Family Leadership Development Funding

We're excited to announce that Family Voices Indiana will continue to serve another year as the family health information center for the state. We dedicate part of our HRSA funding to support family leadership. This funding will continue to be available though May 31, 2015.

From its inception, Family Voices has been committed to leadership training. Recognized as expert stakeholders by government and private leaders, families of children with special health care needs and/or disabilities should be key players in improving state policies that impact them. We encourage families to work with state agencies, to sit on state and local government advisory commissions, and to participate in the legislative process.

Unlike most other groups, this unique community of families also requires child-care stipends, and travel money. Therefore, to support this participation, the family to family health information center at Family Voices Indiana has created the Family Leadership Development Fund. The Family Leadership Development Fund will assist families to participate in activities (public forums and meetings, task forces and work groups, etc.) that are intended to solicit public/consumer input and perspective concerning disability-related public policy, programs and services.

Parents who request to participate in formal meetings, committees, task force, etc. may receive a stipend, if approved. The following stipulations generally apply:

• must be the parent of a child with disabilities and/or special health care needs

• must have no other paid affiliation or role with the organization hosting the formal meeting, committee, task force, etc.

• must not be participating with the financial support of another program

• events or activities of 4 hours or less/day (including travel) may be reimbursed $50

• events or activities of more than 4 hours/day (including travel) may be reimbursed $100

• families may access this for stipends totaling $250/yr

• priority will be given to families who agree to write a summary of the mtg for Family Voices

• An email or signed letter of verification from the head of the agency or organization sponsoring the activity to Family Voices Indiana

To apply for this funding, please request an application from Family Voices Indiana by calling 317 944 8982 or emailing Jennifer@fvindiana.org

CMS Clarification about #Medicaid Covered Services for #ASD

Family Voices shares the following bulletin from the Center for Medicaid. It is important to note that ALL children with Medicaid are covered by EPSDT benefits, not just those with ASD. If you have questions, feel free to contact us.

DATE: July 7, 2014 

 

FROM: Cindy Mann, Director 

 Center for Medicaid and CHIP Services 

 

SUBJECT: Clarification of Medicaid Coverage of Services to Children with Autism 

 

In response to increased interest and activity with respect to services available to children with 

autism spectrum disorder (ASD), CMS is providing information on approaches available under 

the federal Medicaid program for providing services to eligible individuals with ASD.

EPSDT Benefit Requirements 

 

Section 1905(r) of the Act defines the EPSDT benefit to include a comprehensive array of 

preventive, diagnostic, and treatment services for low-income infants, children and adolescents 

under age 21. States are required to arrange for and cover for individuals eligible for the EPSDT 

benefit any Medicaid coverable service listed in section 1905(a) of the Act that is determined to 

be medically necessary to correct or ameliorate any physical or behavioral conditions. The 

EPSDT benefit is more robust than the Medicaid benefit package required for adults and is 

designed to assure that children receive early detection and preventive care, in addition to 

medically necessary treatment services, so that health problems are averted or diagnosed and 

treated as early as possible. All children, including children with ASD, must receive EPSDT 

screenings designed to identify health and developmental issues, including ASD, as early as 

possible. Good clinical practice requires ruling out any additional medical issues and not 

assuming that a behavioral manifestation is always attributable to the ASD. EPSDT also 

requires medically necessary diagnostic and treatment services. When a screening examination 

indicates the need for further evaluation of a child’s health, the child should be appropriately 

referred for diagnosis and treatment without delay. Ultimately, the goal of EPSDT is to assure 

that children get the health care they need, when they need it – the right care to the right child at 

the right time in the right setting. 

 

The role of states is to make sure all covered services are available as well as to assure that 

families of enrolled children, including children with ASD, are aware of and have access to a 

broad range of services to meet the individual child’s needs; that is, all services that can be 

covered under section 1905(a), including licensed practitioners’ services; speech, occupational,

and physical therapies; physician services; private duty nursing; personal care services; home 

health, medical equipment and supplies; rehabilitative services; and vision, hearing, and dental 

services. 

 

If a service, supply or equipment that has been determined to be medically necessary for a child 

is not listed as covered (for adults) in a state’s Medicaid State Plan, the state will nonetheless 

need to arrange for and cover it for the child as long as the service or supply is included within 

the categories of mandatory and optional services listed in section 1905(a) of the Social Security 

Act. This longstanding coverage design is intended to ensure a comprehensive, high-quality 

health care benefit for eligible individuals under age 21, including for those with ASD, based on 

individual determinations of medical necessity.

Read the entire bulletin here: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-07-07-14.pdf

Public Comment: Transition/Renewal Plan for CIH #Waiver

Family Voices shares the following announcement from DDRS:

From: Nicole Norvell, Director, Division of Disability and Rehabilitative Services 

Re: Community Integration & Habilitation Waiver Renewal and Transition Plan; Opportunity for public 

comment 

Date: July 7, 2014 

 

The Family and Social Services Administration’s (FSSA) Division of Disability and Rehabilitative Services 

(DDRS) and the Office of Medicaid Policy and Planning (OMPP) have developed a high level transition 

plan on how Indiana plans to meet the new Home and Community Based Services (HCBS) rules. 

 

The transition plan will include how DDRS will review state standards, rules and policies; how DDRS will 

assess community based settings and a timeline for doing so; a timeframe for the completion of a 

comprehensive transition plan; a process for bringing all HCBS settings into compliance and a plan for 

ensuring the health and safety of individuals. 

 

To support the transition plan process, the Centers for Medicare and Medicaid Services (CMS) has 

reviewed a draft of Indiana’s plan and provided valuable feedback. Now, stakeholders are being asked 

to provide public input and comment in order to allow Indiana to develop a comprehensive assessment 

plan. 

 

The high level transition plan and the Community Integration and Habilitation (CIH) Waiver application 

will be submitted to the CMS no later than August 15, 2014. DDRS has posted the transition plan, for 

review and comment, on the Draft Policies for Public Comment webpage. 

 

Comments and suggestions will be received for a period of 30 days, ending on August 7, 2014, and may 

be emailed to DDRSpolicies@fssa.in.gov or submitted in writing to: 

 

The Division of Disability and Rehabilitative Services 

402 W. Washington St., Rm. W451 

Indianapolis, IN 46204-2243 

Action Alert: Caregiver Support Funds/Respite Available

Family Voices shares the following announcement from BDDS:

From: Julie Reynolds, Director, BDDS

Re: Caregiver Support Services Application Process

Date: July 7, 2014

The Division of Disability and Rehabilitative Services (DDRS) Bureau of Developmental Disabilities Services (BDDS) would like to announce that Caregiver Support Services funds will be available for the fiscal year 2015 beginning July 1, 2014. The Caregiver Support Services is 100 percent state funded and is available on a first-come, first-served basis. Applications received during fiscal year 2014 for Caregiver Support Services do not carry over to fiscal year 2015. An application must be completed for each fiscal year’s Caregiver Support Services funds.

Applications may be made online, by mail or in-person. To apply online, please access the following DDRS webpage at https://ddrsprovider.fssa.in.gov/BDDS/ConsumerInfo/CaregiverSupportRequest.aspx.

To apply by mail or in-person please call or visit your local BDDS District Officeand request an application. A frequently asked question document is also available on the BDDS webpage.

As long as the Caregiver Support Services funds are available, services may be approved and available when 1) an individual meets the state definition of intellectual and developmental disabilities eligibility and 2) the primary caregiver selects a provider. Caregiver Support Services will not be available to the primary caregiver if the individual is receiving or begins to receive other services from the BDDS or programs such as (but not limited to) Vocational Rehabilitation Services, First Steps, CHOICE, Division of Aging waiver, etc.

The initial budgets will be approved in the amount of $500 for each eligible individual regardless of the number of eligible individuals residing in the residence. Upon exhaustion of funding, subsequent budgets may be requested by the Caregiver Support Services provider and will be reviewed on a case by case basis. Any new budget is dependent upon available funds.

Important Information about the 1634 (June 1) #Medicaid Transition

To:      Parents of Children with Autism Receiving Applied Behavior Analysis (ABA)Therapy Services

From:  Your Indiana Family Advocacy Organizations - About Special Kids (ASK), The Autism Society of Indiana (ASI), The Arc of Indiana, Covering Kids and Families (CKF), Family Voices Indiana, The Indiana Chapter of the American Academy of Pediatrics (INAAP), and The Indiana Resource Center for Autism (IRCA)

Re:  ABA Therapy Coverage, Medicaid and the “1634 Transition” (Also called “The June 1^st Changes”)

Because of a transition at the state level, some parents have heard conflicting information regarding the type of Medicaid their child must have after June 1, 2014, if the child also has Supplemental Security Income (SSI).

We want to provide parents with accurate information and provide a way to contact  The Office of Medicaid Policy and Planning (OMPP) and the Family and Social Services Administration (FSSA) to clarify any of their questions.  Much of this confusion is based upon the “1634 Transition” that Indiana began on June 1, 2014.

What is the 1634 Transition?  Simply put, in the past, the State of Indiana used different eligibility criteria for disability determination than the Social Security Administration, which is a federal entity.  In July 2012, the state started accepting Social Security Administration (SSA) determinations of disability.  As of June 1^st, the “1634 Transition” means that the State of Indiana must now cover all SSI recipients automatically without meeting other criteria other than receiving SSI, and must abide by the eligibility determination by the Social Security Administration, whether approval or denial of disability eligibility. 

For more information please visit: www.in.gov/fssa/files/1634_Stakeholder_Presentation_FINAL.pdf or

www.in.gov/fssa/ddrs/4861.htm

For example, several families report that their child has been moved from MDWise under Hoosier Health Wise (HHW) a managed Medicaid program, which covers ABA, to what is being called “MASI”, which does not cover ABA.  MASI is a different category; it is SSI-related Medicaid coverage.

If this happens, you have the option to switch to MASI, or remain on Hoosier Health Wise (HHW) if still eligible.   If the child is under MDWise, to keep ABA service coverage, contact your local DFR and tell them you would like for your child to remain on MD Wise with HHW.  If your contact at your local DFR tells you that you must accept MASI, we recommend that you give them the information below from Matthew Cesnik, the Eligibility Director for OMPP.

Individuals that receive SSI will be enrolled into the new category, MASI.  However, individuals may opt into another category for which they may qualify, such as a children’s Medicaid category under Hoosier Healthwise.  An individual cannot opt into CHIP (Children’s Health Insurance Program) if eligible for a Medicaid category.

Protections were put into place in the State’s eligibility system for children receiving ABA services so the children would remain on the Hoosier Healthwise Medicaid category for the month of June in order to allow time for the family to contact DFR.  If the families believe that coverage was switched in June, DFR should contact OMPP Eligibility Director.

We hope that having this reference to give to DFR will make the process of switching your child back to a Medicaid category that covers ABA a little easier for you, if you choose to switch from MASI.  Please share this information with your ABA provider and ask them to check on your status with Medicaid more frequently as they file claims for their services to be sure that your child remains in a Medicaid category that covers ABA.

Parents may contact any of the advocacy organizations listed below for assistance with these types of coverage issues.   We will contact OMPP Eligibility on your behalf so that they can assist you and work with DFR leadership on your particular situation.

Thank you.

Family Voices Indiana

PH: 317-944-8982

www.fvindiana.org

About Special Kids (ASK)  

PH: 317-257-8683

Toll Free: 1-800-964-4746

www.aboutspecialkids.org

The Autism Society of Indiana (ASI)       

Toll Free: 1-800-609-8449

www.autismsocietyofindiana.org

The Arc of Indiana

PH: 317-977-2375

Toll Free: 1-800-382-9100

www.arcind.org

Covering Kids and Families (CKF)

PH: 1-574-968-1645

www.ckfindiana.org

 

The Indiana Resource Center for Autism (IRCA)

PH: 812-855-6508

Toll Free: 1-800-825-4733

www.iidc.indiana.edu

The Indiana Chapter of The American Academy of Pediatrics

PH: 317-586-0732

www.inaap.org

#HHS announces auto-enrollment plans for current #ACA Marketplace consumers for 2015

Family Voices Indiana shares the following announcement from HHS:

Today, the U.S. Department of Health and Human Services (HHS) expects to announce its plans for helping existing Marketplace consumers get auto-enrolled for next year.  These plans would give existing consumers a simple way to remain in the same plan next year unless they want to shop for another plan and choose to make changes.

“As we plan for open enrollment in year two and continue to build a sustainable long-term system, we are committed to simplifying the experience for consumers by allowing auto-enrollment,” said Sylvia Mathews Burwell, Secretary of HHS. “We are working to streamline the process for consumers wishing to remain in their current plan.”

In today’s health insurance market, the vast majority of consumers are generally auto-enrolled in their plan year after year.  For example, about 88 percent of employees receiving coverage through the Federal Employee Health Benefits Program don’t choose to change plans and are instead auto-enrolled in their current plan with updated premiums and benefits.  These guidelines aim to bring the Marketplace in line with this practice in the existing insurance market.

As with existing open enrollment periods for employer-based coverage, consumers are strongly encouraged to use the open enrollment period as an opportunity to update their information and reevaluate their health coverage needs for the coming year.

Consumers always have the ability to return to the system for shopping, changing plans, or reporting life changes, or a change to their annual income to ensure they are getting the lowest cost possible on their monthly premium. And, to help ensure the program integrity of how taxpayer dollars are spent, while also protecting consumers from having to pay back tax credits they are no longer eligible for, under the approach that the Federally-facilitated Marketplace would use in 2015, the small number of consumers whose updated income information suggests they no longer qualify for a tax credit next year, will still be auto-enrolled in their current plan, but without a tax credit. State-based Marketplaces may take this approach as well, or propose an alternative.

Under the plans that HHS expects to announce today, consumers in the Federally-facilitated Marketplace will receive notices from the Marketplace informing them how to update their information to get a tailored and updated tax credit that keeps up with any income changes. Consumers will receive information from their health insurance company about the premium and the amount they are eligible to save on their monthly bill close to the beginning of the open enrollment period, when they will be able to take action should they choose to do so.

“We are continuing to plan for a second open enrollment period, and as we do so, are mindful of our ongoing work to improve the Marketplace for consumers, offering families a way to make the choices that meet their health care needs year after year,” said Marilyn Tavenner, Administrator of the Centers for Medicare & Medicaid Services (CMS). 

We are also announcing plans for additional flexibility for State-based Marketplaces in this area, including the ability for State-based Marketplaces to propose unique approaches that meet the specific needs of their State, while streamlining the consumer experience.

To read today’s proposed rule visit: http://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/508_CMS-9941-P-OFRv-6-26-14.pdf

To read today’s Guidance on Annual Redeterminations for 2015 visit: http://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/2014-0626-Guidance-on-annual-redet-option-2015-FINAL.pdf

The draft issuer renewal and discontinuance notices are open to public comment and may be viewed here:http://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/2014-0626-Bulletin-on-Renewal-and-Termination-Notices-FINAL.pdf

Instructions are available here: http://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/0626-2014-Notice-instructions.pdf

Family Voices Indiana is #hiring in the #Evansville/Southwest Area

Family Voices Indiana

Seeking a Family Leader

to serve as a

Health Information Specialist in the West Lafayette area

If you are a parent of a child with a disability, Family Voices of Indiana wants and needs YOU!

The Indiana’s Family to Family Health Information Center Project will:
Address the health care financing information needs of Indiana’s families raising children with special health care needs and disabilities
Connect families to existing resources, direct support and advocacy
Support and expand our parent to parent network statewide

Now accepting applications from Family Leaders to support this project as contractors working up to 40 hours a month from your community

Requirements:

Live in the West Lafayette area

•Bilingual preferred

•Must be the parent of a child with special health care needs

•Knowledge of Family Leadership

•Knowledge of services and systems in Indiana. We provide additional training and support

Responsibilities:

Provide information, assistance and support regarding healthcare financing and resources to families raising CYSHCN
Contribute to the FV Indiana electronic information network to ensure access to timely and accurate healthcare financing information and resources for families
Report data related to the work of the FV Indiana Family to Family Health Information Center

If you are interested in receiving more information and/or an application packet, please contact:

Jennifer Akers, Project Coordinator

317 944 8982

Jennifer@fvindiana.org

Applications due by July 7