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This bulletin informs you that beginning January 1, 2022, the Virginia Department of Medical Assistance (DMAS), in collaboration with Ascend Maximus, the vendor responsible for this initiative, will launch an Inter-rater reliability (IRR) study – as mandated by the General Assembly. This study will validate the children’s criteria used to determine eligibility for Medicaid Long Term Services and Supports (LTSS) and will design and implement an IRR process to verify the consistency and accuracy of the LTSS Waiver screening process, including the Uniform Assessment Instrument (UAI).  

This IRR study is designed to demonstrate that current LTSS screening practices:

• consistently and reliably assess the level of care needs for children and adults 
• provide individuals across the Commonwealth the same opportunity to obtain services
• identify the most integrated and appropriate setting choice, minimizing unnecessary

institutional placements 

The study will include identification of potential areas of data collection, measurement, analysis and reporting. Throughout the entire process, Ascend Maximus will collaborate with and report directly to DMAS, its sister agencies in the Virginia Department of Health (VDH), Department of Aging and Rehabilitative Services (DARS) and targeted stakeholder groups, which will provide program oversight in collaboration with DMAS. At the end of the project DMAS and Ascend Maximus will provide a detailed summary of the findings and any recommendations to its partner agencies and stakeholders including the local screening team representatives.  The screening teams will play a critical role as key partners in this project. Their cooperation, understanding and participation in this study are critical for the success of the study and compliance with the Joint Legislative Audit and Review Commission (JLARC) recommendations for the program and its overall success as indicated in the report which can be found on the DMAS website at https://www.dmas.virginia.gov/media/3502/jlarc-report-managing-virginias-medicaid-spending-2016.pdf.

DMAS thanks you in advance for assisting ASCEND MAXIMUS staff as they pursue study related processes. These processes will, in some cases, include their additional review of previously assessed Medicaid members and observation of real-time screenings.

Although the General Assembly has mandated an Inter-rater reliability study of Virginia’s LTSS screening process, be assured that no part of this study will negatively impact a previously completed screening and no changes will be made to any previously completed screenings, outcomes or services received. This is a comprehensive study of the screening tool, its use and training materials that may impact the use of the screening tool in each locality and not an evaluation of individual screeners and their practices.

DMAS and Ascend Maximus both recognize the importance of minimizing disruptions to normal day to day business processes. Although Ascend Maximus will need assistance from LTSS Screening teams in order to review the same supplemental information that was available to the original screener in completion of the IRR screening, we anticipate that this will result in minimal provider and individual impact, particularly if we work together. Although IRR screeners will request supplemental information available to the original screener, copies of the original screening will not be requested and will not need to be provided.  Of note, ASCEND MAXIMUS is a contractor of DMAS and a Business Associates Agreement has been completed between the two allowing free sharing of information between the screening teams and Maximus/Ascend.

As a valued partner in this process, DMAS recognizes and appreciates your ongoing commitment and partnership toward ensuring service excellence for Virginians. Be assured that DMAS is committed to ongoing transparency.

The results of this instrument-focused initiative will be used to ensure reliability across different settings, determine baselines, assure confidence in the LTSS screening process and the validity of the screening tools, Study findings may also be used to inform best practices and enhance training mitional information 

• MAXIMUS Website tools and resources site is now available: https://maximusclinicalservices.com/svcs/virginia_irr
• MAXIMUS Email communication/inbox is available now: VAIRR@maximus.com
• MAXIMUS Help Desk phone support: 833.73 VAIRR (833.738.2477)

DMAS website link: https://www.dmas.virginia.gov/for-providers/long-term-care/programs-and-initiatives/ltss-screening

14. process and the validity of the screening tools 

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