Promising Practices

This webinar focused on how states can use a PASRR to divert or transition individuals from nursing facilities into Home and Community-Based Waiver Services (HCBS). Key takeaways included understanding the context of long-term services and supports (LTSS) in the public health emergency, the history of PASRR, and the role of PASRR for nursing facility diversion and transition.

This webinar will help attendees understand how state Medicaid/Mental Health/Intellectual Disability PASRR Authorities and Nursing Facilities can effectively partner to advance quality of care for nursing facility residents with PASRR conditions.

This webinar will initially highlight the regulatory language that defines the distinct responsibilities of the State Mental Health and Intellectual Disability Authorities. The webinar will then shift to a facilitated panel discussion with three State MH Authorities and three State ID Authorities that have demonstrated a passion for the role PASRR plays in supporting individuals with serious mental illness or an intellectual disability. The states will be selected based on a historical interface with PTAC that demonstrates a commitment to PASRR.

This webinar will initially highlight the important role of Specialized Services in the PASRR process, with references to Subpart B and C regulatory requirements for Long Term Care Facilities and PASRR, and review of related guidance in FAQs on the subject. The webinar will then shift to facilitated panel discussion with up to five states that are providing Specialized Services. The states will be selected from those who have actively participated in the Specialized Services Workgroup calls.

The September Indiana PTAC webinar is Part II of the broader state initiative to improve its PASRR process. A key feature of their improvement effort is the recognition that PASRR shares many goals associated with the No Wrong Door initiative in the state. The webinar will include discussion on how these two distinct initiatives share common values and goals. The webinar will help states understand the lessons Indiana learned in connecting the NWD and PASRR initiatives.

This webinar highlights how the state of Indiana, with leadership from the Division of Aging (DA), has significantly transformed their PASRR system through a highly collaborative process. From 2014 through 2016, the DA worked with a range of stakeholders to build support for, and ownership of, the new PASRR system, including the state’s Area Agencies on Aging, nursing facilities, the Indiana Hospital Association, advocacy organizations, and other divisions within the Family and Social Services Administration. The stakeholders agreed their objective was “to provide a person-centered PASRR system that effectively and efficiently identifies the most appropriate services and settings.”

Preadmission Screening and Resident Review (PASRR) requires states to employ or contract with behavioral health care professionals to conduct assessments across a state, which may include assessments for individuals in remote locations, and requirements for assessments to be done within a relatively short time frame. In addition, the growing shortage of skilled behavioral health care professionals needed to conduct assessments may magnify barriers to PASRR compliance. Many of the barriers that people face when seeking in-person health care—including time, transportation, affordability issues and access to the appropriate health care provider—can be mitigated by using telehealth. The use of telehealth in PASRR is explored in a white paper recently completed by CMS’s PASRR Contractor. A few highlights of what the paper covers include: the definition of telehealth compared to telemedicine; modalities for telehealth; federal policies governing telehealth; and suggested applications of telehealth for PASRR. This new resource for state PASRR programs is now available here or at the bottom of this page.

This presentation will provide strategies for integrating the PASRR evaluation process, cross-consultation, quality monitoring, and service delivery to support person-centered care for individuals with co-occurring disorders. Examples of state procedures will be used to illustrate various approaches in integrated PASRR systems.

This session aims to facilitate a basic understanding of PASRR and highlight current PASRR trends in states. The presentation will illuminate avenues where PASRR is effecting positive change at the individual and macro level. Common barriers for states will be addressed and effective strategies will be recommended. Strategies for implementing and maintaining quality in PASRR assessments will be shared, with an emphasis on person-centered care. The presentation will examine PASRR best practices from Ohio.