DHHS FACILITY CONSTRUCTION

1. DHHS FACILITY CONSTRUCTION

2. DHHS facility construction has undergone some changes. We took a look at our processes, our statutory and regulatory requirements and most importantly, we listened to our customers and made changes in order to simplify submission of documents and to reduce the amount of time approvals were taking (both to begin construction and once construction was completed). As a result, we changed our forms to make them more understandable, some of the forms were made ‘fillable’, we updated our webpages, added an electronic submission process and we are working to revise regulatory requirements. We hope you will find our new electronic facility construction process quicker, smoother, and easier to navigate through. We welcome any comments and/or suggestions as we continue on our process improvement quest.

3. WHAT IS FACILITY CONSTRUCTION AND WHO DOES IT APPLY TO? Construction applies to any facility that is currently licensed by the State of Nebraska or that will be requesting a license upon completion of the construction project. (NOTE: Rural Health Clinics and Healthcare Practitioner facilities are not required to be licensed, therefore do not need to submit construction project information). All construction for a licensed healthcare facility must meet the physical plant requirements for that specific facility type and mustbe approved by the DHHS Licensure Unit prior to use and occupancy. Construction meansa facility or distinct part of a facility in which services are to be provided, which is enlarged, remodeled, or altered in any fashion, or is built from the ground up. Minor projects such as repairing or replacing existing materials do not fall under these requirements.

4. One BIG change to the new construction process is that the DHHS Licensure Unit is now requiringthe facility (as the licensee) to submit the documentation for the project instead of the architect or engineer. The facility has a regulatory obligation to notify DHHS Licensure Unit of any new construction, therefore, this change makes that notification a required part of the submission. So…what do you need to do if your facility is planning a construction project? The facility first needs to designate a ‘contact person’. This person could be anyone the facility chooses, from the CEO to the Environmental Services Director to the Director of Quality. This person should start by visiting our construction webpage: http://dhhs.ne.gov/publichealth/Pages/crlFacConstHome.aspx

5. Once you navigate to our webpage, you will see a ‘menu’ on the left hand side of the page. This menu was designed to assist you with questions, to provide you with access to the necessary forms, and to help you navigate our new electronic submission process.

6. Let’s take a look at the ‘menu’ choices. CONTACT INFORMATION: Provides you with names and contact information for DHHS Licensure Unit and State Fire Marshal staff. The State Fire Marshal’s office conducts plan reviews for any federally certified facility. The DHHS program managers can assist you with specific regulatory questions you might have.

7. FAQs: These are a compilation of frequently asked questions from our customers. We are hoping these will be helpful to you as you navigate through our construction process. FORMS: This page is divided into two separate areas. One area has the forms for Pre-Construction and the other has the forms for Post-construction. We have identified the necessary forms and have provided links for your use. NOTE: The names of the projects and phases must match on all forms submitted or they will be returned to you for clarification.

8. INSPECTIONS/FEES: There is no charge by DHHS Licensure Unit for the construction process, however, there is a fee associated with the State Fire Marshal’s office for plan reviews they conduct. If you are unsure whether you need a plan review or not, please contact the State Fire Marshal’s office at: www.sfm.nebraska.gov REGULATIONS/STATUTES: This page has links to licensure regulations for each licensed facility type. If you have questions about a regulation, please contact the Program Manager for that specific facility type.

9. SUBMISSION INFORMATION: This page walks you through both the new electronic process and the postal mail process necessary to submit construction plans, documents and forms to the DHHS Licensure Unit construction office for approval. Please keep in mind that all construction projects need approval by DHHS, Licensure Unit prior to beginning construction as well as once the construction has been completed and prior to occupancy.

10. Now let’s walk through the new electronic submission process…this process has been designed to streamline and expedite the submission and approval of facility construction projects. PRE-CONSTRUCTION ELECTRONIC SUBMISSION: Have your architect/engineer complete the Architect/Engineer Plan Certification form and have them provide the facility contact person with the construction plans on CD. Once you have these items, you are ready to go to the pre-construction submission website. Go to: http://www.nebraska.gov/dhhs/pre-construction.html Once you have mailed the construction plans on CD to the DHHS Licensure unit, attached the Architect/Engineer Plan Certification form and completed the required information on our website, click SUBMIT. It’s that simple!

11. The facility contact person will receive notification back from our website that your project information has been submitted, as well as an email copy of exactly what was submitted to the DHHS Licensure Unit. Please keep this email as your record of submission. Our goal is to have your pre-construction plans approved within 10 working days of the date of submissionif all of the documentation is accurate. The facility contact person will receive email notification as to the approval of your project, or if we need additional informationor clarification. Once you have received approval, you can start constructing your project!

12. POST-CONSTRUCTION ELECTRONIC SUBMISSION: Now that your project has been completed, make sure the facility contact person has the following documents filled out and signed by the appropriate person. Make sure the names of the facility and project match what was submitted initially. A Completion Certificate Occupancy Approval from the State Fire Marshal’s office (or delegated authority) A Floor Plan/Schematic drawing Zoning (required ONLY if this is a new facility in a previously unlicensed location) Bed Count Form (required only if the facility has beds and if the beds increased or decreased as a result of the construction project)

13. Go to the DHHS Licensure Unit Post-Construction submission link, attach the required documents, complete the required information and click SUBMIT. • http://www.nebraska.gov/dhhs/post-construction.html • The facility contact person will receive notification back from our website that the project information has been submitted, as well as an email copy of exactly what was submitted to the DHHS Licensure Unit. Please keep this email as your record of submission. • Once the DHHS Licensure Unit construction office has determined that all documents have been received and are accurate, the facility contact person will receive notification that your project information has been forwarded to the individual Program Manager for that specific facility type for final approval for use and occupancy. • Please keep in mind that some projects may require a walk-through inspection and/or may have other licensing requirements that need to be fulfilled prior to use and occupancy.

14. While the DHHS Licensure Unit hopes that facilities will utilize the new electronic submission process, we realize that some facilities may choose to utilize the postal mail process for submission of their construction project. Should you choose to utilize that method of submission, please go to our construction website for those directions and links to the required forms. • http://dhhs.ne.gov/publichealth/pages/crlFacConstSubmissionInfo.aspx • If you have questions or comments, please email them to: • DHHS.faciltiyconstruction@Nebraska.gov • Or • Call 402-471-2110 • Diana Meyer, RN, BSN – Program Manager, Acute Care Facilities/Construction/CLIA • DHHS Public Health Licensure Unit

15. Governor Pete Ricketts Vision: Grow Nebraska Mission: Create opportunity through more effective, more efficient, and customer focused state government Priorities: Efficiency and Effectiveness Customer Service Growth Public Safety Reduced Regulatory Burden We Value: The Taxpayer Our Team Simplicity Transparency Accountability Integrity Respect

16. Recent DHHS Accomplishments • Economic Assistance received a $607,000 grant to improve ACCESSNebraska by providing client texting capability, workforce management software and electronic message boards to show real-time performance data. • New processes and internal controls resulted in federal restrictions lifted on the use of Child Care Development Fund (CCDF) grant funds. • Implemented SNAP Employment and Training Pilot in Grand Island. 20 clients are receiving training to move to higher-paying jobs. • Escapes from YRTC-Kearney have dropped as a result of operational changes. • Launched a new Intensive Family Preservation program Oct. 1 using evidence-based practices to target front-end families for six weeks. • System of Care receives $12 million grant to help in implementation. • Medicaid is collaborating with the Divisions of Behavioral Health, and Children and Family Services as well as Probation to cover multisystemic therapy (MST), an intensive family-and community-based treatment program. • Nurse licensing improvements – simplified applications, streamlined screening, and faster turnaround time. More licensing improvements are underway in the areas of mental health, EMS, child care, and long-term care. • Alternative Response is being used in 57 counties. To expand to the other counties and to continue the program, legislation will need to be passed in the next session. At the end of October, 652 families had been served with 193 families currently served. A study by the Center on Children, Families and Law found that 97% of children served are safe. • Division of Public Health achieved national accreditation. • Nebraska’s most recent ranking in processing SNAP applications improved from 32nd of 53 one year ago to 17th. • Nebraska Pre-Admission Screening & Resident Review (PASRR) Program improved turnaround time from seven days to less than three days. • Six of seven federal child welfare standards exceeded in Children and Family Services. • 2016 ACCESSNebraska average call wait times is below 5 minutes. • Grand Island Veterans’ Home earned 2016 Bronze National Commitment to Quality Award. • Waiver approval from Centers of Medicare & Medicaid Services (CMS) gives official federal go-ahead to roll out Heritage Health on Jan. 1, 2017. • Ranked 9th in the US for accuracy of approving and denying SNAP benefits by the USDA’s Food and Nutrition Service. • An RFP was issued by CFS for full-service case management in Douglas and Sarpy Counties. Bids will be opened December 13th. • Medicaid and Behavioral Health implemented ICD-10 coding changes.

17. Looking Ahead – DHHS Priorities • Heritage Health Medicaid Managed Care to integrate physical and behavioral health care and pharmacy services effective Jan. 2017 • System of Care for children and youth with a serious emotional disturbance. • Behavioral health supported employment and housing as key supports to recovery. • Long-Term Services and Supports Redesign. • Renewal of Medicaid adult waivers and one children’s waiver for people with developmental disabilities • Coordinated efforts of Behavioral Health, Public Health, and Medicaid and Long-Term Care to combat opioid addiction and over prescribing of opioids. • Reduction in out-of-home placements for state wards. • Improved DD application and eligibility determination processes. • Medicaid Management Information System (MMIS) replacement planning process. • Prescription Drug Overdose Prevention – $3.5 million in federal grants to help reduce misuse and abuse of prescription drugs. DHHS Divisions of Public Health, Behavioral Health and Medicaid and Long-Term Care collaborating to address the issue. • Behavioral Health Electronic Billing System. • Introduce new evidence-based practices in CFS. • Expansion of community-based practices. • Protection and Safety process improvement. • Workforce retention.