Uniform Assessment System

Have YOU heard about the UAS-NY?
In March 2013, the Office of Health Insurance Programs, Division of Long Term Care began the implementation of the Uniform Assessment System for New York (UAS-NY), a Medicaid Redesign Team (MRT) project. The overall goal of the UAS-NY is to utilize a comprehensive assessment system within eight Medicaid home and community-based long-term care services and programs.

The UAS-NY is used to determine eligibility for long-term care programs. It has replaced the PRI/Screen as the assessment tool for the TBI and the NHTD  Medicaid Waivers. Throughout the process of implementation, BIANYS and other brain injury advocates have raised alarms that the UAS-NY underestimates cognitive disability.

The Department of Health (DOH) responded to these concerns by adding a training component on cognitive issues for nurse evaluators performing assessments, but the tool itself has not been adjusted. They also hired a firm for an independent audit of the tool’s use as an assessment, which found that the UAS lacking in providing a score that reflects issues related to cognitive skills, memory issues, and iADL needs.

CONCERNS REGARDING UAS-NY
UAS-NY does not accurately assess the level of need for people who have cognitive disabilities. This is cause for concern because current waiver participants could lose their services due to the tool and/or the assessor not assessing their needs accurately.

BIANYS strongly feels that any evaluation tool used to determine eligibility for people with brain injury must fully evaluate the cognitive disability of these individuals. Many people with brain injury have few physical disabilities, yet their cognitive issues result in the need for assistance to remain safe and healthy in the community. The TBI Waiver was created to address this issue, and the UAS-NY appears to undermine that mission.

As part of the implementation of Managed Care for Medicaid, the UAS will be established as the tool determining eligibility for all Managed Long Term Care programs. BIANYS and many other advocates fear that the UAS-NY will turn away many people who currently depend on these services, resulting in dangerous situations for those people. We strongly advocate that the UAS-NY be reevaluated to properly assess cognitive disability and best meet the needs of New Yorkers with brain injury or that another tool be implemented.

What to do if you score low on the UAS-NY
If you are a Waiver participant and the UAS score you receive is less than 5, you should be contacted about a follow-up UAS assessment provided by the Regional Resource Development Center. Ask your Service Coordinator if you are not informed about this option.

If you receive a Notice of Decision from the Waiver indicating that you will be discontinued from services because of an ineligible UAS score, follow the instructions to file for a Fair Hearing to overturn this decision. In addition, contact Disability Rights NY at 1-800-993-8982 to discuss your rights and get assistance from the program for Protection and Advocacy for TBI.

UPDATES AND ACTIONS ON THE UAS-NY: 

• Following the audit of the UAS, DOH issued a method by which participants can receive a second UAS assessment from a nurse with expertise in brain injury. Should this second UAS result in a score lower than 5, the individual is able to have a medical provider give documentation that they qualify for the program. The medical intervention component of this plan has not yet been implemented.
• The Traumatic Brain Injury Services Coordinating Council (TBISCC) created a subcommittee at the April 2016 meeting to evaluate the UAS-NY and other tools and issue recommendations for screening tools for people with brain injury. BIANYS will be represented on that committee.

• BIANYS is researching on the types of assessment tools used in other states. We have connected with several states who are also using tools developed by the company that developed the UAS-NY (InterRAI) and are doing outreach to brain injury advocates in those states, as well as national organizations to provide national attention and additional feedback on this issue.

• Because of strong advocacy from the brain injury community, the NYS DOH is working with University of Michigan to evaluate the tool and make adjustments if needed. The University has assembled a workgroup with other states using this tool and InterRAI to get input into the specific issues related to brain injury and how they may manifest on an assessment. There has not yet been a report issued by this workgroup, despite the completion of meetings in 2016.

• BIANYS continues to provide insight and input into the needs of individuals with brain injury to the many different agencies and organizations, both statewide and nationally, on the issue of appropriate assessment tools.

• We ask participants of the TBI and NHTD Waivers to share their experiences with the UAS-NY with BIANYS and with their elected officials, particularly the Chairs of the NYS Senate and Assembly Health Committees, Senator Kemp Hannon and Assemblymember Richard Gottfried.

 

WHAT CAN YOU DO?

• Share your concerns with the New York State Department of Health by emailing them to Andrew M. Cuomo, Governor of New York State
  NYS Capitol Building
  Albany, NY 12224
  governor.ny.gov/contact/GovernorContactForm.php Mark Kissinger, Director, Division of Long Term Care
  NYS Department of Health
  One Commerce Plaza, Room 1624
  Albany, NY 12210
  mark.kissinger@health.state.ny.usThe UAS-NY Support Team: uasny@health.state.ny.us
• Your representatives in the NYS Assembly and NYS Senate particularly the Chairs of the NYS Senate and Assembly Health Committees, Senator Kemp Hannon and Assemblymember Richard Gottfried. Share your story. Inform them on how these changes will impact your life.

• Stay informed by joining the BIANYS email list, located at the bottom of this page. If you have received an unsatisfactory assessment via the UAS-NY tool, share your story with BIANYS.

For more information regarding the Uniform Assessment System for New York please visit:
http://www.health.ny.gov/health_care/medicaid/redesign/uniform_assessment_system/