August 19, 2020
Dear Adult Day Health Providers,
Commonwealth Care Alliance (CCA) is aware that MassHealth has provided direction allowing adult day health providers (ADH) to start the reopening process. At this time, we do not feel it is appropriate or safe for many of our members to return to an inperson care environment due to the risk of exposure to COVID-19. As a participant in CCA’s provider network, we want to partner with you to understand your plans for reopening, the level of service you will be able to provide to our members and to mutually agree to the plan for CCA members to return to your program. Like you, we want to ensure that your participants, our members, remain safe and healthy during these challenging times. As soon as CCA became aware of the ADH COVID shutdown, we engaged our members and put alternative services in place to meet their medical, physical, functional and behavioral health needs. As we consider each member’s potential return to your program, it will be necessary for us to review and update individual care plans to ensure that members’ needs continue to be met in accordance with their goals, preferences, and level of risk deemed acceptable by the member.
To ensure member safety and prevent any service disruptions for our members, we ask that you provide CCA with the following information to better help us all determine our path forward. Please provide the following information by 8/28/20:
- Your reopening plan to include, expected date of reopening, capacity at reopening and your criteria for identifying members whom you will reengage.
- An outline of the services that you will be providing onsite upon reopening.
- Your MassHealth Re-Opening Attestation.
In addition to the information above, we ask that you submit the following by 8/28/2020:
• A list of CCA members that were participating in your program prior to the shutdown with the services provided and the number of hours/days they attended.
• A proposed reopening plan, including scope of services and number of
hours/days for each of these members as you reopen. Please complete in full the attached spreadsheet.
• We will also expect that you participate in case conferences with CCA care
partners to review the member’s individualized care plan, and the required risk assessment, to determine the appropriateness for bringing them back into your program.
CCA will appropriately update ADH authorizations for all members following the care plan review and update. If the ADH fails to provide the information above and does not schedule to participate in the individual member case conferences with the care partner, CCA will end date these inactive ADH authorizations with an effective date of 9/30/2020.
We realize these are challenging times and look forward to working with you to ensure the appropriate care and safety for our members.
Senior Vice President, Network Management