Proposal Presented for the Master Plan for Aging (#74)
Disclaimer
Throughout the MPA process, more than 100 proposals were developed thanks in particular to thousands of hours of work by external stakeholders and members of the public. These proposals and the MPA Council commentary are being submitted to the Governor and shared with policymakers and the public to inform policymaking. These proposals represent a starting point for discussion. Further discussion is necessary between relevant state agencies and stakeholders to both refine these proposals and assess which may be appropriate to adopt and implement.
Summary
Review and engage in an update of the Patient Review Instrument (PRI) Screening Tool in consultation with appropriate partner agencies and stakeholders with the goal of reflecting the current acuity-based Medicaid reimbursement system and an evolving health information technology landscape, increasing efficiencies, and better integration into the State HIT and exchange framework for the aging and LTC services providers.
Justification
The PRI medical evaluation tool meant to assist older adult in their transition between care settings lacks practicality and consistency, does not align with the current Medicaid reimbursement system, and causes delays in long-term care facility admissions and access to necessary services. Updating the PRI may better reflect the current reimbursement system and improve access to and quality of care for older adults.
Full Proposal
Review and engage in an update of the PRI Screening Tool in consultation with appropriate partner agencies and stakeholders with the goal of reflecting the current acuity-based Medicaid reimbursement system and an evolving health information technology landscape, increase efficiencies and better integrate into the State HIT and exchange framework the aging and LTC services providers. Actions to update the PRI screening may include but are not limited to:
- Convene a PRI stakeholder group of hospitals, nursing facilities, State Psychiatric Centers, HCBS providers, including housing and homeless/shelter providers, and patients/families, to review a small number of alternative tools and/or processes.
- Maximize the use of health information technology and exchange.
- In consultation with OPWDD and OMH, ensure that the SCREEN tool is updated to reflect an updated PRI/patient transfer process, or consider whether any additional updates are needed to consolidate the SCREEN tool or process.
- In consultation with NYSOFA, ensure the COMPASS tool reflects an understanding of the potential interoperability with the updated PRI.
- Review the existing State regulations and propose changes needed to reflect an updated PRI process.
- Propose the updated PRI process to PHHPC and other relevant State bodies, as necessary.
- Ensure the updated tool is person centered and reflects the interdisciplinary, comprehensive nuances of the patient accurately to minimize the discriminatory medical profiling that delays acceptance within, especially, long-term care communities.
- Develop a tool that is advanced and informed in areas of trauma, PTSD, psycho-social, and language appropriate.
- Develop a tool that encompasses a comprehensive data set for rare diseases that are undocumented in history and will continue to be more prevalent.
- Develop a workforce education plan to educate relevant interdisciplinary staff, including ensuring certified PRI nurses are smoothly transitioned to the new system.
- Utilize language access programs for immigrants, refugees and others for whom English is not their first language.
This proposal is focused on primary and secondary prevention.
MPA Council Commentary
This proposal is categorized as long-term. A comprehensive update to the PRI may require regulatory changes and additional State resources. As other MPA proposals governing data infrastructure and continuum of care transitions are implemented, this proposal may continue to be evaluated for feasibility and impact. This proposal may result in additional State costs which would need to be considered as part of the annual budget process and are subject to the availability of resources.