November 2, 2015

A Note from the State Long-Term Care Ombudsman:

I am pleased to report that the Office of the State Long-Term Care Ombudsman had one of its most successful Residents' Rights Month campaigns ever in October. In addition to pushing out four weekly newsletters dedicated to the 2015 theme "CARE Matters," the Local Long-Term Ombudsmen partnered with the AmeriCorps VISTA volunteers at the Iowa Department on Aging to host a series of events in eight communities across Iowa that highlighted the significance of respecting and advocating for residents' rights.

More than 130 people, including long-term care professionals, aging network professionals, advocates and community leaders, attended the events to learn how to be stronger advocates for residents and tenants living in Iowa's long-term care facilities. After taking part in several activities and receiving handouts with tips and tools, the attendees were ready to go back to work or out to their community and encourage others to start advocating, as well.

That type of commitment and willingness to help spread the word about doing the right thing when it comes to providing high quality care to older Iowans and Iowans with disabilities is one of the things that makes me so grateful to live and work in Iowa. Although there is much work to be done and a number of places where we need to improve, I am thankful to have the opportunity to work alongside each and every one of you to help ensure the health, safety, welfare and rights of the individuals we serve.

Happy Thanksgiving!

Deanna Clingan-Fischer, JD

OSLTCO welcomes staff into two newly created positions to oversee Medicaid Managed Care

Managed care is the wave of the future for the State of Iowa. Beginning Jan. 1, 2016, the state's Medicaid programs will be covered by a group of selected Managed Care Organizations (MCOs).

Members will have an opportunity to choose the MCO that best fits their needs and will continue to receive the same services that Medicaid offers today, but in a much more coordinated approach that takes into consideration all of a member’s needs to help them maintain their independence for as long as possible.

Because this change impacts so many individuals the Office of the State Long-Term Care Ombudsman (OSLTCO) already works to protect, including older Iowans and Iowans with disabilities, the State selected the OSLTCO to serve as the managed care ombudsman for the new program, called IA Health Link.

To take on this new task, the OSTLCO was allocated additional funding to hire two full-time employees. At the end of October, Kelli Todd joined the office as Managed Long-Term Services and Supports (MLTSS) Program Manager and Kelsey Zantingh started as the Managed Long-Term Services and Supports (MLTSS) Ombudsman. Together, Kelli and Kelsey will work with Medicaid members living in long-term care facilities as well as those on the seven Medicaid waivers (Health and Disability, AIDS/HIV, Elderly, Intellectual Disability, Brain Injury, Physical Disability and Children’s Mental Health) to advocate on their behalf during any complaint, grievance or appeal process.

For more information on IA Health Link and its impact on Iowans you serve, please visit the DHS website. More information on the role of the managed care ombudsman will be added to the OSLTCO website soon, so please stay tuned!

The importance of Case Activity Reports for long-term care facilities

The Office of the State Long-Term Care Ombudsman (OSLTCO) has recently received several questions from facilities regarding Case Activity Reports, including why they are necessary and when they should be submitted.

According to Iowa Administrative Code and Iowa Department of Human Services (DHS) informational letters, Iowa's Medicaid Nursing Facilities, Intermediate Care Facilities for Individuals with Intellectual Disabilities, Mental Health Institutes, Psychiatric Medical Institutions for Children and Residential Care Facilities are required to submit form 470-0042, Case Activity Report, to DHS when:

• A resident applies for Medicaid;
• A Medicaid-eligible person enters the facility;
• A Medicaid-eligible resident's Medicare coverage starts or stops and the Medicaid rate is higher than the Medicare rate; or
• A Medicaid-eligible resident dies or is discharged.

For each of these situations, a Case Activity Report is required to be completed, signed by the facility administrator or designee and submitted within two business days of the event.

When changes occur and the Case Activity Report is not completed in a timely manner, payments to facilities may be delayed or billing could be affected when a Medicaid-eligible resident moves from one facility to another. It is extremely important that the Case Activity Report be filled out accurately and submitted in a timely manner.

For further information, please refer to the DHS website or contact the OSLTCO at (866) 236-1430.

OSDM works on behalf of Iowans unable to make their own decisions 

The Office of Substitute Decision Maker (OSDM) is established in Iowa Code 231E and strives to enhance the quality of life for Iowans who are not capable of making their own decisions about legal, financial or health care matters.

Depending on the situation, the OSDM may act as an individual's guardian; conservator; attorney-in-fact under a health care power of attorney document; agent under a financial power of attorney document; personal representative; or representative payee.

According to Iowa Administrative Code, the OSDM may only take on 10 consumers per full-time employee.  That means, at this time, it may only take on up to 20 consumers. Tyler Eason is the OSDM Administrator and Sherri McLerran is the Program Coordinator. For more information, please call (800) 532-3213.