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Welcome to the CBAS Initial Certification Training My name is Denise Peach and I'm the Chief of the CBAS Branch here at California Department of Aging. And with me today is Barbara Estrada.She will be assisting in providing an overview of our CBAS Initial Certification process and a overview of many of the forms that are involved in the entire process So, welcome to the training today This is designed for potential applicants for CBAS certification. On the Agenda today, we are going to give you a little bit of background of how we got here today. We are going to talk about Initial CBAS Certification process in an overview of high level discussion. At that point, we are going to walk to steps and forms in details for two pieces of this process; The pre-screening process for CBAS and the Initial Application Process. After that, we will talk about some final steps to prepare you for CBAS certification, summarize and will be done. The training objective today prospective new CBAS center applicants will have information needed to complete the CBAS Initial Certification Process. So, we are not going to cover all today and we are going to to do our best to give you the information you need to get started and to get the forms completed for the process. So, lets start with the CBAS Initial Certification Process Overview. First step For the first time since August 2004, CDA is now accepting request from prospective applicants to begin the process to be certified to provide CBAS. So, this is the first time since a more time was imposed on new adult day house care providers back in August 2004 and then we converted to the CBAS program in 2012. So, no new centers have been brought online since that time and we are now beginning this process. So, this is all brand new to us and to you so we are going to learn to this process together. The new CBAS center certification process is designed to ensure that new CBAS center applicants are well prepared to deliver quality services to Medi-cal managed care plan members. So is designed with these two major steps in order to prepare prospective applicants for providing CBAS services. So, again the two main Components are the Pr-Screening Process designed to provide prospective applicants with resources, so lots of links, lots of education materials trainings, like this one today and a template for developing a Program Plan so that only providers and the centers that have the support of managed care payers and that are prepared to deliver quality services proceed on to the application process. So, that what the pre-screening process is is about. To make sure you are ready for the application process. The second main component is the application itself which provides the state with the required forms for Medi-Cal participation and further demonstrates readiness for CBAS certification. What I would like to do now is to Click on this link and take you out to the CDA CBAS webpage. the landing page here is what we come to is on our forms tab and this is application materials Want to take you with what Materials are posted on the CDA's website at this point for the Initial CBAS certification application. There are no application materials posted on this page What you will find is an overview document that describes the process and provides links. You'll find the pre-screening requests form so this is form you will use if you are interested in obtaining the documents for the Pre-Screening to get started so that's the form you'll click. Here is a resource guide that is full of helpful links and Information. If you're anticipating filling out an application or you are thinking about the CBAS this is the place to go to learn more, or to find the resources for developing and moving on to your next steps. The last document here This is actually a link to the training page of the CBAS website and this is where you'll find the links to the two training's required as part of the pre-screening process. One which is overview of ADHC-CBAS Program requirements and the other this training for Overview of Certification of process. I would like to briefly click on this overview document here and show you now some of the information that is here in this document again provides you with some background about the Initial Certification process. The two main components the pre-screening process which consists of some mission of acceptable program plan like a business plan the provides details about the applicants organization, plan for operating CBAS center. It consists of two online training modules and then communication with what we manage care plans regarding the proposed center. This is the opportunity that we are creating here for conversation between the perspective applicant and local manage care plans that are the the pairs for this Medi-care managed care benefit so that's the part of Pre-Screening process, too. After successful completion and only after successful completion we will tell you when the successful completion has been accomplished. The pre-screening process is done and you may request the application from us to complete the process for Initial application materials. so, there are four part to that and we are going to talk to that talk about those parts in details today. The applicant Information Part 1, part II - Management Information and Services and Part III - Facility Information Part IV - FIscal Information and there is a note here that I want to call your attention to At the time of submission are the Initial Certification application to CDA. So, wants you to complete it successfully the pre-screening you obtained your application you've submitted it to CDA. You must either have an ADHC license for the proposed CBAS center or have submitted an application for ADHC licensure. So, no CBAS certification unless you are a either License already licensed of healthcare center or you have applied to healthcare because CBAS as Medi-cal benefit can only be provided in a license to the healthcare center. So, here is the more information to getting started You click on this link back to the request form that you need to submit to get started with the pre-screening process and then Here is what you will send the request form. Our address here CDA. Our email address which is the easiest way to send us back request form to get started. A little bit of information about CDA CBAS branch staff and what you can expect during the process. They will provide you with techincal assistance including assistance in completing the ADHC licensing application. Because that is going to be big part of this if you are not already a licensed center. Completing the pre-screening reviews with we are going to do here at CDA and process your certfication application in the order which they are received so first in first out. Review pre-screening forms and application materials and communicate with applicants by phone and in writing to address issues that need to be resolved or corrected before certification can be finalized. We will coordinate with the department of Public Health Licensing Staff as needed, including to ensure the timely onsite surveys by both department of Public health and Department of Aging. And, we will finalize all of the processes for enrollment in Medi-Cal program and activation of of your national providers identifier which is what you will need in order to be Medi-cal provider. So, we will complete all those activities. There is a foot note here on this document that CBAS Initial certification now requires an onsite survey by CDA staff. So, you'll have a onsite review by Department of Public Health licensing and by CDA to complete this process. Here is what the onsite survey will include some of it reviewing the facility layout; your staff qualifications and their training; executed subcontracts; with sub-contracting providers operating policies and procedures any cited deficiencies at that time will be written into a plan and will obtain a plan of correction prior to approving certification. There is few resource documentation here that are listed resources, links Here is a link to the CDA webpage for CBAS the training Modules and resource guide that I just showed you on the applicaiton link and thats the great place to obtain the resources information. Here is a department of health webpage and here is a contact information. So, that's all in the overview document and we will take a really quick look now at the pre-screening request form. and this one is what you're going to use in order to ask for a copy of all of the pre-screening documents to get that process started. So, these documents are not actually posted on the CDA website. You are going to ask for them. so, you are going to tell us your name, applicant's name, your address, the county where you are interested in opening up your center, your contact name, phone number, email and fax number. When we get this from you, we will at CDA then assign tracking numbers and put information into our documents for you and we will not accept any pre-screening forms that don't have the tracking number and that haven't come in through this process.So, this is the document you'll need to complete to get the process started. So, I would like to now go out here and tell you a few more things about the certification by high level review. So, again the main components of pre-screening are there is a program plan like a business plan is going to layout bunch of information of who you are as a entity; what is it organization about what kind of services you provide; what your plans are for the center in detail. So, this is a long document and I am going to walk through that in a moment. It has the training components and it has the Managed Care plan communication component where you are talking to the Managed Care Plan payers in your area to find out if they are interested in having a new CBAS center that they can contract with. You want to find out if they are interested in contracting with you and the plan services that you are anticipating. And, then the CBAS Initial Certification are high level of review The components are Required State application forms, and we are walk through those in a moment. Some of them in detail to give you a sense of forms that you will have to fill out. Another component we are going to have Organizational and administrative information that you are going to provide to us that shows more details about your readiness structurally as an organization administratively to operate the center policies and procedures; duty statement, etc. The third component here is the facility layout and design information. So, you are going to tell us about what your building looks like and your use of space, etc. in detail and then fiscal information about your Organization and projections for the center so that we can review the soundness of fiscal part of the application. So, those are the four main components of the Initial Certification Application. So, again the two steps, pre-screening in the application itself and now we are going to spend a little time walking through some of the forms for pre-screening So, there are five Pre-Screening forms or documents.The first one we already took a look at that's the request form for CBAS Pre-Screening and that's the one on CBAS webpage at CDA you're going to click on that, fill it our and send it us to get started and we will send back to you the template for program plan, the program plan Addendum. So, there is addendum to that plan provides some information about your current director etc that we use that for some required screening that we do of the application. So, we are going to do upfront in the pre-screening then we have the training form Completion. So, you're going to certify to us that you completed the training modules and then you are also going to document your contacts with the Managed care plans. in your area. So, now what I would like to do is to jump out and walk to some of those forms. So, lets take a look at the Program Plan and this is the most extensive part of the pre-screening process. What you are going to be sharing with us information about your organization and the plan for the center. This is going to be the real detail of your plan. Then, we are going to review upfront before the application starts. I want to highlight that there will be tracking number on here and we at CDA are going to fill out this header information. Again, if we don't do this and we receive a plan from some one we are not going to be processing that; we will be returning it. So, lets just high level of overview and let me jump in and help you with some of the details. Here are I think six or seven main sections So we have a section A where we will look at applicant's information background, center overview and you're going to tell us about what your organization is, what your history, mission values, objectives what your organization is about? So, you will be talking to us about that Then we are going to be going through And I just want to highlight that this document contains some references so you can look up the laws and regulations and policy that gives you some support for some of these items that we are asking for. The facility information is the second section where you are going to tell us about information about where when you'll be operating, where you plan to operate and we already got your facility some of you already have your center in mind or you location in mind if you dont, you will be telling us what your plans are some facility Section C is about center administration again some information about the leadership in the organization your mission,vision, values kinds of information talking about your staff orientation and training plans for when they were first hired. the first six months your staff training plans want to see what the game plan is to get your staff on board in the initial phases of operation. Again, this is to preparedness to provide quality services Section D talks about Target Population some information about Ethnicity languages spoken by people you plan to serve Specialty population whether you will be inspecting to serve a frail/elderly population or DD population Alzheimer's population or whatever that maybe. you are going to tell us about that there. You're going to talk about anticipated services that you are going to be providing to meet the needs of these individuals. And in Section E here are more details about the center services, the programs elements that you are required to have as an ADHC-CBAS provider and then again some details about how those program elements are going to meet the specialized needs of the population you are serving. Section F is about the Center staff. Again the special qualifications of these staff, their responsibilities in meeting the needs of these people you serve Section G we are going to ask complete a sample individual plan of care for hypothetical participant. So, you are going to give us a sense that you've a game plan for the type of care you are going to be providing per center care for individuals you are planning to serve. Section H is any additional information that you think is relevant that we missed in first few section and then this is going to be submitted with your Program Plan along with the other forms to CDA as part of your complete Pre-Screening package. Lots of thing I missed here to let people know in this program plan for right now. I think you did a really good overview Be very careful, read everything and answer all the questions Were they were applicable Because if you don't, we will think you missed something. So, I really don't have any we have a lot of details/ So, this is the program plan document. Next step: we have the program plan addendum. This is a form that is going to come alon g with the program plan that provides information about various individuals in your organization so that we can do some pre-screening upfront Department of Aging is required by the federal goverment to Medicated We do certain types of screening of the individuals in your organization so we are going to ask you for the information about those individuals upfront. Some of them will learn later in the process in the application but these are the ones that are identified upfront that we are going to take a look at just to make sure that are clear for participation anything else on that So, here is a list of individuals involved. in more about the application that we going to go over in just a moment. This is the pre-screening training module form again pretty basic here you are going to be a required to complete two training modules one is the overview of Program Requirements for ADHC/CBAS The other is overview of Initial Certification Process which is what are doing right now and you're going to put names of individuals from your organization that are completing the training in here the date they completed, they are going to sign it and you can either scan this document and send it back electronically with all the documets becuase you can either send it out documents that way or you can print it out have them sign and mail it so your choice either to send the document back electronically or to mail them to us. The only thing I like to add Is no plan is prohibited from reviewing the training modules we highly recomment that everybody atleast look at the program requirements if nothing else. so, probably not every body is interested in filling out the form but most definitely process all your staff can b benefit from training module. around the basic program requirements. so, if you put that in your program plan one of the in service training plans for your staff that will probably be a great idea In the final document before pre-screening This is Manage Care Plan Contact list Here you are going to be documenting the date that made contact with the managed Plan in your area the representative that you made contact with and their contact information you're going to tell us a little bit about the content of your discussions so if you met them in person You talked to them over the phone you shared your program plans they gave you some feedback on your program plan you meeting with them What ever is it that you can share about the interaction with the plan thats terrific you can put that here unable to the succession of the communicating with the managed care plan We want you to document that as well If you are in one of those counties where you have a lot of managed care like San Diego county and you five six, seven, eight of them you can copy this form and give it to us second pge any thing else here NO.. So, thats the detail of four steps to the pre-screening process or the four components So... I have lost my place Here we go.. So, now lets talk about the in more specific detail Here we have talked about all five forms for pre-screening. Now,. successfully completed your pre-screening provess. and at that point you may if you still want to go you can ask for the application and we will send you the application materials and we are going to work with you because there is going to be a lot of different cases where perspective applicant come to us at different phases. You may already have ADHC license through Department of Public Health you already filed an applicaton you are already serving private pay and now you are coming after CBAS or you are going to submit an application to Department of Public Health We want to work with you as to what kinds of forms that need to be submitted in completing the process for CBAS. Either way all of the forms we are talking about todya are required both steps in process for CBAS where you are in process with licensing. Lets go Walk-Through Initial Application Process Here again Main components The application when you receive the application instructions You will see that there are four parts of the application. There is the applicant information piece which has the required state application forms or many of them in that section including the provider agreement and disclosure forms This part will go through some of those in details Next The Management and services Information where we have information about your organization your organization charat your staffing forms so there are some required forms in this section duty statement, sub contract boilerplate, policies and procedures. So, we want to see all pieces are in place so that you demonstrated a rediness to get up and operating Part three is the facility information where you are going to give us a map and floor plan at vary end of the process copy of your ADHC license Again you cant be CBAS certified until you have a ADHC license and if its appropriate if you are sharing space with someone there are required forms that you have to submit for that. In part 4,we are going to look at Fiscal Information for your organization balance sheet, operating budget and cash flow forecast and assumptions. So, we are going to take a little walk through to some of these forms now and this is we are trying to keep it as only as detailed as it needs to be on the important forms trying to spend a little bit of more time and Caution you about some of the things that might be confusing want to also just remind you that after you receive the application documents, you are welcome to call us and talk to us during the process of completion. So, we make sure that you get the things right the first time. So, we are going to spend a little time in details on some of these forms now and some of the important forms overview the others So, let me go ahead and pull up the first document I think that Barbara agree is probably the most significant document in the application and probably one of the most Challenging. Yes, this is very critical. you really give this form and all of the instructions those that come with each form as well as general instructions that come with your application you will get the guidance in both. Please make sure that you review everything carefully I am going to scroll really quickly just down to end of this form to show where the application instructions are Here and there will be additional CBAS instructions that we are going to give them These are the general forms that instructions that come with the form and there is some additional instruction that we will give you as part of the application make everybody dizzy here As we said, this is very critical form and is very universal form First of all, you are not going to know all the languages thats with on it. This form is for all categories Provider types Department of Public Health for licensure Some of the languages not going to be clear So, lets start with the first page Page one Section A Item Number 1 I am going through this pretty details and I am going to probably do one other form like this. We will just then touch rest of the form But again please make sure you read all of the instructions prior to completing the form. So, in section A number 1 what type of application is this? This is your initial ADHC CBAS application So, you want to make sure that indicated there. Item number 3 I am not going to go through each item I am just going to highlight most of it but not all of it Item number 3 Your licensure fee will be enclosed. you make out a cheque, money order whatever to the Department of Public Health The licensure fees rates I mean cost I'm sorry are on the Department of Public Health website there in your resource guide you'll find the link there that will take you there The type of change will not apply..ofcourse The type of facility you are going to indicate ADHC K. Adult day healthcare center For item number 6 you're not applying for the medi-care programs You want to enter No there And then on number seven You are applying for the Medi-Cal (Medicaid) program. So, you would enter yes there Number 8 This item is where some of the confusing language is Adult day healthcare centers do not have facility bed capacity But they do have licensure capacity So, thats where you are going to put This is where you will put your proposed licensed capacity Enter there on B a b Item Number 9 It ask for the Age range of Clients Adult day healthcare CBAS providers. They provide services to individuals eighteen years and older and thats what you will have to put in here This form ask for your days and hours of operation on item 10 General instructions for this form that go along with this Is asking you to also not just to enter the days and hours of operation but also to include your hours of service that you are going to provide available for participants These are those four hours atleast and they are required to receive excluding transportation services in order for you to be reimbursed. for day of service We are going to jump down to page 2 Section b This is very very critical The whole form is critical. Section B item number 1 This is where you are going to enter licensee number this is the name that you have registered with Internal Revenue Services and the secretary of state This is asking for the licensee Name only so please do not add doing business as whatever Licensee name only here Now, this form I am recommending use as a Master sheet This licensee name will be going to use all of the others forms in this package So, please make sure that you reference B 1 as your licensee name for all documents Jumping down to the 2 you're going to add your employers tax ID number There is going to be questions about this on other forms So of course you want to enter the same number And, item three, you are going to enter Owner type How have you registered with Secretary of State IRS This is how you want to make sure that you registered with or indicate here your owner type should be the same your licensee address and needs to entered there as well if anything is pending as far as I can email and fax number thats fine but we would like that information Prior to your initial licensure and certification survey. Item number 5 you are going to enter any other facilites agencies, or clinics that you have either operated, managed or has some ownership and then after section B which says asks if there is been any revocation of licesnse or any activity imposed or any of those You want to make sure that you disclosed any additional information as requested. Item number 6 you would also complete that section if you are the licensee is a subsidiary of another organization Please complete the questions asked or provide the information as asked Page three in Section C Item number 1 does not right now Because it says it is applying only to SNF facilities however if you are are going to be under Management answer some things later on this document Section is E where you are going to go regarding the management agreement So item number 2 again is very critical on this form. This is where you are going to be proposed center's name you are not going to have facility license number but you will have you name of your center Item 2 is going to be like a lot of the other forms So make sure whatever you have here is exactly the same on the other forms please be consistent. It will cause delays if you are not So be very careful Item number 4 if the mailing address for the center is different go ahead and enter that here if it is not But we do want the fax and the email address for the center again on the initial submission If it is pending indicates that prior to your initial licensure and certification survey you're going to want that have available Item number 5, the person you have incharge of your facility if it is not the center's administrator or program director we would like to have the contact number that we are asking that you enter in the title field there item number 6 is the name of your administrator, the date of hire B as a role for name of director of nursing if not really applicable to adult day CBAS center However, we will see is not necessary. There is no director of nursing in CBAS Item number 7 is very critical This is where you want to Share who are the individuals persons with atleast that 5% ownership or interest in your organization Please make sure the names are legal name The percentage of ownership is indicated Their EIN number..thats the Emp;oyer's Identification number is entered What relationship if any they have with one another Now, if you are going to enter or have another organization company or what the owner is of your organization and is not name of the individual person you will have to disclose that company's