On Tuesday night, April 14th, the United States Senate agreed 92-8 with a previously House passed bill to replace the Sustainable Growth Rate (SGR) method of Medicare reimbursement with a new system focused upon “quality, value, and accountability”. Commonly referenced as the “Doc Fix”, the legislation applies primarily to physician reimbursement but includes unrelated items and several nuances that bode well for ADS .
Immediately, the bill does not affect adult day services because they are not direct recipients of Medicare reimbursements. However, additional important goals of the legislation are to link Medicare reimbursements to quality metrics and to encourage better care coordination and chronic care management. These stated goals provide an opening to fortify adult day’s efforts for direct Medicare reimbursement.
Here is a link to the Kaiser Health News report and FAQs about the new legislation, which President Obama said he will sign describing it as “a milestone for physicians, and for the seniors and people with disabilities who rely on Medicare for their health care needs.” http://kaiserhealthnews.org/news/faq-could-congress-be-ready-to-fix-medicare-pay-for-doctors-2/
NADSA Public Policy Advisor
New Senate Republican Bill Offers Medicare Opportunities for ADS
—ADS Included as a Medicare Option–
On March 11, Senators Chuck Grassley (R-IA) and Ben Cardin (D-MD) introduced S.704, which proposes to establish a Community Based Institutional Special Needs Plan (CBI-SNP) demonstration program to target home and community based care to eligible Medicare only beneficiaries. The bill was referred to the Committee on Finance, upon which both Grassley and Cardin serve.
In his press release, Senator Grassley noted that HCBS services are less expensive than institutional care and that the plans would tailor services to the beneficiaries specific needs. Most importantly, Adult Day Care Services are specifically included as one of the Medicare options in a bill sponsored by a member of the new Senate Republican majority.
Senator Grassley further stated, “One estimate shows four-year savings of nearly $60 million for a demonstration of 5,000 Medicare members by postponing or preventing hospitalization and institutionalization” [emphasis added]. Although only a limited demonstration proposal, this bill offers an opportunity for ADS to fit legislatively into Medicare as an institutional option and the Senator’s words mirror NADSA’s focus of Modernizing Medicare With ADS for Cost Avoidance!
Now is the time to contact your Senator to ask him/her to co-sponsor and support passage of S. 704 with the continued inclusion of ADS!!
In short, this is the closest NADSA has come to legislatively fitting ADS into the tent of Medicare. We cannot allow this opportunity to pass!
Here is a link to Senator Grassley’s full statement: http://www.grassley.senate.gov/news/news-releases/grassley-cardin-introduce-bill-help-older-americans-stay-their-homes-care-avoid;
And a link to the full text of the bill: https://www.congress.gov/bill/114th-congress/senate-bill/704/text?q=%7B%22search%22%3A%5B%22s704%22%5D%7D
NADSA Public Policy Advisor
The Centers for Medicare & Medicaid Services (CMS) recently updated portions of the CMCS Home and Community-Based Services (HCBS) Toolkit. Updated versions (Version 1.0) of the HCBS Basic Element Review Tool for Statewide Transition Plans and the HCBS Content Review Tool for Statewide Transition Plans are now available. This information is part of the CMS ongoing effort to assist states in meeting regulatory requirements for residential and non-residential home and community-based settings.
The full HCBS toolkit, including the updated portions, is available online at http://www.medicaid.gov/hcbs/
Providers may find it helpful to review the information and examples CMS is providing for state administrators.
Roy Afflerbach, NADSA Public Policy Advisor
Posted October 13, 2014
The National Adult Day Services Association (NADSA) wishes to recognize leaders in the adult day services field that serve as members of the association’s board of directors.
NADSA’s board of directors is responsible for governing the association, providing strategic direction, fiduciary oversight and developing new policies and programs. These individuals represent adult day services providers from across the country.
Chip Cromartie of Adult Center for Enrichment, Greensboro, North Carolina, serves as chair of the board. The following individuals join Cromartie as board members:
- Marco Alvarez – Meridia, Mexico
- Keith A. Anderson – University of Montana, Missoula, MT
- Joel Bednoski – Insight Memory Care Center, Fairfax, VA
- Terry Fishler – ADS Data Systems, Inc., Stevenson, MD
- Lyn Geboy – Cygnet Innovations Group, LLC, Milwaukee, WI
- Corrine Jan – Family Bridges, Oakland, CA
- Herbert Ann “Herbie” Krisle – Page Robbins Adult Day Center, Collierville, TN
- Lydia Missaelides – California Association for Adult Day Services, Sacramento, CA
- Edwin “Ned” Morgens – Gyrfalcon Senior Care, Johns Creek, GA
- Simon Ortiz – Mi Jardin Del Rio Adult Day Centers, Rio Grande City, TX
- Kerri Pendley – Addus Healthcare, Palatine, IL
- Lisa Peters-Beumer – Easter Seals, Chicago, IL
- Lori Sanchez – Morning Star Adult Day Program, Denver, CO
- Jocelyn Schowalter – Amherst H. Wilder Foundation, St. Paul, MN
- Amanda Sillars – Total ADHC Solutions, Chatsworth, CA
- Christopher Vito – Nevada Adult Day Healthcare Centers, Las Vegas, NV
- Kim Vogt – Meadowbrook Adult Day Program at The Highlands, Pittsford, NY
- Steve Zarit – Penn State University, University Park, PA
In Cromartie’s words, “NADSA is founded on collaboration and partnerships forged by members in communities all across the country. The new board of directors represents these adult day service providers as they work with consumers, families, policy makers and the media. NADSA’s new team of incredibly gifted and committed members are working together to develop leadership that will tell the story of adult day services’ value across the country.”
About NADSA The National Adult Day Services Association (www.nadsa.org) is the leading voice of the rapidly growing adult day services industry in the United States. NADSA is an independent national organization dedicated to advancing the national development, recognition and use of adult day services. Adult day services provide community-based care for people who need supervised care during the day. Persons of all ages who have multiple and special needs associated with conditions such as Alzheimer’s disease, developmental disabilities, traumatic brain injury, mental illness, HIV/AIDS, vision and hearing impairments attend adult day centers. NADSA’s Officers and Board Members reflect the range of adult day services providers in the industry. NADSA provides its members, adult day centers across the U.S., with effective national advocacy, educational and networking opportunities, and technical assistance, research and communication services.
Posted January 30, 2014
in In the News
The Early Memory Loss Program created by House of Welcome Adult Day Services of the North Shore Senior Center has won the American Society on Aging/MetLife Foundation 2014 Mind Alert Award. The award recognizes innovative community-based, nonprofit programs based on research to maintain cognitive fitness in older adults. This award will be presented at the American Society on Aging’s national education conference in San Diego at the National Brain Health Forum on Saturday, March 15.