New York State DOH
Health Home Care Management
Reporting Tool (HH-CMART)
Support Calls – Session #8
April 10, 2013
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Q+A Themes from April 3 Call
Questions and Comments
Feedback, Help, and Ongoing Support
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Please submit your questions in writing to the
webinar
 If you would like to ask your questions, raise
your hand (making sure you have entered
your audio pin code) and we will unmute the
call one at a time
 We are working on a Question and Answer
document that will be posted on the Health
Home website under the HH-CMART section
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Question and Answer Themes
Care Management Programs lacking data exchange
agreements (e.g., subcontractor packet) with Lead
Health Homes – Care Management Programs are required
to do the FACT GP & Health Home Functional
Assessments. But if the CM Program has not entered into
a data exchange agreement (subcontractor packet) with a
Health Home, and has “converting TCM to Health Home
members” , the CM Program should collect & keep the
FACT GP and HH Functional Assessment scores to send to
HH after a data exchange agreement (subcontractor
packet) is in place.
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Question and Answer Themes
Fact
GP and Health Home Functional AssessmentsThe Health Home FACT-GP / HH Functional Assessments
should be collected to assess every member. These
assessments do not replace the initial comprehensive
assessment.
Collection Intervals :
Initial
( upon engagement) when member enters and agrees
to Health Home services
 Annual- counted from the initial date (element #35 – on
next slide)
Upon discharge
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Question and Answer Themes
Fact
GP and Health Home Functional Assessment Date•Element #35 DateFactHH- Date that the FACTGP+HH Functional assessments were completed
•Note: Orange color = Needs to be reviewed for
new date each report ( quarterly)
The
department suggests scoring the assessment using the FACT GP
and Health Home Questionnaire Scoring Sheet. This can be found on
the Health Home website:
http://www.health.ny.gov/health_care/medicaid/program/medicaid_health_homes/
assessment_quality_measures/index.htm
http://www.health.ny.gov/health_care/medicaid/program/medicaid_health_homes
/assessment_quality_measures/docs/fact-gp_sccoring_sheet_hh_locked_mod.xls
 The scoring sheet scores are entered into the HH CMART tool or
whatever agreed upon method between the Lead HH & CM Program
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Question and Answer Themes
The
Initial Health Home Comprehensive
Assessment- Should be completed when member
agrees to participate in Health Home Services
Used to contribute to Care Plan development
 A comprehensive assessment includes: physical/functional,
psychosocial, environmental/residential, care-giver capability,
medication lists and/or compliance.
Note: Red font= Once in, date remains the same always
 Element #14 – AssessedCM: Indicates if the member received
an initial comprehensive assessment for needs with an initial
care plan. An initial review of a priority problem is not a
comprehensive assessment.

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Question and Answer Themes
15
– AssessDate: Date when the initial comprehensive assessment with
care plan is completed. If the member is not assessed or not able to be
contacted, the AssessDate will be blank.
The completion of the comprehensive assessment and care plan may occur
over more than one interchange. In these cases the date of the interchange
when the initial assessment and care plan is completed should be used as
the date.
For converting TCM to Health Home members ONLY- If the comprehensive
assessment has recently been completed, the date of that assessment can
be used, provided it is not greater than 3 months prior to the reporting
period. That is the date that is placed in element #15– AssessDate
If the comprehensive assessment was done more than 3 months prior to
the reporting period, then a review and update of that assessment should
be completed and the date that was done is the date placed in element # 15
– AssessDate
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Announcement of
Upcoming Webinars
Health Home Bi-Weekly Policy Implementation
Webinar Series
Session 14 – Wednesday, April 10 2013 at 1:00 PM-2:30 PM
Topic: Data Exchange
Presentor: Caryl Shakshober, Eric Weiskopf, DOH legal
Registration Link:

https://www1.gotomeeting.com/register/886369472
All Previous Webinars can be found here:
http://www.health.ny.gov/health_care/medicaid/program/medicaid_health_ho
mes/meetings_webinars.htm
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We encourage your feedback
◦ Case Scenario development
◦ Clarify fields so that the thinking behind how a question is answered in
the HH-CMART is the same across the board
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Email the Health Home Team at
[email protected]
with the Subject : HH-CMART
Or Call the Health Home provider line – 518.473.5569
Health
Home website, Assessment and Quality Metrics menu, Process
Measures section:
http://www.health.ny.gov/health_care/medicaid/program/medicaid
_health_homes/assessment_quality_measures/process_measures.ht
m
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
Weekly call every Wednesday from 10 a.m. to 11 a.m.
◦ The next call for April 17th, 2013 will be announced via email
and information will be posted on the HH Website under
“What’s New” menu
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Slides from all webinars can be accessed by visiting
the Health Home website at:
http://www.health.ny.gov/health_care/medicaid/program/me
dicaid_health_homes/meetings_webinars.htm
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