understanding uas ny - association on aging in new york … acuu/handout… · ·...
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16thAnnualAgingConcernsUniteUs(ACUU) conference(ACUU)conference
Understanding the UAS‐NY
UAS-NYUAS NY
Uniform Assessment System – New York
UAS-NY
Uniform Assessment System – New York
Carla R. WilliamsDeputy Director,
Division of Long Term Care,Office of Health Insurance ProgramsOffice of Health Insurance Programs
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UAS –NY: GoalUAS–NY:Goal
Develop a comprehensive assessment instrument that:
evaluates an individual’s health status, strengths, care needs and preferencescare needs, and preferences.
guides the development of individualized long term care service plans.care service plans.
ensures that individuals with long term care needs receive the right care, within the right setting and at the right time.
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Current EnvironmentCurrentEnvironment
multiple screening and assessment tools in current usemultiple screening and assessment tools in current use complicates an already fragmented and poorly coordinated delivery system
many instruments lack standardization, have not been tested for reliability or validity, and are not automated
care plans and referrals are open to subjectivity
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Objectives of UAS ‐NYObjectivesofUAS‐ NY
i di id l’ f ti l d d biliti th hassess individual’s functional needs and abilities through empirically tested and validated meansprovide accurate data to develop individualized plans of care that are consumer‐driven, build on consumer strengths and offer consumer choiceidentify level of careidentify level of careassist with care planning and oversightreduce redundancy
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ObjectivesObjectives
improve the quality, consistency, and accuracy of assessment and care plansenhance the state’s capacity for program developmentenhance the state s capacity for program development and policy decisions that are data‐drivenincrease access to data by multiple providers via l t ielectronic meansprovide compatibility with other data sets and align with existing standards to the extent possible
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BackgroundBackground
extensive review of literature to identify uniform data ysets and assessment instruments developed by other states and countries
secured expertise to validate preliminary findings and recommendations
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LearningfromOtherStatesandCountries
Conducted focused discussions about uniform assessmentConducted focused discussions about uniform assessment instruments, e.g., Washington, Michigan, Massachusetts, New Jersey, Maine, Louisiana, Canada.
why particular tool was chosen/developedhow business plan developed, from goals to implementationpfunctions of the toolsettings in which the tool is usedstake holder supportstake holder supportscreening process to determine who gets the in‐home assessment
8training needs and resourcesinter‐rater reliability
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Tool SelectionToolSelection
two possibilities surfaced: CMS CAREinterRAI Community Health AssessmentinterRAI Community Health Assessment
an interRAI Community Health Assessment was chosen (interRAI CHA)
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Capabilitiespevaluates an individual’s health status, care needs and preferencespreferencesby design, compatible in key areas with the nursing home RAIconsistent, standardized, and validated level of care and assessmentassessmentautomatablehigh inter‐rater reliabilityd t t b d tti ith t i ti fdata set can be used across settings with customization for specific settingsreasonable length of assessment
il bl favailable for use
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DevelopmentforSoftwareandTrainingp g
evaluate the interRAI CHA vis‐à‐vis programs and l iregulations
map the current assessment process in all programsdocument use of the current assessmentidentify outcomes and initiate curriculum for assessor education programcomputer readiness survey of userscomputer readiness survey of usersbeta testing preparationweb‐based training being createdt i i t l i t d i t fttraining tools incorporated into software
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ScopeScopeAssessment:
Community Health AssessmentCommunity Health AssessmentFunctional SupplementMental Health Supplement
lScales, Triggers, CAPs, RUG IIINew York State Adds:
Skilled Nursing Facility Level of Careg yNew York State‐Specific Data
Summary Output Will Support:Service PlanningService PlanningCare PlanningCase Management
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UAS‐NYContent:List ofAssessmentTools in the SuiteListofAssessmentToolsintheSuite
Current UAS‐NY Tools:Community Health Assessment (Home Care)Community Health Assessment (Home Care)
Functional SupplementMental Health Supplement
Other Tools Available for Future:Other Tools Available for Future:Community Mental Health Mental Health Acute CareAcute Care Post‐Acute Care Contact Assessment Long Term Care FacilityLong Term Care Facility Assisted Living Emergency Screener for Psychiatry Palliative Care 13Palliative Care Intellectual Disability
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UAS‐NYContent:AssessmentTool FeaturesAssessmentToolFeatures
t l h if d t ttools have a common uniform data set
tools contain assessment domains
assessment domains contain subcategories
subcategories contain items (questions)
scales embedded to assist in measuring severity of needs
scores and algorithms produce outcomes
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UAS‐NYContent:DomainsandSub‐Categoriesg
• Instrumental Activities
Sub‐Categories
L ti /W lki• Instrumental Activities of Daily Living (IADLs)
• Activities of Daily Living (ADLs)
Functional Status
• Locomotion/Walking
• Physical Function Improvement Potential
• Falls• Dyspnea• Pain Symptoms
b l h l dHealth Conditionsai
ns
• Balance• Pulmonary • Neurological
• Tobacco, Alcohol and Substance Abuse
• Skills for Daily Decision
Dom
• Instability of Conditions
• Periodic Disordered• Skills for Daily Decision Making
• Memory Recall Ability• Change in Decision
Making
Cognition
• Periodic Disordered Thinking or Awareness
• Acute Change in Mental Status from Usual Functioning 1515
UAS‐NYContent:AssessmentOutcomesAssessmentOutcomes
Level of CareLevel of Care
Clinical Assessment Protocols
Quality IndicatorsQuality Indicators
Aggregate Reports
Ad H R tiAd Hoc Reporting
Resource Utilization Groups
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DevelopingtheUAS‐NYApplicationp g pp
Obtained application development expertise pp p pdefined system requirements and issued an RFPsolicited and evaluated proposals
Procured expertise to build the software application:GCOM S ft & CIM f li ti d l tGCOM Software & CIM for application developmentNYSTEC to assure software quality and completeness
Conducting an iterative system development cyclemeasure progress and quality throughout system development
17enables us to adjust to changing circumstances
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UAS‐NYDevelopmentCyclep y
Iterative Development Cyclep yIteration 1: May – July 2012Iteration 2: August – November 2012
i 3 b h 20 2Iteration 3: November – March 2012Iteration 4: BETA April‐ August 2012Revision and System Evolution: August 2012‐ Oct 2012Final Testing: October – November 2012Pilot Implementation: November 2012 – February 2013
State‐wide ImplementationFebruary/March 2013 onward
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UAS‐NY System ArchitectureUAS NYSystemArchitecture
Web‐based software applicationppInternet Explorer and FireFoxSecure connection (https:\\) 128‐bit encryption
Health Commerce System (HCS) Web Portal IntegrationHCS User LoginSystem SecurityRole‐based system
On‐line and Off‐line capabilitiesOn‐line: access from any computer that has internet access and approved browser 19approved browserOff‐line: from a laptop computer if internet not available
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BetaTestGoals
provide insight into system technical stability
inform statewide roll‐out strategygy
provide insight into organizational ability to integrate UAS‐NY into business practicesintegrate UAS‐NY into business practices
provide insight on UAS‐NY impact on d i di id lassessed individuals
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BetaParticipantsAdirondack Manor Home for Adults
Albany County DSS
Amber Court of Westbury
Montefiore Home Agency
Nassau County Department of Social Services
New York City Human Resource Administration
Broome County Community Alternative System Agency
Catholic Health Systems
Chautauqua Department of Social Services
Chemung Department of Social Services
New York Congregational LTHHCP
Otsego Department of Social Services/NY Connects
Otsego Manor LTHHCP
Parker Jewish Instituteg p
Eddy Visiting Nurse Association
Elant Choice
Elderplan
ElderServe Health
Senior Health Partners, Inc.
Sunrise & Lakeside Adult Day Health Care Programs
Total Aging in Place
Unity Health SystemsElderServe Health
Elderwood Village at Westwood
Emblem Health
Erie Department of Social Services
Fid li
Unity Health Systems
VIP Health Care
Visiting Nurse Association of Long Island
Visiting Nurse Service and Hospice of Suffolk, Inc.
Vi i i N S i f N Y k CHOICE
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Fidelis
GuildNet
Gurwin Jewish Nursing and Rehabilitation Center
McAuley Assisted Living
Visiting Nurse Services of New York ‐ CHOICE
Visiting Nurse Services of New York ‐ Home Care
Warren County Health Services
Warren Department of Social Services21
Medford Hamlet
Metropolitan Jewish Long Term Home Care
Monroe Department of Social Services
Willcare ‐ Buffalo
Wellcare of New York
Westchester Department of Social Services
BetaTestActivities
l ti th lf d li th tcompleting the self‐paced, online courses that are available through the UAS‐NY Training EnvironmentEnvironment
conducting the UAS‐NY Community Assessment
using report options
reviewing current business practices to identify changes to support UAS‐NY acceptance
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Foradditionalinformationvisit:
http://www.health.ny.gov/facilities/long_term_care/#uas_ny
Questionsmaybeemailedto:
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