Thursday, October 27, 2016

Hoosier Healthwise Open Enrollment

The Indiana Health Coverage Programs (IHCP) is providing a special open enrollment period for Hoosier Healthwise members from November 15, 2016, through December 15, 2016. 

During this open enrollment period, Hoosier Healthwise members can choose to enroll with any one of the four health plans that will serve the program as of January 1, 2017 – Anthem, CareSource, MDwise, and Managed Health Services (MHS). All Hoosier Healthwise members will receive advance notice of the open enrollment time frame along with health plan summaries for the four health plan options. 

Current Hoosier Healthwise members, or the parents or guardians of current members, may elect to change health plans during this special open enrollment period or elect to remain with their current health plan.

If the member does not wish to choose a new health plan or does not make an election by the close of open enrollment, December 15, 2016, the member will remain with the health plan to which they are currently assigned. Members will not have another opportunity to change plans until the next open enrollment period occurs. Enrollment changes to new health plans will take effect January 1, 2017. 

The IHCP is making providers aware of the open enrollment period in case Hoosier Healthwise members ask providers about the open enrollment period. Members are being asked to:  Review the health plan summaries they receive in the mail to learn more about the different health plans and decide which is best for them. 
Call the Hoosier Healthwise Helpline by December 15, 2016, if the member wants to change plans effective January 1, 2017.
  Do nothing if the member is satisfied with his or her current health plan. 

Providers can refer members to the Hoosier Healthwise Helpline at 1-800-889-9949 to find out which health plan networks their providers participate in or for assistance with the open enrollment process. 

Tuesday, October 25, 2016

Time to Review Your Health Care Needs and Options

Why is now a good time to take a closer look at your health care needs and options?

2017 Open Enrollment
November 1, 2016
open enrollment begins

December 15, 2016
enroll before this date to have coverage January 1, 2017

January 31, 2017
open enrollment ends
If you're uninsured or looking for more affordable health insurance, the “open enrollment” period is the time to visit healthcare.govor your state’s exchange. During “open enrollment”, private health insurance options can be reviewed and coverage can be purchased. People with low and moderate incomes may be able to get financial help to pay for health insurance coverage. Assistance to pay for premiums and other cost-sharing may be available for individuals and families, depending on which plan is purchased. If you get health insurance through your employer, Medicaid or Medicare, you are not eligible for this assistance. You can also sign up for insurance outside of the open enrollment period, if you  lost your job, married, divorced or had a baby.

You may enroll in Medicaid and the Children’s Health Insurance Program (CHIP) at any time, year round. Certain requirements must be met to qualify for these public programs. Medicaid provides long-term services and supports to people with disabilities.

Do you already have health insurance through the Marketplace?

It is also important to update your income and household information in the Marketplace to make sure you get the assistance that is available. 

  • This is a good time to check your health insurance coverage and see if it still meets your healthcare needs.
  • You may enroll in a different plan each year or you will be automatically re-enrolled in your current plan or a similar one byDecember 15, 2016.
  • If a new plan does not cover your providers or services, seek more information about transition rights.
  • You should carefully read all health insurance notices and updates.

Why should you check your coverage?

  • Even if you like your current health plan, new plans may be available and premiums or cost sharing may have changed since last year.
  • Even if your income has not changed, you could be eligible for more financial assistance.
  • If your income has increased, updating your information with the Marketplace will help avoid paying future penalties.

If you have a disability or a health condition, pay attention to details or possible changes:

  • Are a broad range of health care providers included in the health plan’s network of providers?
  • Are there enough medical specialists in the network to meet your needs?
  • Are needed medications included in the plan’s list of covered drugs?
  • Is there adequate access to non-clinical, disability-specific services and supports?
  • Does the plan have service limits, such as caps or limits on the number of office visits for therapy services?
  • Are mental health services covered to the same extent that other “physical” health benefits are covered?

Are you or your family members uninsured?

Most individuals will be able to get health insurance coverage regardless of pre-existing health conditions or prior denial of coverage. Interested individuals can go online, enter information and review insurance options. Information on monthly premiums, deductible costs, doctors, hospitals and which drugs are covered by a plan should be available. Enrollment is limited to individuals who live in the United States, are U.S. citizens, nationals, or non-citizens who are lawfully present, and not currently incarcerated.

If you have not signed up for an insurance plan, it is important to note that you may be subject to a fee for not having health care coverage. If you or your dependents do not have insurance that qualifies as minimum essential coverage for tax year 2016, you may have to pay either 2.5 percent of your household income with a maximum of what the national average premium is for a bronze plan, or a flat fee of $695 per uncovered adult and $347.50 per child under 18, with a maximum of $2085 -- whichever is higher.

Where to get help?

Purchasing health insurance can be complicated. If you or your family member needs assistance with understanding the options, can help. This website has information about seeking assistance in local communities, explanations of health insurance terms, enrollment information, assistance with out-of-pocket cost estimation and much more. There is also a 24-hour phone line for consumer assistance at 1-800-318-2596 to call for help.

In addition, each state has health insurance “navigators” to assist individuals with enrollment in health insurance plans. Individual health plan information should be available in late October 2016 on the website. If you would like more information on specific topics, the National Disability Navigator Resource Collaborative ( a comprehensive set of materials available on disability issues and the Affordable Care Act.


Phone:  1-800-318-2596 (Available 24/7 with access to 150 languages)

TTY:   1-855-889-4325

In-Person Assistance

Monday, October 24, 2016

Holding Children Accountable for Behaviors When They Have a Disability

Several years ago, I was in Juvenile Court with a teen client. I was her IEP advocate, but on this day I was there for moral support. The grandmother had asked me to speak to the judge regarding her educational programming (or lack thereof, as it was). This teen had been dealt life’s worst–her parents were in and out of jail, in and out of rehab, let their friends abuse and molest her…the worst of the worst, this young girl lived it. And, like her parents, she made lots of bad choices.
It was like a cliche out of a movie–the 60-something, white-haired, male judge looked at this young, black female, wagged his finger and said, “Young lady, you need to make better choices.”
When it was my turn to speak, I said, “Sir, with all due respect, you asked her to make better choices. That is like asking me to go build a house right now. I do not have the resources nor the tools in my tool kit to go build a house. She does not have the tools and resources to make better choices.” And I meant it. There is a contingency of people out there who think that advocates like me want our kids to just “get away with everything.” But when you really look closely at the situation, you can see that what I said was truth.
You’ve heard of the school to prison pipeline, right? I can tell you it is alive and well, all over the country. And there are extra seats reserved for kids with disabilities! Despite making up only about 20% of the population, kids with IEPs make up about 75% of the kids who are arrested or suspended from school.
But how do we do this? How do we hold children accountable for their behaviors when they have a disability? How do we find that balance, between offering supports yet not making excuses?
I remember six years ago, a mom from the “best” school district in Pennsylvania called me. Her kindergartener was suspended from school and the school was threatening to call police. Kin-der-gar-ten. It is no longer shocking for me to hear about 5 or 7-year-olds being arrested or at least handcuffed. We have to take behaviors seriously, as the schools are fed up and don’t have the resources and they are giving up on our kids. We can’t give up on them. We must teach behaviors early.
Tips for holding children accountable for behaviors when they have a disability
Live for the years, not for the moment: Individual behaviors may appear suddenly. But behavior patterns, they develop over time. With our kids, we have to live for the years, not the moment. So when you are pushing your child through a tantrum or through a negative behavior, when you are NOT caving in to a demand….even though you sooooo much want to, just to have this moment end….remind yourself–The Years. Our kids take longer to learn everything. They don’t always learn things inherently from watching others–they have to be direct taught. They often do not have the skills to self-evaluate and self-correct, they have to be taught. So in those stressful moments, allow this to come to your mind–that you are doing this for the long term. And it may take a long time for your child to learn this.
Identify and document their complete skills set: You might need professional help for this, but your child needs a complete functional assessment. It would be cruel for me to punish Kevin for spilling food while he eats. His motor planning and OT skills are such that he still cannot eat without making some mess. We work on that every meal and in school, but like I said, would be cruel to punish him for that. If the skill is beyond your child’s skill set, you teach the skill, not punish them for not having the skill.
Everyone must be on same page with skills: My husband and I disagree with some of Kevin’s skill sets. But in order for consistency, we must agree on what he is going to be held accountable for. Any behaviorist will tell you, you must be consistent. This goes for your school team too. The IEP team must agree upon what skills the child possesses. Remember, they may not be able to apply all skills across all environments, so that must be noted. If your child has some skill discrepancies, then you should develop a plan so that they emerge in all environments. Of course our end goal is desirable behaviors across all environments!
Support your child’s team if they are following the agreed upon plan: Our kids are able to use certain discipline procedures built into IDEA. But, if your child has a behavior plan and IEP that is being implemented and is being held accountable for behaviors within their skill set….then they need to be held accountable. Look, I know many of you are rolling your eyes at the thought of your child’s IEP being implemented consistently…but c’mon, it is implemented, at least some of the time. While I’ll be the first to admit there is room for improvement, not every IEP is completely ignored all day, every day. Communicate with your team. Let them know that you want to work with them, that you want your child to learn personal responsibility…but without a consistently implemented IEP, it’s very difficult to do that. Anyway, my main point is….the whole Manifestation Determination process is not meant to be a “get out of jail free” card. And when it is used as such, it’s not helping anyone.
Find what motivates your child: Along of people dislike the word ‘punishment’ but I don’t. In the right context, it makes a lot of sense. Punishment doesn’t mean I hit my kids or scream at them. It means I take away screens or highly desired toys. It means we reinforce good behaviors with desired items and praise.
Don’t overthink it: Start small and start simple. Don’t make it into something so complex, that no one will implement it. Simple rewards, simple punishments.
Remember that not everything they do is related to their disability: We forget this sometimes. Not every undesirable behavior that our kids do stems from their disability. Sometimes it is age appropriate, but undesirable behavior. Skills have to be learned by all kids, not just those with disabilities. What we have to extract out is if our child will be or should be expected to take longer to master this skill, and what supports they will need in mastery.
For example, if my almost 7-year-old, non-disabled child spills his milk at the dinner table, he gets in trouble. He has to help me clean it up and he gets a stern ‘talking to’ about not paying attention at the dinner table. He has the skills to not spill a cup of milk. Kevin does not. Along the way, some of the support Kevin needs is therapeutic feeding items and hand over hand practice. With just a few stern discussions, Brian’s spilling incidents have decreased. The same could not be said with Kevin.
However, Kevin does have the skill set to not hit people or not throw things, both of which he does sometimes. He does get a stern talking to and preferred items taken away if he hits someone.
Seek a behaviorist: Your health insurance may have options for family services or behavioral health. Your state may have wraparound services which can help with this. But if you are unable to come up with a consistent, effective plan, get help.
Final thoughts: There are a lot of great books out there. Positive parenting, no yelling parenting, optimistic parenting, and many of the Ross Greene books. Take time to really understand your child. This might seem condescending advice, but I have worked with many families who really did not grasp some of the behaviors associated with ODD, SPD and other conditions. It’s important to really know what is going on inside your child’s head, because it often is very different from ours. Be a good role model to your kids and talk about your own mistakes, even if they do not learn without direct teaching. We all make bad choices and mistakes, it’s important that we learn from them.
© copyright 2016 – All rights reserved

Thursday, October 20, 2016

ACA Enrollment Begins Nov 1

Starting Nov 1, you can renew, update, and compare plans
Americans can sign up for affordable health plan that meet their needs and their budgets at or their state Marketplace websites beginning November 1. Open Enrollment runs through January 31, 2017. Health coverage can start as soon as January 1, 2017 for consumers who sign up by December 15, 2016
new report showed that 2.5 million Americans who currently purchase off-Marketplace individual market coverage may qualify for tax credits if they shop for 2017 coverage through the Marketplace. Furthermore, new research analyzing gains in health insurance coverage from 2010-2015 found that Affordable Care Act coverage gains have been widely shared across key demographic categories of Americans, including income, age, geography, race and ethnicity.

Wednesday, October 19, 2016

Managed Care Orgs for Hoosier Healthwise, HIP and Hoosier Care Connect

Indiana Health Coverage Programs (IHCP) relies primarily on a managed care delivery model to serve the healthcare needs of its members. This model is designed to combine quality of care with the efficient use of tax dollars. Contracted managed care entities (MCEs) provide members with medical homes, also known as primary medical providers (PMPs), responsible for all the members’ physical and mental health needs. Payment structures offer incentives for coordinating care, keeping members healthy, and identifying and eliminating fraud and abuse. 

Under state law, MCE contracts are four years in duration, with two optional one-year extensions, necessitating the need for reprocurement at least every six years. Accordingly, the Indiana Family and Social Services Administration (FSSA) recently conducted a procurement for MCEs to serve the approximate 1 million members enrolled in the Healthy Indiana Plan (HIP) and the Hoosier Healthwise programs. 

As a result of the procurement process, the FSSA has begun negotiation with four selected MCEs: 
 Anthem Blue Cross and Blue Shield 
 CareSource Indiana 
 MDwise Inc. 
 Managed Health Services of Indiana (MHS) 

Contracting with the MCEs will be dependent upon successful negotiations between the State and the companies as well as demonstration by each MCE of its readiness to serve members applying FSSA’s readiness review criteria. The intent is for contracts to begin January 1, 2017. 

Anthem, MDwise, and MHS are the current MCEs serving the HIP and Hoosier Healthwise programs. CareSource will be a new option for members. Hoosier Healthwise members will have an open enrollment period later this year to switch plans, if desired. The IHCP will provide more information about the open enrollment period at a later date. HIP members are able to switch plans once a year at their eligibility renewal.

To participate in the Hoosier Healthwise and HIP MCE networks, providers must be enrolled with the IHCP as well as contracted with one or more of the MCEs. Providers currently contracted with an existing MCE may be required to enter into new contracts to remain in-network as of January 1, 2017; providers should contact the MCE directly for further direction. CareSource will be establishing an IHCP provider network and can be contacted directly for more information.

Please note that beginning January 1, 2017, MCE networks for the Hoosier Healthwise program will be enhanced to include pharmacy and dental services. 

Tuesday, October 18, 2016

Exciting NEWs from Family Voices Indiana

Exciting NEWs from Family Voices Indiana!

We’ve been working hard these past few months to better serve YOU! We’re really excited about the results—the same great, reliable information and support you’ve come to expect from us but much easier to use!

Here are some of our NEW and IMPROVED changes!

1. We have a NEW toll free number!

Just dial 844-F2F-INFO (844-323-4636) to be connected with a specialist who best meets your needs, including someone who is bilingual, if you need support in Spanish.   

We have a NEW fax number, too: 317-960-4291

2. We have a NEW website!

Visit to find resources, fact sheets, contact info, and MORE!

3. We have NEW Transition to Adulthood fact sheets and trainings!

Learn more about supported decision making, guardianship, employment, special needs trusts, and more.

4. We have a NEW logo!

We updated our logo to better represent our mission of advocacy BY families FOR families. We encourage you to share your voice and advocate for your own family and others.

5. We have IMPROVED materials!

We work hard to keep our resources updated, so you always have access to helpful and relevant resources!

Enjoy our NEW features! We look forward to serving you!

Family Voices Indiana

Monday, October 10, 2016

Thank you, Joe's Show!

Family Voices Indiana relies on grants and donations to support our work. Our services are free to families and professionals so that anyone who needs help can access it.

Sadly, one of our specialists, Heather Dane, lost her child, Joe, this year. He touched the lives of many, including those of us at Family Voices Indiana. 

The Dane family chose to donate the proceeds of their annual fundraiser to Family Voices Indiana. We are extremely grateful that during such a difficult time,  they still chose to make a difference for others. We plan to use this funding to support efforts around inclusion, an issue that is especially dear to the Danes. We know that we are stronger together.

Thank you.