welcome to the webinar!...scheduled to begin in the ros 57 counties on october 1, 2016. •the bhit...
TRANSCRIPT
Welcome to the Webinar!
We will begin the presentation shortly.
Thank you for your patience.
Attendees can access the presentation slides now at:
http://www.MCTAC.org/page/events
A recording of the event will be made available on the
same event page in the next few days.
Housekeeping & Logistics‣ Housekeeping
• WebEx Chat Functionality for Q&A
• Slides will be posted at MCTAC.org and nyehealth.org a
recording will be available soon (usually less than one week)
‣ Reminder: Information and timelines are current as of
the date of the presentation
Behavioral Health Information
Technology for
Home and Community-Based
Services (HCBS) 101
An Introductory Webinar
3
Dates
August 30th 12 PM
and September 14th 11 AM
Presenters
Sharon Bari MBA CCE PCMH
Senior Implementation Manager
Healthcare Advisory Professional Services (HAPS)
New York eHealth Collaborative (NYeC)
Phone 646 619 6503
Erica Manganelli
Project Coordinator
Healthcare Advisory Professional Services (HAPS)
New York eHealth Collaborative (NYeC)
Phone 646 619 6491
Fax: 646 619 6796
Behavioral Health Information
Technology for HCBS 101
5
Agenda
• Purpose of the BHIT program for HCBS providers
• BHIT eligibility and participation
• HCBS workflow and Electronic Health Record (EHR) systems
o EMR and Billing components
• BHIT program structure and technical assistance
o full, partial and upgrade software implementation services
• Program Tasks Timeline
• Completing the NYeC Provider Information Assessment (PIA)
• Next Steps
Provider Workflow Beginning Steps
Eligibility for State Start-up funding to providers of HCBS services
Provider Information Assessment (PIA) submission and approval
MCO contracting and credentialing or LOI to contract
OMH Readiness Survey completion and submission
Provider Participation Agreement (PPA) (official enrollment documentation)
signed by provider lead and co-signed by NYeC
At least 1 active HCBS service provided (not all on Hiatus)
Vendor services begin
Full Partial or Upgrade Implementation Services
BHIT 101 Initial Concepts
Supporting the Transition to Medicaid Managed Care
• NYeC will assist eligible NY State Adult Home and Community Based Service (HCBS)
behavioral health providers from the Rest of State (ROS) to adopt Electronic Health
Records or upgrade their electronic systems to meet HCBS Medicaid Managed Care
(MMC) documentation and billing requirements
• Adult Behavioral Health (BH) Home and Community Based Services (HCBS) are
scheduled to begin in the ROS 57 counties on October 1, 2016.
• The BHIT program is being supported by the NYS DOH, NYS OMH, NYS OASAS
• NYC DOHMH is working with HCBS providers in NYC
Behavioral Health Information
Technology Program
June 2016 – May 2018
Supporting Health IT Adoption and Practice
Transformation
New York eHealth Collaborative
HIE Qualified EntitiesNY State Federal
EHR & HIT
Assessment, Adoption, Implementation
Meaningful Use Preparation, Attestation, Support
HIE Adoption Data Exchange Incentives
Federal And State Grant Programs Execution and Incentive Delivery
Clinical Quality Measures PQRS, Group Reporting Support & Registry
DSRIP PPS Support Analysis, Planning, Contracting, Execution
Patient Centered Medical Home Training, Assessment, Recognition
Training and Education Services
State Designated Entity, Federally recognized REC & strong RHIO/QE Relationships
9
HIT Steering Committee
Program Partners/Stakeholders
OASAS
10
New York State
Behavioral Health Medicaid Reform
BH Medicaid Reform
DSRIP
Home and Community
Based Services (HCBS)
Health Homes
Transition from FFS to Value
Based Managed Care
Medical
Neighborhood
BHIT team is working with identified EHR vendors to build in a Standard Set of
HCBS functionality across all HCBS provider systems
Educate providers on the importance of interoperability or the exchange of
data with stakeholders including Health Homes and RHIOs
BHIT Grant Program
Data
Exchange
12
Home & Community Based Services (HCBS)
Live Independently
•Psychosocial Rehabilitation
•Community Psychiatric Support and Treatment
•Residential Support Services
•Habilitation
•Non-Medical Transportation
Manage Crisis and Stress
•Short-Term Crisis Respite
•Intensive Crisis Respite
•Mobile Crisis Intervention
Return to School
Find a Job
• Education Support Services
• Pre-vocational Employment
• Transitional, Intensive, and Ongoing Supported Employment
Help from Peers and Other Support
•Peer Support Services
•Family Support and Training
Assist those with substance abuse disorder and severe mental illness to
reacclimatize to daily life – Including services to guide them to
Provider
Eligibility and Participation
13
Designated Adult BH HCBS Provider
o Adult BH HCBS providers have been pre designated by DOH
o At least 1 active HCBS service (not on Hiatus)
Adult BH HCBS Provider eligible for or participating in HCBS Startup funding
o OMH scoped ROS HCBS Provider Organizations with little to no experience
billing Medicaid and provided them with Startup funding to help them conduct
the initial set up. This funding could be used for building an IT infrastructure.
Contracted with MCO or have an LOI with an MCO
o Adult BH HCBS Provider intends to or is currently contracted and credentialed
with at least one Managed Care Organization (MCO)
BHIT Provider Eligibility
• Designated HCBS providers for NYC and rest of NY State:
HCBS Provider Designation
http://www.omh.ny.gov/omhweb/bho/provider-designation.html
HCBS Provider Designation List
Rest of State (ROS)
BHIT Program Technical Services
Technical Services available to each organization will be based on an
Organization’s HIT needs including whether they qualify for full, partial or upgrade
support.
Technical services may include:
• On-site assessment
• Vendor selection assistance
• EHR implementation, training and operational workflow assistance provided by
the EHR vendor with BHIT oversight
• Adult BH–HCBS Medicaid Managed Care billing assistance
Fixed funding support provided based upon milestone completion and deliverables
submission – according to Provider Support category
1. Full Implementation Service
2. Partial Implementation Service
3. Upgrade Implementation Service
18
BHIT Program Funding Support
Milestone Phase Payment
Milestone 1 BHIT Program Enrollment for one time EHR setup fees (full and partial only)
Milestone 2 HCBS Go Live Year 1 BH HCBS monthly User EHR Licensing
Fee – based on a pre-set number of EHR
licenses.
Milestone 3 HCBS Billing –
Remittance from an MCO
Year 2 monthly user EHR monthly license fee
• The State Adult BH-HCBS Readiness Survey will be sent to Rest of State providers at the
end of August. Failure to respond to the survey may jeopardize the agency’s Adult BH-HCBS
designation status.
• The Adult BH-HCBS Readiness Survey must be completed and submitted by a provider in
order for that provider to participate in and receive funding from the BHIT program.
• What is the readiness survey about?
o Determines HCBS readiness at a provider’s sites.
o Survey allows the agency to put service(s) into "Hiatus" status for up to one year from
the date the survey is sent.
o Note: If ALL designated HCBS services at an agency are put on “Hiatus” status, BHIT
funding will not be available for that agency.
BHIT funding may become available when at least one HCBS service has been taken
off “Hiatus” status
Adult Behavioral Health Designation
Survey – an HCBS Readiness Survey
Survey
Important
HCBS Workflow
Electronic Health Record Systems
Case Management and Billing
20
• NYC EHR vendors have been identified and ROS vendors will be determined shortly
Integrated solutions
o Practice Management (Demographics; Billing Codes, Modifiers & Rates; Reporting)
o Behavioral Health Case Documentation
o Clinical Care and Care Coordination
21
Vendor Identification Process
• ONC Certified
• Interoperability and Health Information Exchange capabilities identified - RHIO/QE
• Flexibility to enable/disable components to accommodate each agency
• Flexibility to add NYS-OMH/OASAS HCBS Technical Specifications
• Cloud-based and web native solutions preferred
RFI sent for Vendor Response
104 Vendors were invited to participate
22 responded to the RFI
20 Vendors included in Pre-Qualified Vendor ListCharacteristics
1. Pre-qualified vendor list - those that expressed intention to incorporate
HCBS functionality.
2. Qualified vendor list - those that upgraded and met the HCBS technical
specifications.
Vendor Lists
• The BHIT team is working with pre-qualified vendors to upgrade their software
based on HCBS requirements
Pre Qualified and Qualified Vendors
Qualified Vendor List
Tested and verified by State as
upgraded according to HCBS
Technical Specifications
Pre Qualified Vendor List
Tested and approved by the state
ready for upgrade to HCBS
workflow
23
Pre-Qualified Vendor List
link - http://www.fphny.org/whatsnew/rfps
Note – The Qualified Vendor List will be found at this same link.
Expect new Vendors
to be added to these
lists due to differences
in the ROS
• NYeC Provider Information Assessment
• Technology Assessment Interview
• BHIT Provider Information Assessment Fields
o Sites Staffing Forms, MCO Status, Billing Status, IT Hardware Assessment, Software
• Security Risk Assessment
24
Provider EHR and Technology Status
Existing E.H.R. System Configuration
Adult BH HCBS Member registration in the E.H.R. System
Delivery of HCBS Services
Company Information
Billing Configuration
Practitioner/Staff Profile
Data Capturing Diagram
Completion of paperwork
Electronic Chart
· Patient Information Sheet
· Confidentiality/HIPAA/etc.
· Consent for Services· Consent to Release
Information· HCBS Consents
Adult BH HCBS Provider Assessment *
Individual Service Plan*
MCO Authorization Response
Progress Notes*
Extended Service
Additional Service
Discharge
*= Billable
Alerts/Rules configuration
Authorization Form*
Security and Access Control
Data Capture and Flow of Information
BHIT Program Structure
26
:
Full
BHIT Program Supports Three
Implementation Models
HCBS Providers with no Certified for Meaningful Use
EHR
• Need to Purchase a Certified EHR
HCBS Providers with either a Case Documentation that
is ONC Certified or an Electronic Billing system
• Needs to purchase a case documentation and/or billing
module
HCBS Providers with a “Qualified” EHR
• Needs to UPGRADE their current solution to incorporate
HCBS functionality
Full
Partial
Upgrade
- Once the Provider Information Assessment has been submitted and
approved…
- Schedule a “Meet and Greet” with provider organization key team members
Discuss the following:
o Health Information Technology Assessment – by the BHIT Team
o BHIT Enrollment of Provider – Practice Participation Agreement
o Interoperability Education
o Vendor Selection
o EHR Implementation
o HCBS Medicaid Managed Care Billing
BHIT Program Services
Next
ste
ps
Once the Provider Information Assessment has been submitted and approved…
Health Information Technology Assessment – by the BHIT Team
A Health Information Technology Assessment will be conducted by the BHIT team to establish the
technology requirements of the provider organization. This is especially important for organizations
needing new EHRs or either an electronic case management or an electronic billing system.
Interoperability Education
Provider organizations will be educated about the benefits and goals of connectivity to various
stakeholders in the landscape including Health Homes and RHIOs/Qualified Entities (QEs). A report
will be prepared showing the affiliated organizations in their environment with whom they can
exchange information.
BHIT Program Services
Vendor Selection HCBS providers needing either an EMR, an EBS or both will be offered EHR/EBS choices (that would meet their requirements for HCBS documentation and billing), from a list of qualified vendors. The provider will connect with the vendors that interest them, and find out more information about their options. Recorded demonstrations of EHR/EBS software and specific HCBS capabilities will be available. The provider will make their selection and contract with the vendor.
EHR Implementation
Vendor solutions implementation will include a predefined set up at the practice. Software training will be provided by the vendor according to an established schedule, with oversight by the BHIT team. The “go-live” milestone will indicate a successful implementation has been reached.
HCBS Medicaid Managed Care Billing
Training of HCBS staff on the billing workflows will be facilitated by the vendor, to confirm understanding of the billing requirements. Successful outcome of this program is a successful billing transmission to and remittance from the Medicaid Managed Care Organization.
BHIT Program Services
• Milestone 1 – Assessments, Enrollment and Vendor Contracting
Assessment Submitted and Approved
HIT Assessment Completed (form) Submitted and Approved
Interoperability Report and Education Complete
PPA Enrollment form submitted and approved
Submit signed contract for vendor services with a qualified vendor
Three Paths - Full service or Partial service or Upgrade
• Milestone 2 – Go Live on an EHR
Provider schedules and receives relevant vendor services based on their service category (Full, Partial or Upgrade)
This may include setup (full or partial) and includes full, partial, or upgrade training by the vendor.
Submit Go-Live documentation and relevant attestations to NYeC
Demographics, Assessment, Progress Note
• Milestone 3 – MCO Billing
Submits Services MCO Billing documentation and attestation to NYeC
Sustainability Check and submit attestation to NYeC
31
What Are the Provider Milestones?
Setup Fee
payment at
completion
Year 1 Licensing
Payment at
completion
Year 2 Licensing
Payment at
completion
Frequently Asked Questions (FAQs)
Q. What is the EHR Vendor System Preferred Model?
A. Cloud or SAS integrated qualified EMR/Billing system
Q. How and when are payments made?
A. Standard cap dollar amount per organization are made soon after provider
milestones are complete
Q. What if I have BHIT funds remaining after my EHR has been implemented?
A. There is spending guidance for the use of remaining funds
Q. What is the timeline for executing a contract with an EHR vendor for ROS
Adult BH-HCBS Provider agencies?
A. A contract with a qualified EHR Vendor must be executed between June 1,
2016 and December 31, 2017 for the ROS program.
33
Guidance for those Receiving other
Adult BH HIT Grants
HCBS providers participating in the BHIT program may have received other BH HIT
grants that are active. In order to understand the spending rules and how to
optimize these HIT funding opportunities– refer to:
Spending Guidance: Adult Behavioral Health (BH) - Home and Community
Based Services (HCBS) Providers receiving or eligible for multiple HIT grants
or programs” at this link:
https://www.omh.ny.gov/omhweb/bho/final-guidance.pdf
All questions about spending should be directed to either the OASAS or the OMH
mailboxes listed below:
OASAS e-mail: [email protected]
OMH e-mail: [email protected]
Timeline
34
• Program duration – June 2016 – May 2018
BHIT Program Timeline
Tasks Expected Start
Date
Actual Start
Date
Status
BHIT Intro Webinar August 30 and
Sept 14
On target
Provider Information Assessment sent August 2016 August 23 Complete
HIT Assessment September 2016 On target
PPA Enrollment Contract September 2016 On target
Qualified vendor list populated – Match begins Q4 2016 On target
ROS unique EHR vendors identified - contracting Q4 2016 On target
Full/Partial Provider Vendor Contracting Q1 2017 On target
Interoperability Assessment Q1 2017 On target
Full and Partial Implementation Q1 2017 On target
Upgrade Implementation Q2 2017 On target
Go-Live Q2 2017 On target
Billing to MCO Q3 2017 On target
Sustainability Billing Q3 2017 On target
Completing the
NYeC Provider Information Assessment (PIA)
36
The Provider Organizations were sent a welcome email that included an attached NYeC
Provider Information Assessment (PIA) to be completed by the provider and returned to
NYeC.
The PIA must be returned completed to NYeC by Wednesday, September 21st .
If you have not seen the welcome email from Erica Manganelli at NYeC, and you are eligible for the
ROS program as a Designated Provider, please contact Erica at:
Erica Manganelli [email protected]
The PIA assessment must be completed by the main contact person at the provider
organizations.
PIA assessment must be kept up to date throughout the life of the BHIT program. Update the
PIA assessment with staff or status changes and send them to NYeC. An up-to-date PIA is
required for Milestone payments.
You must complete the following to remain eligible for the BHIT program:
o NYS OMH Readiness Assessment – Hiatus status or ready to provide services
o BHIT Assessment – Hardware and Software Status of the provider organization
NYeC Provider Information Assessment (PIA)
Provider Information Assessment
In addition to the instructions tab, there are four tabs to be completed on this form.
1. Provider Organizations
2. Provider Sites
3. Staff Details
4. Affiliate Network Information
Required fields on the provider information assessment are indicated with a * red asterisk and
must be filled in for this step to be complete and approved.
Note: Many fields are “drop downs” allowing you to select from options
Examples are provided on each sheet to show how the fields may be completed.
NYeC Provider Information Assessment
Tabs
Provider Organization and Sites
Collects provider organization/site information including practice location, contacts with
identifiers such as organization and site NPI numbers.
EHR Case Management and Billing System
For those providers currently using an EHR, provide your current EHR/EBS vendor name and
version number. If software varies by site, include the name of the EHR/EBS at each site.
Completing the NYeC Provider
Information Assessment
Provider Staff and Services Details
Provide the number of overall agency staff requiring access to the EHR, and the number of
specific HCBS staff requiring access to the EHR (to determine number of licenses needed).
List staff names, roles, NPI/licensing information of those expected to use the HCBS
technology and billing system. Indicate the HCBS services they will be providing. There is
space for 12 HCBS services
Status options for Direct HCBS Service include
Providing Services
Designated and prepared to provide services
Expected Hires
For those not yet but expected to be hired for HCBS roles, use HCBS as their first and STAFF as
the last name in those cells. Please fill in their expected hire date.
NYeC Provider Information Assessment
Hiatus
De-Designated
Affiliate Network Information Tab
Providers must select the names of the affiliate networks that the organization is connected to
and the status of their relationship.
The list of affiliated networks includes
o Health Homes
o Managed Care Organizations (MCOs)
o Qualified Entities (QEs or RHIOs)
o DSRIP PPS
o Accountable Care Organizations (ACOs)
The affiliate networks are drop downs, so they may be selected from the list.
If there are multiple affiliates for an organization, they should continue to list them in the
appropriate column
41
NYeC Provider Information Assessment
• Provider Participation Agreement (PPA)
• By completing the PPA, you will be considered officially enrolled in the BHIT program, and
eligible for the program benefits. This agreement should be signed by the lead person in the
provider organization, and will be countersigned by NYeC. It must be submitted to NYeC.
42
Enrollment in the Program – the PPA
The Practice Participation Agreement (PPA)
is the agreement between NYeC and the Provider
Organization
that specifies the terms of the engagement
The PPA is signed by both parties
Next Steps
43
• To assure a smooth implementation of the BHIT program for the Rest of
State - providers must meet these requirements:
Have you received (or are you eligible for) start-up funds from the State to
provide HCBS services?
Have you completed the Provider Information Assessment (PIA) and submitted
it? Was the PIA approved by NYeC?
Are you contracted with and credentialed by an MCO or have an LOI?
Have you completed and returned the OMH Readiness Survey?
As you receive other program materials – complete and return them.
HIT assessment
PPA – the official enrollment documentation
Do you have at least 1 active HCBS service (not all on Hiatus)
Vendor services begin
Takeaways for Providers
Sharon Bari MBA CCE PCMHSenior Implementation ManagerHealthcare Advisory Professional Services (HAPS)New York eHealth Collaborative (NYeC)
Phone 646 619 6503
[email protected] is Senior Implementation Manager at NYeC having worked there since 2010 and serving as lead on numerous projects including the HEAL 22 program for Behavioral Health Organizations. She managed state and federal programs for EHR adoption, Meaningful Use and the privacy and security of health information. Sharon is a Certified Content Expert (CCE) in PCMH, and is expert and training, development and delivery of content.
Erica ManganelliProject Coordinator Healthcare Advisory Professional Services (HAPS)New York eHealth Collaborative (NYeC)
Phone 646 619 6491
Fax: 646 619 6796
As project coordinator at NYeC, Erica will be the lead for tracking milestones for the BHIT program and fielding questions. During her tenure managing the ONC Regional Extension Center Meaningful Use program she has honed the experience that will be drawn upon for the BHIT program. Previously Erica administered programs at the Regional Extension Center for Rhode Island – RIQI.
Contact Information BHIT Program
Rest of State
Reference Materials
46
47
Glossary of Terms
HCBS Services Workflow
48
49
Eligibility Assessment and Authorization
of Adult BH HCBS Services
50
Delivery of Adult BH HCBS Services
51
HCBS Workflow - MCTAC Slide