about 30 minutes) or you can read through the transcription below the video.

We've got lots of topics to go ahead and cover in this hour to share with you and have you see all the activities that we have been doing for the past 4 months. This is an exciting program. Our panelists are Megan Hart, Nicole Schiavone, myself, and that's our esteemed panel group. Our first presenter today is going to be Megan Hart and she's going to talk about the ALF Medicaid rules. With that I'm going to turn it over to Megan and let her share with you everything that she has on these new rules. She's been attending the meetings monthly over at HCPF and she is our resident expert on this. Megan it's all yours.

ALF Medicaid Rules

Thank you Corky. Like Corky said my name is Megan Hart and I'm in Loveland. I have a small assisted living, 100% Medicaid so I do attend those ACF meetings. I'm just going to share with you guys what's going on in those meetings. One, the ACF specialist position was held by Kaitlin Phillips and her last day was on September 14th of this month. As of right now they're in transition. They have been interviewing for that position for the last few weeks. A replacement should be hired here shortly and we should be hearing about that and who that contact information is. Until the replacement is hired, if you need to get a hold of anybody for day to day ACF operations, you can call Cassandra Keller. She's at 303-866-5181 and I'll post all this, we'll send an email out with notes and this contact information for you guys.

HCPF setting final rule is Sarah Heller. Again, I'll put her contact information on an email. The ALR advisory committee meeting at the department is Diane Ryan. In the meantime, we do have some transition going on, but we will have an ACF specialist that will be replacing Kaitlin's position. ACF meetings are held bi-monthly on the third Tuesday of the month; however, those are being held off until January until the new specialist is there and then we will establish a new calendar.

One thing that we talked about at the last ACF meeting that Kaitlin and Cassandra really like for ACF to start doing is start a daily cost analysis, or a daily cost report. There is a rate revision committee that has been established. This committee set up the future dates, they did that last week on September 16th they were setting up the dates, but I have not seen those published yet. I did go on the website today and I could not find that committee or those dates but Cassandra Keller has that information. On these dates that they'll review they reviewed different services so for example they might say on October 5th we're reviewing physician’s services. They will do 3 different dates regarding physician services and go over that. We have 3 different opportunities to share and present to the committee. What are cost analysis' in ACF.

ACF will be presented in March, but start that now so that we're well prepared and also if anybody can start going to any of those rate revision meetings so you know what to expect once you get there. This will help us get any Medicaid increases that we're hoping for in the future if we can show how much we're really spending a day for our clients. Be prepared for that, and watch for that, and go on to the website and look at those upcoming dates for that committee. Lastly, I just wanted to finish, for those of that don't know ACF has been, our committee has been going over the new regulations, the final rule, and revising regulations.

They will be in effect in January of 2018. Those are all on the website also. We could post those in our email that we're going to send out so you guys can look at those and see what those revisions are, but a lot of changes with person centered care. Again, my name is Megan. If you need to contact me my information is on the CALA website under contact us. You can find me under Megan Hart and send a email or feel free to call me and we will send out an email with new contact information with the ACF specialist and the final rule posted on that. Thank you and that's all I have for you today.

Megan thanks very, very much. Boy that was very enlightening. There's been lots of work going on with that committee, it's a shame that Kaitlin left because she really did interact with our industry. She really did care for it so that is a loss, but I'm sure they'll find another quality person too that we can build that relationship with to go ahead and handle our Medicaid rules.

Corky, Cassandra will be at our CALA conference October 19th and 20th, and she will have a lot more information at that time. Stay plugged into that.

That's correct. You're right. We've got her as one of our featured speakers there so that'll be a, I know that program will be excellent.

ALR New Rules and Regs

All right let's go ahead and talk about the new rules and regs on the ALR's. This committee was formed back last December and they started their work on rewriting all of the rules for assisted living residence's. They have been meeting once a month, the third Thursday of each month, and all of these meetings are open to the public. If you find yourself in the area and you wanted to contribute to that process, all you need to do is head on over to HCPF, not HCPF excuse me, CDPHE and go ahead and attend those meetings. For those of you that are outside the metro area, you can call in and listen to what is going on as they go through each of the items with each month's agenda.

They are not even a third of the way through all of the rules and regs for ALR's. This has been a astronomical process. It's anticipated that they won't get done until sometime in the first quarter in 2017. The significance of this is that the whole section of rules and regs for the ALR's is being rewritten. It's very important. We are going to continue to send out information as we are able to obtain it to keep everybody posted on what's going on. This is an extremely long process because of the extent of the rules and regs that have already been set up under which we are all operating under. We will keep you posted as things get finalized. I looked on the website this morning and could not locate the spot where they had all the materials that they have gone over to date. The next meeting is, well the last meeting was just this past Thursday, yesterday for this group.

If you have questions about this or anything please give me a call at the, let me give you my number. It's 303-263-5422. One other thing I want to mention to you is that our representative on this committee is Bill Boles, the President of CALA. He has been representing us extremely well. Giving our view points and giving the input necessary so that we've got something that we can work with. I want to thank Bill for taking the time and doing all of this material. That's everything I've got. Again, my number is 303-263-5422 and with that our next presenter is going to be Nicole Schiavone. Nicole I'm going to turn it over to you to talk about the new QMAP task force.

QMAP Task Force

Thanks Corky. Again, my name's Nicole Schiavone and I'm with the Wildflower Assisted Living. I also have small assisted livings in the Denver Metro area. I'm going to talk and update a little bit on the QMAP stakeholder task force. As we all know, this past June CALA was integral in passing the QMAP bill to privatize the QMAP. Right now there's stakeholder meetings being conducted and Corky Kyle is actually one of the task force members. Right now what's going on in the meetings is they are starting to talk about processes to create new rules and regs around the privatization of the QMAP and how we are all going to be QMAP instructors, what type of training's and materials we must use, how we're going to be regulated as instructors.

All those types of things. Right now, currently, the meetings are mostly about how we're going to structure the meetings. The next meeting is on October 26th. You can find information regarding this on the department's website and please attend. You can all in, but it's really integral that we start to give a lot of input on what we want to see as members regarding the QMAP and how it's structured for us in the future. That's really about it regarding the QMAP.

Let's share with our listeners, Nicole, that this task force has only had 2 meetings. There's not a whole lot to share with everybody today because, like you said, they're just getting started. The other thing, Nicole, you wanted to touch base about Medicaid and the re-certification of Medicaid providers. Why don't you talk a little bit about that too for everybody.

Yes. Sorry. I needed to grab a quick drink of water. The other thing, we did want to remind all of our members that our Medicaid providers, that it's really, really important that you're going through the re-validation process. You're logging on and you're reapplying for Medicaid, and that you're also getting brand new trader/partner ID numbers so that you can bill. The deadline for all of this is approaching very quickly. It's the end of October and there's bulletins that have been sent out to all of us as Medicaid providers. I know Corky also forwarded the most recent one out to everyone.

They are also anticipating when we go from Xerox to HP as our provider that we also could have delays in payments. I hope that everyone can somewhat prepare for that. We're all hoping that that's not very long. Just so everyone's in the loop and aware, please make sure you're checking your Medicaid bulletins and you are doing everything you need to do to get re-certified for Medicaid.

Thanks Nicole. That was great. By the way folks, Nicole is going to be doing a session up at our conference the 19th and 20th of October up at the Ameristar casino on this. This will be another one of those very important sessions that we've got for all of the attendees. If you haven't yet registered for the conference, please make a point of doing it. You don't want to miss what is going to be presented in these particular programs, as well as the whole day and a half education program that we've got planned for everybody in the Fall conference.

Legislation and Initiatives

Now I'm going to talk a little bit about legislation. I'm not going to try to bore everybody, but there's a lot going on and there's a lot of things that are going on that will affect the way in which you run your business. There are several things that you have to keep in mind. One, this is an election year. Two, there's lots of things going on with it being a Presidential year there's tons of material that you need to familiarize yourself so that when you get your ballot in the mail, you can go ahead and vote accordingly.

The actual election, the day that we vote, is November 8th. In Colorado law, they send out the mail ballots, by the way, everybody who's registered gets a mail ballot. We do all the elections by mail ballot now in Colorado. These mail ballots will be sent out 30 days from November 8th so you will start to see those ballots coming in the mail to you on the second week of October. Once you get those go ahead and open those up, vote, put them back in the envelope, drop them off at all the ballot drop off spots that are in your community, and get that done. That's very, very important.

Another thing that you're going to see coming to you very shortly if you haven't already, is that you're going to start getting a blue book. It is a blue book in the mail. In this blue book they talk about the amendments and propositions on your ballot. On the 2016 ballot. Here's an interesting point just to help you understand the overall process. When you see and when you read in the blue book, in your reading amendments, those mean that you are changing the constitution of the state by adding those particular amendments to it if they pass. Propositions, and you will see another whole section on propositions, those are things that the citizens vote on and if they pass then they go into Colorado statute. They go into the laws of the state.

The thing about that is that once they're in the laws, those propositions can be changed by the legislature. There's 2 distinct items that you're going to be looking at. Changes to the constitution, changes to the law. Now, there's 2 amendments that the association is very concerned about. That is amendment 69, which creates a state healthcare system. This would require all businesses and citizens to go ahead and pay into it. It's anticipated that businesses will see a 10% increase in their taxes to support this program.

This program will be managed by a 25 different members on a state healthcare system board. That could prove to be very unwieldy in the management of this system. As it stands right now, all of the business community has come out against 69. While the association hasn't taken a position yet, we do want to call this to your attention so that when you get your blue book and you're reading that, read it very carefully. The expense to your business is going to be extreme, and it's going to be extreme to your paycheck too.

Another particular amendment that we have been focusing in on is amendment 70. This is the establishment of a state minimum wage. This is at the present time we're at $8.75 an hour. This over up until 2020, it takes the minimum wage up to $12, and then every year thereafter it is adjusted to a percentage, it's not the consumer price index, but it's a percentage of the overall increase in collections from taxes by the state. You will see your minimum wage go up considerably each year. This has some effects, which I'm sure you recognize already, that this will increase your payroll costs for your hourly employees. You're going to have to figure that in when you're doing your budgeting and when you're doing your pricing for having people stay in your assisted living facilities.

You really have to look at this and consider what it means to your business, how can you operate in this environment, and then taking into consideration all of those going ahead and deciding on how you want to vote. The board, again, has not taken a position on amendment 70, but again, it is very integral in your business planning if this particular amendment passes. Now there's 2 other propositions that I'd like to talk about and one of those is proposition 107, which is the Presidential primary election.

Every 4 years we have a Presidential primary election, and under this balloted initiative proposal, it would require that all unaffiliated voters could be able to vote in the election by getting their ballot and deciding whether or not they're going to be a Republican or Democrat. Once they've decided that, then they can go ahead and vote that ticket, and then they can switch back to being unaffiliated. It also requires the payment of this election to be footed by the citizens. The government will go ahead and pay for it through the taxes. Now under our existing system of the caucus system, the caucuses are paid for by the parties. No expense to the voter. This Presidential primary election proposition would have a substantial effect on the community caucus system that we presently have in place.

That is a significant change in the way in which people participate in the Presidential primary election. The other one is proposition 108, which is just primary elections. Every year we have primary elections to determine who the candidates are going to be for that next election. That's determined by the parties, who's up, and who will win by us voting in that primary. Again, this is also bringing it up to unaffiliated voters.

It's interesting to note that Colorado has a third Republican, a third Democrat, and a third unaffiliated voters. This particular proposition would open up voting in primary elections to unaffiliated voters so that they could participate. Presently they can't. Again, on both of these issues, the association does not have a position on those. Again we wanted to call your attention to it because it is a major change into which we go ahead and hold elections.

Basic information, everybody in the house of representatives in Colorado is up for election this year. There's only a third of the Senate that's up for election this year. The Senate is controlled by the Republicans and the House is controlled by the Democrats. That's the make up of what we have presently in the legislature. This could change obviously once the vote is held. We'll have to wait and see what happens. Whether or not the Republicans maintain control of the Senate. Whether or not the Democrats maintain control of the House. The Governor is not up for election this year. That concludes a quick legislative update on behalf of CALA. I encourage all of you to vote and to learn as much as you can about all of the issues so you can make an informed decision when you get that mail ballot within the next couple of weeks.

Fall Conference

Let's switch just a little bit and talk about the Fall conference. This year's Fall Conference is up at the Ameristar casino up in Black Hawk, Colorado. We've been there for the last 3 conferences. You, the membership have told us in the surveys that we have done that you like that facility. It really is very conducive to go ahead and hold a conference. Nice meeting space, great place to be, rooms are phenomenal, and so we're excited about that we're back there again for the Fall conference. Again, those dates are the 19th and 20th. I would encourage all of you to bring as many people as you can to this conference. We have a day and a half of major education for everybody. It breaks down in this way.

On Wednesday afternoon from 1 to 5, we have education for owners, directors, managers, all on major issues affecting the business. We've got the department of labor coming in on the new ruling, to talk about the new ruling about raising the requirements that you pay overtime for your people. The present standard is you had to pay overtime up to $27,000 salary. It's now been moved up to $47,000. If you've got people in your facility that are making below that $47,000, you're going to have to pay them overtime. That's going to be substantial. We have the Assistant Director of the US Department of Labor coming to talk about that particular function.

We've also talked already about the ALF session that we're going to have, and the Medicaid. There are some examples. We have a great keynote speaker opening up on leadership on the morning of Thursday. We have training all Thursday morning for caregivers, owners, and directors. We have our awards luncheon and we have a very special speaker from Legal Shield to talk about identity theft within assisted living facilities and what that means to everybody. That afternoon is all about the state. We have Dee Rehda and Ellen McManus coming in to talk about all of the particular issues that CDPHE as it related to the regulation of the assisted living community here in Colorado. That is a tremendous program.

One thing I forgot to mention, we always have a phenomenal ice breaker reception after we finish up the half-day session on Wednesday. It's a real change to go ahead and network with one another and with all of our associate members, our exhibitor partner members, who provide us with so many services that make our facilities run easily with all their help. I encourage you to attend that. I really am pushing, and please share with everyone, so that you can get your registrations in and participate in this program. The room rate that we have at the hotel is $99. You can't beat it. 99 bucks. It's a great rate. We were able to negotiate that rate with the hotel and they were very supportive of that.

Another thing I want to call to your attention, and I mentioned it very briefly when I talked about lunch, but the luncheon on Thursday, the 20th, is one of the premier events that we have with our conference. That is recognizing people within our industry that have done an exceptional job. We have the caregiver award, we have the department director award, and then we have the executive directors for 30 beds or less, and the executive directors for over 32 beds. I encourage you that if you know someone, that you go ahead and send in that nomination. The nominating committee wants to see as many of those as we can to recognize those very special people that you work with every day. If you know somebody that qualifies, and you can find it on the website, and check out what the requirements are, but take a moment, think about who you know and nominate them.

It's very, very important to the success of our conference, but it's also very, very important to recognize those people that do so much and really make this profession the exciting profession that it is. With that that concludes all of the topics that we were going to go ahead and talk about, and what I'd like to do now is open it up for any questions that you may have with any of the panelists to see if and let us try to answer them for you. Do we have any questions Peter?

Please leave your comments below!

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