1. State Home Per Diem (SHPD) National Association State Veteran Home (NASVH) Summer Conference July 27-August 2, 2014

2. VETERANS HEALTH ADMINISTRATION SHPD Dictionary 2 ADHC Adult Day Health Care BMS Business System Management CBO Chief Business Office CBOPC Chief Business Office Purchased Care DOM Domiciliary HIPAA Health Insurance Portability and Accountability Act IPERIA Improper Payments Elimination and Recovery Improvement Act OMB Office of Management and Budget NASVH National Association of State Veterans Home NHC Nursing Home Care PDF Portable Document Format PII Personally Identification Information PKI Public Key Infrastructure SHPD State Home Per Diem Program SME Subject Matter Expert SVH State Veteran Home VA Veterans Affairs VAMC Veterans Affairs Medical Center VISN Veterans Integrated Service Network 10-10EZ Application for Health Benefits 10-10EZR Health Benefits Renewal Application 10-10SH State Home Program Application for Veteran Care Medical Certificate

3. July 28, 2014 IMPROPER PAYMENTS ELIMINATION AND RECOVERY IMPROVEMENT ACT (IPERIA) OF 2012 PUBLIC LAW 112–248 JAN. 10, 2013 Presenter: Colette Alvarez

4. VETERANS HEALTH ADMINISTRATION FY2014 IPERIA FY2014 Results have been released o SHPD rate 3.02% (Goal 1.5%) Duplicate Payments 10-10EZs were missing or not signed 10-10SHs were missing or not signed Inaccurate tracking in tracking tool –Incorrect per diem rates being used –Incorrect bed hold methodology –Incorrect leave methodology 4

5. Presenter: Colette Alvarez 10-10SH Automation VISN 12 Pilot

6. VETERANS HEALTH ADMINISTRATION Purpose of Pilot Provide the capacity for the SHPD Program to design, launch, support and evaluate automated 10-10 SH pilot between VISN 12 Great Lakes/VAMC and SVH (Marquette) with support of CBOPC and CBO Systems Management. The VISN 12 pilot will serve as Phase I and the remaining facilities will serve as Phase II, based on the outcomes and recommendations from the Phase I pilot. When implemented nationwide, it will improve program efficiency and significantly reduce improper payments. Required to use current 10-10SH form (May 2009) until OMB approves new form with improved clarification and functionalities. 6

7. VETERANS HEALTH ADMINISTRATION Goals of Phase I 7 Convert the current 10-10SH PDF form into a web-based, fillable form that can be electronically submitted to VHA State Home Per Diem Care Program. Include validation on the form that precludes the 10-10SH from being submitted electronically unless all of the required fields/information have information in them. Require an electronic signature or equivalent prior to submission. Provide a date/time stamp upon receipt at the VA facility to assist with the 10 day rule determination. Determine if the 10-10SH should be paired with a 10-10EZ for initial admission to a State Veterans Home (SVH) and for per diem payments for domiciliaries. The VA portion of the application should allow the VA representative to return incomplete applications to the SVH along with a notification to them and record the receipt of a “completed” application.

8. VETERANS HEALTH ADMINISTRATION 10-10SH Pilot Screen Snapshot 8

9. VETERANS HEALTH ADMINISTRATION 10-10SH Pilot Screen Snapshot 9 The automated 10-10SH is made up of a series of panels devoted to specific areas of the 10-10SH form. Filling out the panels populates the actual form. It also makes it possible to populate multiple fields from one entry. The panels are divided between the two sections of the form. There is one set for the SVH, one for purchased care, and another for the clinical reviewer. The fields on the panels are also tied to the business rules for SVH.

10. VETERANS HEALTH ADMINISTRATION Where We Are Today Guided version of the 10-10SH completed and vetted within VA SVH and VA pilot sites selected and contacted SVH personnel obtained PKI and have secure email VA site setting up email account for receipt of SVH submissions Training package for both groups ready Practice data selected and formatted Dates for pilot being coordinated among participants Incorporate lessons learned and feedback from the SVH and VAMC into the form 10

11. VETERANS HEALTH ADMINISTRATION VISN 12 PILOT CONTACTS 11 Colette Alvarez, VA Program Manager, State Home Per Diem Program (SHPD) Colette.Alvarez@va.gov (775) 326-5721 Brad Radichel, VA Project Manager Richard.Radichel@va.gov.Radichel@va.gov (404) 828-5622 Brenda Wiggins, VA Project Manager/COR Brenda.Wiggins3@va (202) 382-2529

12. July 28, 2014 CBOPC State Home Per Diem Program (SHPD) Pilot Organization Pilot Improving Veterans Access to Care Presented to: National Association of State Veterans Home Administrators Presenter: Jeanne Crook

13. VETERANS HEALTH ADMINISTRATION Why an Organizational and Process Pilot? Gathered and reviewed data Determined training alone would not solve root cause Based on Interviews and feedback from SME’s in the field 13

14. VETERANS HEALTH ADMINISTRATION Overall Benefits 14 What SVH Will See Dedicated Staff Standardized forms Consistent processes and procedures Clear escalation path Resulting In … Reduced length of time for application and invoice approvals Improved visibility and communications Decreased requests to you for redundant documentation

15. VETERANS HEALTH ADMINISTRATION Next Steps 15 Hire and Train Lead Contact Representative and 2-Contact Representatives Implement requirements for State Veterans Homes Access Develop Metrics and Analysis for the Pilot October 1 st Launch Continue Monthly Briefings with NASVH Leadership

16. VETERANS HEALTH ADMINISTRATION VISN 19 PILOT CONTACTS 16 Colette Alvarez, VA Program Manager, State Home Per Diem Program (SHPD) Colette.Alvarez@va.gov (775) 326-5721 Andre’ Bynum, VA Project Manager/COR Andre.Bynum@va.gov (303) 372-4659 Martin Ottenbrite, Pilot Project Manager raphael.ottenbriteII@va.gov raphael.ottenbriteII@va.gov (720) 470-4025

17. July 28, 2014 Per Diem Rates 2015 Per Diem Rates Presenter: Jeanne Crook

18. VETERANS HEALTH ADMINISTRATION FY2015 Basic Rates 2015 Per Diem Rates will increase by 2% for the following: – ADHC $81.56 – DOM $44.19 – NHC Basic $102.38 Source of the increase is the Center for Medicare and Medicaid Services’ for Skilled Nursing Facilities for FY 2015, as printed in the 5/6/2014 Federal Register. 18

19. VETERANS HEALTH ADMINISTRATION State Home Per Diem Program Contacts Colette Alvarez State Home Per Diem Program Manager Colette.Alvarez@va.gov (775) 842-2529 or (775) 326-5721 Colette Alvarez State Home Per Diem Program Manager Colette.Alvarez@va.gov (775) 842-2529 or (775) 326-5721 Brenda Wiggins Program Analyst Brenda.Wiggins3@va.gov (202) 382-2529 Brenda Wiggins Program Analyst Brenda.Wiggins3@va.gov (202) 382-2529 Jeanne Crook Program Specialist Jeanne.Crook@va.gov (303) 398-5224 Jeanne Crook Program Specialist Jeanne.Crook@va.gov (303) 398-5224 Andre’ Bynum Program Analyst/COR Andre.Bynum@va.gov (303) 372-4659 Andre’ Bynum Program Analyst/COR Andre.Bynum@va.gov (303) 372-4659 Stephanie Haddock Program Specialist Stephanie.Haddock@va.gov (303) 331-7504 Stephanie Haddock Program Specialist Stephanie.Haddock@va.gov (303) 331-7504 Gloria J. Sanford Deputy Program Manager Gloria.Sanford@va.gov (303) 331-7856 Gloria J. Sanford Deputy Program Manager Gloria.Sanford@va.gov (303) 331-7856 19 Vacant/New Hire Lead Contact EEV Representative (Projected August 2014) Vacant/New Hire Lead Contact EEV Representative (Projected August 2014) Isabel Saunders Program Specialist Isabel.Saunders@va.gov (303) 372-6209 Isabel Saunders Program Specialist Isabel.Saunders@va.gov (303) 372-6209 Stephen Pellicer Program Specialist Stephen.Pellicer@va.gov (386) 623-5534 Stephen Pellicer Program Specialist Stephen.Pellicer@va.gov (386) 623-5534 Monica Scott-Carter Administrative Specialist Monica Scott-Carter@va.gov (303) 780-4733 Monica Scott-Carter Administrative Specialist Monica Scott-Carter@va.gov (303) 780-4733 Gloria Testa Budget Analyst Gloria.Testa@va.gov (303) 398-5573 Gloria Testa Budget Analyst Gloria.Testa@va.gov (303) 398-5573 Vacant/New Hire Contact EEV Representative (Projected August 2014) Vacant/New Hire Contact EEV Representative (Projected August 2014) Vacant/New Hire Contact EEV Representative (Projected August 2014) Vacant/New Hire Contact EEV Representative (Projected August 2014)

20. VETERANS HEALTH ADMINISTRATION State Home Per Diem VISN Liaisons 20 SHPD StaffVISNs Assigned Andre’ Bynum Andre.Bynum@va.govAndre.Bynum@va.gov19 Jeanne Crook Jeanne.Crook@va.govJeanne.Crook@va.gov1, 22, & 23 Stephanie Haddock Stephanie.Haddock@va.gov Stephanie.Haddock@va.gov6, 9, 18, & 20 Steve Pellicer Stephen.Pellicer@va.govStephen.Pellicer@va.gov7, 8, & 15 Gloria Sanford Gloria.Sanford@va.govGloria.Sanford@va.gov3 & 10 Isabel Saunders Isabel.Saunders@va.govIsabel.Saunders@va.gov4, 5, 16, & 21 Gloria Testa Gloria.Testa@va.govGloria.Testa@va.gov2, 11, & 17 Brenda Wiggins Brenda.Wiggins@va.govBrenda.Wiggins@va.gov12

21. VETERANS HEALTH ADMINISTRATION QUESTIONS 21

22. VETERANS HEALTH ADMINISTRATION THANK YOU! 22